Condition Center: Epilepsy

This informational guide, part of POPSUGAR’s Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Having a seizure can be terrifying and dangerous. But having two or more seizures seemingly out of the blue could be a sign of epilepsy.

Epilepsy is a disorder that causes seizures, which are short changes in normal brain activity. “Seizures are like a computer short-circuiting,” says Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica. “When your computer crashes, it needs to restart. When you have a seizure, your brain crashes and needs to restart.”

Seizures look different for everyone and can include staring spells, falling, shaking, and losing awareness of surroundings, according to the Centers For Disease Control and Prevention (CDC).

Just over one percent of Americans have epilepsy, per the CDC. While anyone can be diagnosed with epilepsy, the condition is most common in children and older adults, says Brad Kamitaki, MD, an assistant professor of neurology at Rutgers Robert Wood Johnson Medical School.

The signs and symptoms of epilepsy can be confusing if you’re not sure what you’re looking for. Doctors stress that having one seizure doesn’t mean you have epilepsy. Here’s what epilepsy involves, as well as what causes the disorder and how it’s treated.

What Is Epilepsy?

Epilepsy is a neurological condition that causes recurrent, unprovoked seizures, says Ramya Raghupathi, MD, an assistant professor of clinical neurology at Penn Medicine. “‘Unprovoked’ means that there is no immediate cause for the seizure, such as a fever, an infection of the brain, or head trauma,” she says.

Dr. Raghupathi notes that nearly 10 percent of people will have a seizure during their lifetime. “Most of these are ‘provoked’ seizures during an acute illness or condition,” she says. “These people may never go on to have another seizure, and therefore do not have epilepsy.”

But if you have had more than one seizure, you may have epilepsy, Dr. Segil explains. “Between seizures, most people with epilepsy are completely normal,” Dr. Raghupathi notes. However, she adds, “seizures can occur at any time, often without warning”

These are the most common signs of epilepsy, according to Dr. Kamitaki:

• Abnormal body movements
• Trouble with language
• Staring
• Loss of consciousness

“The typical seizures most people think about are called tonic-clonic seizures — aka grand mal seizures — in which people lose consciousness and then have diffuse body stiffening and shaking,” Dr. Kamitaki says.

What Causes Epilepsy?

In two out of three people, the cause of epilepsy is unknown, the CDC says. In others, there are a few major risk factors. Dr. Raghupathi breaks them down:

• Brain injuries like trauma, stroke, and tumors
• A family history of epilepsy
• Infectious diseases that affect the brain, like meningitis, encephalitis, or a brain abscess
• Developmental disorders, including cerebral palsy
• Other structural brain disorders, like focal cortical dysplasia
• Certain prenatal conditions, like maternal drug use and lack of prenatal care
• Febrile seizures

The Best Treatment For Epilepsy

Epilepsy is best diagnosed and treated by a neurologist, if access is possible, Dr. Segil says. Treatment options for epilepsy include anti-seizure medications to limit the spread of seizures in the brain — these work for about two-thirds of people with epilepsy, according to the CDC.

When seizures come from a single area of the brain, surgery may help stop future seizures or make them easier to control with medicine, Dr. Segil says. Other treatments, like electrical implants or a high-fat, low-carbohydrate ketogenic diet, can be helpful, per the CDC.

“It is important that the decision for treatment, as well as which treatment is undertaken, happens after an open, thorough discussion between the patient and physician,” Dr. Kamitaki says. Anti-seizure medication is usually what doctors will recommend first, he says, although there is a range with those, too.

“There are many anti-seizure medications out there, and the choice of treatment should be made with the individual patient in mind,” Dr. Kamitaki tells PS.

Once a person is diagnosed with epilepsy and is undergoing treatment, communication between the doctor and patient is important so that treatment can be adjusted as needed. “Patient education about the condition and its management is also crucial for empowering individuals with epilepsy to make informed decisions,” Dr. Raghupathi says.