Epilepsy is a disorder that causes abnormal electrical activity in the brain, which leads to repeated seizures. About one in 100 Americans has had at least a single seizure been diagnosed with epilepsy. A person having a seizure may experience jerking, uncontrolled movements, loss of consciousness, confusion, staring spells or muscle spasms.

There are three basic types of seizures:

  • Grand mal seizures: This type of seizure affects the whole brain. During the seizure, the muscles in the body become stiff, and then begin to shake. The person having the seizure usually faints.
  • Petit mal seizures: This type of seizure affects the whole brain, and usually only lasts a few seconds. During the seizure, a person may stare, be unaware of his or her surroundings, suddenly stop talking or moving, or have abnormal muscle movements.
  • Partial seizures: This type of seizure affects only one part of the brain. The symptoms depend on which part of the brain is affected, but may include staring, abnormal body or eye movements, hallucinations, increased heart rate, dilated pupils and sweating.

Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown.

Doctors and Specialists

As your epilepsy is diagnosed and managed, you may see a variety of doctors and specialists, each focuses on a different aspect of care. The following providers may be part of your team for managing this condition:

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: Doctors who provide general medical care for adults. Adults with epilepsy may be monitored by both an internist or family physician and a neurologist.

Preparing for Your Appointment

After you make an appointment for epilepsy diagnosis and treatment, there are some steps you can take to make your visit a smooth one.

  • Write down everything you can remember or you were told about the seizure or seizures that prompted you to seek medical care.
  • Write down a list of symptoms, including any that may seem unrelated to epilepsy.
  • 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, what happens during the seizures, and if you notice anything specific that seems to trigger them.

If you’re diagnosed with epilepsy, you’ll probably have a lot of questions for your doctor. Review this list of common concerns before your appointment, or print it out to bring with you.

Questions About My Epilepsy 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 and 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?

Tests and Diagnosis

There are several tests that doctors use to diagnose and monitor epilepsy. Listed below are the most common ones, along with why you need them and what they can tell you about your condition.

Neurological exam

  • Checks how well the brain and nervous system are functioning
  • During this test, the doctor has the patient perform different physical and mental tasks.
  • The doctor looks for any problems with the muscles, senses, reflexes, memory and coordination.

Electroencephalogram (EEG)

  • Checks electrical activity in the brain
  • Flat metal disks called electrodes connected to wires are attached to the head to record brain activity.
  • Abnormal patterns of electrical activity may indicate epilepsy and show the area where seizures start.

Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans

  • Views the structures of the brain
  • A patient lies on a table that slides inside a large machine. Dye may be injected into the veins first 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

  • Monitors brain activity and detects abnormalities in brain function
  • A patient lies on a table that slides inside a large machine. Dye is injected into the veins first to help make clearer images.
  • Abnormalities in brain activity and function can provide clues about what is causing the seizures and how best to control them.

Blood test

  • Checks blood chemistry, blood sugar levels, and liver and kidney function
  • Blood is drawn with a syringe, typically from the arm.
  • Abnormal results indicate other problems in the body that may be causing seizures.

Lumbar puncture

  • Looks at the fluid surrounding the brain and spinal cord; also called a spinal tap
  • After a numbing medication is injected into the spinal area, a needle is inserted to collect a sample of spinal fluid.
  • Abnormal results indicate other problems in the body that may be causing seizures, like meningitis or encephalitis,

Medications and Treatment

The most common treatment for epilepsy is taking medication to control seizures. These medications, called anticonvulsants drugs, antiepileptic drugs or anti-seizure drugs include:

  • Sodium channel blockers
  • GABA receptor agonists
  • GABA reuptake inhibitors
  • GABA transaminase inhibitors
  • Glutamate blockers

These drugs, which are usually 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 and cost.

Surgery may be performed if seizures are caused by a structural problem in the brain, such as a tumor, abnormal blood vessels or bleeding. Surgery to remove abnormal brain cells or implant a device known as a vagus nerve stimulator may be performed if multiple anti-seizure drugs have been unable to control a patient’s seizures.

Children with epilepsy 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.