What is Epilepsy?

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BY: ALLISON BROWN

According to the International League Against Epilepsy and the International Bureau for Epilepsy, there are changes in the definition of epilepsy. It is noted that … although a revision of the definition has generated some controversy, it is likely that real-world changes will be fairly minor. Some people will be able to say their epilepsy is resolved. Others may encounter the problems and stigma of being told that they have epilepsy after one seizure in some circumstances, rather than after two seizures. The definition might stimulate research on how likely another seizure is after the first seizure in various clinical circumstances. Governments and regulatory agencies, people who do therapeutic trials for epilepsy, insurance companies and other third-party payers might have to adjust some of their definitions. One reason changes will be small is that individuals with one seizure and a high risk for another are currently practically thought of as having epilepsy by many treating physicians. (Robert S. Fisher MD Ph.D. on 4/2014)

A person is considered to have epilepsy if they meet any of the following conditions:

At least two unprovoked (or reflex) seizures occurring greater than 24 hours apart, or one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next ten years.

Diagnosis of an epilepsy syndrome:

Epilepsy is considered to be resolved for individuals who had an age-dependent epilepsy syndrome but are now past the applicable age or those who have remained seizure-free for the last ten years, with, no seizure medicines for the last five years. (http://www.epilepsy.com/article/2014/4/revised-definition-epilepsy).

Epilepsy is a common brain disorder characterized by recurrent seizures. Approximately 1 in 100 Canadians has epilepsy. The highest number of new cases is in seniors and young children, but epilepsy can begin at any age.

A medical diagnosis of epilepsy is based on multiple pieces of information: the description of the episodes; the person’s medical and family history; and the results of diagnostic tests. Fortunately, epilepsy is a treatable condition. Many people with epilepsy (two out of three) will achieve good seizure control with medication. When medication is not effective in preventing seizures, there are other treatment options available. (http://epilepsyontario.org/about-epilepsy/what-is-epilepsy/)

A seizure is a brief disruption in normal brain activity that interferes with brain function.  The brain is made up of billions of cells called neurons which communicate by sending electrical messages. Brain activity is a rhythmic process characterized by groups of neurons communicating with other groups of neurons. During a seizure, large groups of brain cells send messages simultaneously (known as “hypersynchrony”) which temporarily disrupts normal brain function in the regions where the seizure activity is occurring. Seizures can cause temporary changes or impairments in a wide range of functions. Any function that the brain has can potentially be affected by a seizure, such as behavior, sensory perception (vision, hearing, taste, touch, and smell), attention, movement, emotion, language function, posture, memory, alertness, and/or consciousness. Not all seizures are the same. Some seizures may only affect one or two discrete functions, other seizures affect a wide range of brain functions.

Potentially anyone can have a seizure. A seizure is an indication of a transient disturbance in normal brain activity. Approximately 1 out of every 10 people will experience a seizure at some point in their lifetime. Many people who experience a single seizure will never have another one. It is not always possible to determine why a seizure has occurred.

Some causes of seizures are, fever, infection, low blood sugar (hypoglycemia), changes in sodium or potassium levels, a recent head trauma or brain injury, alcohol withdrawal, epilepsy.

Most seizures are brief events that last from several seconds to a couple of minutes and normal brain function will return after the seizure ends. Recovery time following a seizure will vary. Sometimes recovery is immediate as soon as the seizure is over. Other types of seizures are associated with an initial period of confusion afterward. Following some types of seizures, there may be a more prolonged period of fatigue and/or mood changes.  

As I continue to write these articles I cannot stress enough the importance of partnering with your health care practitioners and advocating for yourself and family members. “Truly, your health is in your hands”.

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