Epilepsy is a brain disorder that causes a person to have recurrent seizures caused by abnormal electrical activity in the brain. Approximately one in 100 Americans have experienced a seizure or been diagnosed with epilepsy (meaning they have had repeated seizures).
A patient having a seizure may experience jerking, uncontrolled movements, loss of consciousness, confusion, staring spells, or muscle spasms.
There are three basic types of seizures:
- Generalized Tonic - Clonic Seizures (also called grand mal seizures) – involve full body convulsions.
- Absence Seizures (also called petit mal seizures) - typically involve brief staring spells that last less than 15 seconds and, possibly, twitching or jerking muscles.
- Partial, or Focal, Seizures - affect a specific area of the brain. Symptoms vary widely depending on the area of the brain affected, including staring spells, abnormal body or eye movements, hallucinations, increased heart rate, dilated pupils, sweating, etc.
Written by Laurie LaRusso, MS, ELSShow All
Doctors Who Treat Epilepsy – Patient Education
As epilepsy is diagnosed, treated and managed, you may encounter the following team of doctors and specialists listed in this patient education guide.
- Neurologist - Doctor who specializes in disorders of the brain and nervous system. Neurologists prescribe medication to prevent seizures, monitor patients with epilepsy, and supervise their ongoing treatment.
- Neurosurgeon - Doctor who specializes in surgical treatments of the brain or nervous system. If surgery is required to treat epilepsy, a neurologist refers the patient to a neurosurgeon.
- Epileptologist - A neurologist who specializes in treating epilepsy. Like general neurologists, epileptologists prescribe medication to prevent seizures, monitor patients with epilepsy, and supervise their ongoing treatment.
- Pediatric Neurologist - Doctor who specializes in treating children with disorders of the brain and nervous system. Like general neurologists, pediatric neurologists monitor children with epilepsy, prescribe medication to prevent seizures, and supervise the child’s ongoing treatment.
- Pediatrician - Doctor who specializes in the medical care of children. Children with epilepsy are often monitored by both a pediatrician and a neurologist.
- Internist or Family Physician - Doctors who provide general medical care for adults. Adults with epilepsy may be monitored by both an internist or family physician and a neurologist.
Written by Laurie LaRusso, MS, ELS
How to Prepare for Your Epilepsy Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions that you need to take in order to maximize the benefit of your epilepsy doctor visit. Read more in this patient education guide.
- Write down everything you can remember or you were told about the seizure or seizures that have prompted this visit to the doctor.
- Write down a list of symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Make a list of all medications, vitamins and supplements that you’re taking. Include the dosage you are taking of each.
- Write down key personal information, including any major stresses or recent life changes.
- For future doctor visits, keep a diary of when your seizures occur, the characteristics of the seizures (staring, confusion, convulsions, etc), and if you notice any triggers (such as smells, sounds, lights, lack of sleep, alcohol use, medications, etc.) that seem to precede your seizures.
Questions to Ask Your Doctor About Epilepsy
From your initial diagnosis throughout your treatment and care, you will have questions about your epilepsy. Below is a list of questions to discuss with your doctor so you can make informed decisions about your condition.
Question About My Diagnosis
- What causes epilepsy?
- Are there symptoms of epilepsy other than seizures?
- Will I ever stop having seizures?
- Will I feel a seizure coming on?
- Is there anything I can do to prevent seizures?
Questions About My Treatment
- Will I need to see a specialist for my epilepsy? Will insurance pay for this?
- What type of medication is used to treat epilepsy? Are there side effects?
- Will I have to take medication forever?
- What should I do if I forget to take my medication?
- Will other medications I take interact with my epilepsy medication?
- Can I drink alcohol?
Questions About My Lifestyle & Family
- Are there certain jobs or activities I cannot do if I have epilepsy?
- Can I drive a car if I have epilepsy?
- Will the seizures cause brain damage?
- What can I do to prepare myself, my family, and my friends for a seizure?
- Is there a support group for people with epilepsy?
- Will my children have epilepsy?
Common Tests or Labs to Diagnose Epilepsy
There are several tests used to make a proper diagnosis and monitor your ongoing condition. Listed below are the most common tests and labs ordered for epilepsy, why you need them, and what they can tell you about your condition.
What is Normal?
|Neurological exam||To check how well the brain and nervous system are functioning||A doctor performs physical tests and observes a patient performing physical and mental tasks||The doctor is looking for any problems with functioning of muscles, senses, reflexes, memory or simple mental tasks, as well as trouble with walking or coordination.|
|Electroencephalogram (EEG)||To check electrical activity in the brain||Flat metal disks (called electrodes) connected to wires are attached to the head with a sticky substance.||Abnormal patterns of electrical activity may indicate epilepsy and show the area where seizures start.|
|Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) Scans||To view the structures of the brain||A patient lies on a table that slides inside a large machine. Dye may be injected by syringe into your veins to help make clearer images.||Abnormal findings, such as brain tumors, cysts, or other structural abnormalities, may be the cause of seizures.|
|Positron Emission Tomography (PET) or functional MRI Scans||To monitor brain activity and detect abnormalities in brain function||A patient lies on a table that slides inside a large machine. Dye is injected by syringe into your veins to help make clearer images.||Abnormalities in brain activity and function can provide clues as to what is causing the seizures and how best to control them.|
|Blood Test||To check blood chemistry, blood sugar levels, complete blood count, liver and kidney function||Blood is drawn with a syringe, typically from the arm.||Blood chemistry, blood sugar, and liver or kidney enzymes that are out of the normal range indicate other problems in the body that may affect seizure activity.|
|Lumbar Puncture||To look at the fluid surrounding the brain and spinal cord||After a numbing medication is injected into the spinal area (usually the lower back area), a needle is inserted to collect a sample of spinal fluid.||No nodules visualizedNo punched out or eroded areas of bones|
Written by Laurie LaRusso, MS, ELS
Common Medications and Treatments for Epilepsy
The most common treatment for epilepsy is taking medication to control seizures. These medications, called anticonvulsants drugs, antiepileptic drugs or anti-seizure drugs, are described in the table below.
How the Medication Works
||There are numerous anticonvulsant medications available in the United States.These drugs, which are typically taken in pill form, work by decreasing abnormal electrical activity in the brain.
Doctors and patients work together to choose a medication or combination of medications based on the type of seizures the patient experiences, which side effects should be avoided, convenience of use, cost and physician experience.
- Surgery may be performed to correct a structural problem in the brain, such as a tumor, abnormal blood vessels, or bleeding in the brain.
- Surgery to remove abnormal brain cells or implant a vagus nerve stimulation device may be performed if multiple anti-seizure drugs have been unable to control a patient’s seizures.
- Children may be placed on a special diet, called a ketogenic diet, which is high in fats and low in carbohydrates. This diet can help reduce the frequency of seizures in some children with epilepsy.
Written by Laurie LaRusso, MS, ELS