Epilepsy 101

What is a Seizure?

Seizures are when neurons fire abnormally and excessively in a part of the brain. This can manifest in many different ways depending on where the neurons are and how they are connected to different areas of the brain.

For example, a patient who has a seizure that starts in the dominant (where language is) temporal lobe, may have a seizure where they will stop speaking and cannot remember their seizure. It can sometimes spread to the frontal lobe and they may have problems moving their opposite side of the body. Or, it can go back into the occipital lobe and cause visual hallucinations.

Seizures

One in 26 people will have at least one seizure in their lifetime. Although it is a symptom of epilepsy, seizures are also associated with a variety of other disorders.

Epileptic seizures can look many different ways, from falling down and shaking episodes to simply staring off into space.

There are two main types of seizures that patients can have:

• Generalized seizures, or “grand mal” seizures.
• Partial or focal seizures, also called “petit mal” seizures.

Generalized Seizures

Generalized seizures usually come from misfiring of deep neurons that then travel to both of the hemispheres (right and left) at the SAME time.

The patient may scream, extend their arms and legs, and turn their head to the opposite side of where the seizure comes from, followed by rhythmic shaking of the arms, legs, and body.

They may also bite their tongue and lose control of their urine or bowel. They will be confused afterwards and may sleep for several hours.

Partial Seizures

Partial seizures start in neurons in one lobe, or part of the brain, and can spread to the surrounding lobe or even to both hemispheres. When the latter occurs, this looks just like a generalized seizure.

Depending on where the seizure starts, patients can experience a wide variety of symptoms or auras preceding the seizure, including:

• Loss of awareness.
• Twitching of a part of the body or mouth.
• Abnormal perception/thoughts.
• Auras (warning signs pre-seizure) — tingling, feeling flushed, and nausea, déjà vu, or vision changes.
• Automatisms — lip smacking, picking at clothes etc.

Certain types of partial seizures result in the patient not losing awareness and this may be called simple partial seizures. Seizures where the patient loses awareness and cannot remember or respond during the seizure  can also be called complex partial seizure.

Causes of Seizures

New or old injury to the brain from:

• Brain Tumors
• Strokes
• Brain trauma/injury
• Infections
• Lack of oxygen during birth

Causes related to other systems:

• Low sodium or blood sugar
• Kidney or liver failure
• Alcohol or illicit drug use such as cocaine/crack

Understanding Epilepsy

Epilepsy is a chronic disorder of the brain which causes recurrent seizures. It affects 1 in 26 people in the U.S. and is the 4th most common brain disease.

Epilepsy affects 2.3 million people in U.S (CDC), which is around 1% of the population.

• The World Health Organization (WHO) states that approximately 50 million people worldwide live with epilepsy.
  • Nearly 80% of the people with epilepsy live in low- and middle-income countries
• Each year, 48 in 100,000 people will DEVELOP epilepsy
  • U.S: 150,000 people develop epilepsy each year
  • City of Detroit: ~336 people develop epilepsy each year

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