|What does "Epilepsy"
The word "Epilepsy" is derived from a Greek word meaning
"a condition of being overcome, seized, or attacked."
People used to believe that the seizure was caused by a demon,
and Epilepsy became known as a sacred disease. This is the background
to the myths and fears that surround Epilepsy; myths that colour
people's attitudes and make the goal of a normal life more difficult
than it needs to be be for people who have Epilepsy. The word
"Epilepsy" means nothing more than the tendency to
|Is Epilepsy a Disease?
Epilepsy is not a disease. It is a symptom of a neurological
disorder -- a physical condition -- which causes a malfunction
of the electrical signals which control the operation of the
brain. It is characterized by sudden, brief seizures whose nature
and intensity varies from person to person. Epilepsy is not
|What is a seizure?
The brain is a highly complex and sensitive organ. It controls
and regulates all our actions. It controls motor movements,
sensations, thoughts, and emotions. It is the seat of memory,
and it regulates the involuntary inner workings of the body
such as the function of the heart and the lungs.
The brain cells work together, communicating by means of electric
signals. Occasionally there is an abnormal electrical discharge
from a group of cells, and the result is a seizure. The type
of seizure will depend upon the part of the brain where the
abnormal electrical discharge arises.
|What is an aura?
Before the onset of a seizure some people experience a sensation
or warning called an "aura". The aura may occur far
enough in advance to give the person time to avoid possible
injury. The type of aura experienced varies from person to person.
Some people feel a change in body temperature, others experience
a feeling of tension or anxiety. In some cases, the epileptic
aura will be apparent to the person as a musical sound, a strange
taste, or even a particular curious odour. If the person is
able to give the physician a good description of this aura,
it may provide a clue to the part of the brain where the initial
discharges originate. An aura could occur without being followed
by a seizure, and in some cases can by itself be called a type
of simple partial seizure.
|When was Epilepsy discovered?
Epilepsy is the oldest known brain disorder. It was mentioned
more than 2,000 years before Christ. References can be found
in ancient Greek texts and in The Bible. It wasn't until the
mid 1800's, however, that Epilepsy was given serious study.
Sir Charles Locock was the first to introduce a sedative that
aided in controlling seizures in 1857. In 1870, John Hughlings
Jackson identified the brain's outer layer, the cerebral cortex,
as the part involved in Epilepsy. Hans Berger demonstrated that
the electrical impulses of the human brain could be recorded
| People With
|What kind of people have Epilepsy?
Virtually everyone can have a seizure under the right circumstances.
Each of us has a brain seizure threshold which makes us more
or less resistant to seizures. Seizures can have many causes,
including brain injury, poisoning, head trauma, or stroke; and
these factors are not restricted to any age group, sex, or race
and neither is Epilepsy.
|How many people have Epilepsy?
Epilepsy is far more common than most of us realize. Current
estimates indicate that more than one per cent of the population
have had, or will have, some form of Epilepsy in their lifetime.
It occurs in about 1 in every 100-200 people.
|Does Epilepsy strike at any particular
Epilepsy primarily affects children and young adults, although
anyone can get epilepsy at anytime. 20 percent of cases develop
before the age of five. 50 percent develop before the age of
25. It is also increasingly associated with the elderly, and
there are as many cases of epilepsy in those 60 years of age
and older as in children 10 years of age and under.
|Does Epilepsy occur more in some
Epilepsy occurs more frequently in some cultures. In Tanzania,
4% of the population experiences severe seizure disorders. In
this case, genetic predisposition to lower seizure thresholds
is known to exist. In Canada, 1-2% of the population has Epilepsy.
| Types of
|Are there different types of
Many varieties of epileptic seizures occur, and frequency and
form of attacks vary greatly from person to person. With modern
methods of treatment, however, most cases can be fully controlled.
Because there are so many nuances in Epilepsy and so many different
kinds of seizures, a specific classification system is being
promoted by the International League Against Epilepsy. The International
Classification of Epilepsy Seizures has been adopted by the
medical community and is gradually replacing outdated seizure
terminology including "grand mal" and "petit
The new classification scheme describes two major types of seizures:
"partial" and "generalized". It also divides
each of these categories into subcategories including simple
partial, complex-partial, absence, tonic-clonic, and other types.
|What is the difference between
partial and general seizures?
The distinction between "partial" and "generalized"
seizures is the most important feature of the new classifcation
system. If the excessive electrical discharge in the brain is
limited to one area, the seizure is partial. If the whole brain
is involved, it is generalized. In all, there are over 30 different
seizure types. Therefore, the new classification format subdivides
the partial and generalized Epilepsies into a number of different
|What are partial seizures?
Partial seizures (formerly known as focal seizures) with elementary
symptomology are often referred to a simple partial. During
this type of seizure the patient can experience a range of strange
or unusual sensations including sudden, jerky movements of one
body part, distortions in hearing or seeing, stomach discomfort,
or a sudden sense of fear. Consciousness is not impaired. If
another seizure type follows, these sensations may be referred
to as an "aura".
|What are complex partial seizures?
Complex-partial seizures (formerly psychomotor or temporal lobe
Epilepsy) are characterized by a complicated motor act involving
impaired consciousness. During the seizure the patient appears
dazed and confused. Purposeless behaviours such as random walking,
mumbling, head turning, or pulling at clothing may be observed.
Usually, these so-called "automatisms" cannot be recalled
by the patient. In children this seizure may consist of staring
or lip-smacking, and therefore may be confused with the absence
seizure described below.
|What are absence (petit mal)
Generalized absence seizures (formerly petit mal) are characterized
by 5 to 15 second lapses in consciousness. During this time
the patient appears to be staring into space and the eyes may
roll upwards. Absences are not preceded by an aura and activity
can be resumed immediately afterwards. Typically, they occur
in children and disappear by adolescence. They may, however,
evolve into other seizure types, such as complex-partial or
tonic-clonic. The occurrence of absences in adulthood are rare.
|What are tonic-clonic (grand
The tonic-clonic (formerly grand mal) seizure is a generalized
convulsion involving two phases. In the tonic phase, the individual
loses consciousness and falls, and the body becomes rigid. In
the clonic period, the body extremities jerk and twitch. After
the seizure, consciousness is regained slowly. If the tonic-clonic
seizure begins locally (with a partial seizure) it may be preceded
by an "aura". These seizures are said to be secondarily
While the tonic-clonic seizure is the most visible, obvious
type of Epilepsy, it is not the most common. Partial seizures
are more frequently encountered and occur in 62% of all Epilepsy
patients. Complex-partial seizures account for approximately
30% all cases.
|What are other types of seizures?
Benign rolandic epilepsy is an epileptic syndrome occurring
in young children that is age limited (you stop having seizures
in the teen years) . Salivation, twitching of the mouth or upper
extremity on one side are typical manifestations. Seizures occur
almost exclusively nocturnally.
Juvenile myoclonic epilepsy is an epilepsy characterized by
onset in childhood or adolescence and is associated with extremity
jerking or generalized tonic clonic seizures ('grand mal') within
an hour or two of wakening from sleep. Seizures which may be
precipitated by sleep deprivation, alcohol intake or coffee
(strange) tend to occur in the morning.
Pleases contact your local Epilepsy association or clinic for
additional information. Other seizure terms include: Atonic
(Drop Attacks), Myclonic, Infantile Spasms, Nocturnal, Photosensitive,
Visual, Musicogenic, Jacksonian, Sensory, Bilateral Myclonus,
Atkinetic, Autonomic, Prolonged seizures, and Ictal State.
|What are "status" seizures?
Status epilepticus is the term used to describe recurrent seizures
without recovery of consciousness between attacks. This is a
medical emergency and can be life threatening, or cause brain
damage. Immediate action to get the necessary medical care should
|What are pseudoseizures?
Psuedoseizures (or psychogenic seizures) are quite common and
can occur in people who have, or do not have, Epilepsy. The
attacks are triggered by a conscious or unconscious desire for
more care and attention. The seizures start with rapid breathing,
triggered by mental stress, anxiety, or pain. As the person
breaths rapidly, they build up carbon dioxide in their body
and change their chemistry. This can cause symptoms very much
like Epileptic seizures: prickling in the face, hands, and feet,
stiffening, trembling, etc. The appropriate treatment for pseudoseizures
is to calm the person and start them breathing at a normal rate.
Treatment should also involve investigating the mental and emotional
factors that led to the psuedoseizure.
|How do you distinguish epileptic
seizures from pseudoseizures?
Epileptic seizures and pseudoseizures are distinguishable both
by their nature and symptoms, but the diagnosis can be difficult.
Epileptic seizures are caused by a change in how the brain cells
send electrical signals to each other, while pseudoseizures
are triggered by a conscious or unconscious desire for more
care and attention. Thus, measuring brain activity with an EEG
and video telmetry is important for distinguishing epileptic
and pseudoseizures. Also, pseudoseizures often lack the exhaustion,
confusion, and nausea that is associated with epileptic seizures.
Psychogenic seizures can occur in people who also experience
|Can seizures occur if a person
does not have Epilepsy?
Epilepsy is a chronic condition of recurrent unprovoked seizures.
Isolated seizures and provoked seizures (e.g., drug or alcohol
induced) are not Epilepsy even though the events are real seizures.
There are many types of non-epileptic seizures. Non-epileptic
seizures differ from epileptic seizures in that there is usually
no evidence of abnormal electrical activity in the brain after
the seizure, and they do not occur repeatedly. Some of the more
common causes of non-epileptic seizures are: low blood sugar,
fainting, heart disease, stroke, migraine headaches, kinked
blood vessels, narcolepsy, withdrawal, and extreme stress or
|What are the seizures like?
The nature of the seizures varies depending upon the type of
Epilepsy the individual has. Some seizures may be very noticeable
while some may go completely unrecognized. With the most common
types of seizures there is some loss of consciousness, but some
seizures may only involve small movements of the body or strange
feelings. The different seizures types have certain characteristics
that accompany them.
|What does it feel like to have
Epilepsy is a broad classification for a wide variety of seizures,
so different people's seizures can be very different. Common
feelings associated with seizures include uncertainty, fear,
physical and mental exhaustion, confusion, and memory loss.
Some types of seizures can produce visual and auditory phenomena,
while others can involve a "blank" feeling. If a person
is unconscious during a seizure there may be no feeling at all.
Many people also experience an "aura" before the seizure
|How long do the seizures last?
Depending on the type of seizure, they can last anywhere from
a few seconds to several minutes. In rare cases, seizures can
last many hours. For example, a tonic-clonic seizure typically
lasts 1-7 minutes. Absence seizures may only last a few seconds,
while complex partial seizures range from 30 seconds to 2-3
minutes. "Status Epilepticus" refers to prolonged
seizures that can last for many hours, and this can be a serious
medical condition. In most cases, however, seizures are fairly
short and little first aid is required.
|Is there such a thing as a "minor"
case of Epilepsy?
There are over 30 types of seizures, and some types are more
severe than others. Long tonic-clonic convulsions, for example,
can produce more physical and mental effects than shorter partial
seizures. Some people may experience very frequent seizures
(every few hours), while others can go for months or years without
a seizure. Also, some seizures are easily controlled by drug
therapies, while others may continue regardless of the medication
that is tried.
|I have seizures but have been
told that I don't have epilepsy. Why is this?
Seizures can happen for many different reasons so
not all seizures are caused by epilepsy. Epileptic seizures
are seizures that start in the brain. Sometimes people have
seizures which occur as the result of other conditions. These
include metabolic disorders, heart problems, and psychological
reasons. More information on seizures not due to epilepsy.
|I have had seizures but the
EEG and brain scan are normal. Why have I been diagnosed with
Diagnosing epilepsy is often based on finding out what happened
to the person before, during and after the seizure. While tests
such as EEGs and brain scans can be useful, they cannot, on
their own, say if someone has or doesn't have epilepsy. Sometimes
the EEG and brain scan show unusual brain activity or physical
causes of epilepsy, but it is not unusual for them to be normal.
Electrical activity in the brain may be normal between attacks.
Therefore the EEG can show nothing different, unless some kind
of seizure activity happens at the time the test is carried
out. The brain scan looks for structural abnormalities within
the brain. It does not diagnose epilepsy but may help to explain
why seizures are happening. If it is negative, this means that
no cause for the seizures has been found. It does not mean that
the person doesn't have epilepsy. More information on diagnosis.
|I always have seizures at the
same time every month. Does this mean anything?
Seizures in women can sometimes happen at certain times in their
menstrual cycle - linked to their periods. If seizures occur
only during particular times in the cycle, this is called catamenial
epilepsy. This link may be due to the changes in hormones that
happen through the menstrual cycle.
|What first aid do I give for
different types of seizure?
The best way to help someone having a seizure depends on the
type of seizure it is and what happens to the person. Most seizures
stop of their own accord, and no specific first aid is needed
apart from keeping the person safe. During a convulsive siezure
(where the person jerks or shakes) it helps to put something
under their head to protect it. It is important that nothing
is put in their mouth during a seizure. Reassurance when the
seizure is over may also be needed. In complex partial seizures,
there may be a change in the person's awareness so it is important
to be reassuring and guide them gently away from danger where
|Is there anything I can do
to help reduce my seizures?
Taking anti-epileptic medication regularly as prescribed helps
to get the best possible control of seizures. Risks from accidents
such as burns, cuts and head injuries can be lowered by making
the home as safe as possible, and following simple safety precautions
for leisure activities. It is also helpful to try to identify
factors which may trigger seizures, such as lack of sleep or
too much alcohol, and to avoid these where possible.
|What causes Epilepsy?
There is no single cause of Epilepsy. Many factors can injure
the nerve cells in the brain or the way the nerve cells communicate
with each other. In approximately 65% of all cases there is
NO known cause. The following are some of the most frequently
- Head injury that causes scaring of the brain tissue.
- Trauma at birth, or high fever.
- Excessively rough handling or shaking of infants.
- Certain drugs or toxic substances when administered
in large doses.
- Interruption of blood flow to the brain caused by stroke,
tumour, or certain cardiovascular problems.
- Diseases which alter the balance of blood or its chemical
structure, or diseases that damage the nerve cells in the
- When physicians can identify the underlying disorder,
such as those mentioned above, the condition is referred
to as "Symptomatic" Epilepsy. In some cases, however,
the underlying disorder can't be identified and this is
called "Idiopathic" Epilepsy.
| Epilepsy inherited?
In most cases Epilepsy is not inherited. In a few cases the
tendency towards Epilepsy might be inherited, but even with
this tendency certain conditions must exist in the brain before
a person will experience epileptic seizures. It is most unlikely
that children will inherit the disorder.
|Is Epilepsy contagious?
Epilepsy is in no way contagious. No one can get the disorder
by talking to, kissing, or touching somebody with Epilepsy.
Epilepsy can only be transmitted through hereditary transfer.
Epilepsy that runs in families suggests an underlying metabolic
or genetic etiology, and this is the least common of all Epilepsy
|Is it caused by a virus?
Epilepsy can be the result of an infection or disease. Some
conditions known to have a risk of resulting in Epilepsy are
meningitis, viral encephalitis, and less frequently mumps, measles,
diphtheria, and abscesses.
|Can certain things trigger seizures?
In some cases, epileptic seizures can be triggered by things
that happen in the environment. Seizures can be triggered by
flashing lights or sudden changes from dark to light (or vice
versa). Other people can react to loud noises or monotonous
sounds, or even certain musical notes. It is important for people
with Epilepsy to learn what kinds of events can trigger seizures
|Can seizures be triggered by
"Photosensitive Epilepsy" is the name given to a form
of the disorder where seizures are triggered by flickering or
flashing lights. Though it occurs more frequently in girls aged
6-12, it can occur at any age and regardless of gender.
|Can certain foods or drinks cause
People with Epilepsy should have regular meals at regular intervals
and pay attention to what they eat and drink. Prescription and
non-prescription drugs, as well as food additives, may interact
with anti-convulsant drugs. Alcohol can lower seizure thresholds.
|Can lack of sleep cause seizures?
Excessive sleep deprivation can lower seizure thresholds and
possibly result in a seizure. Lack of sleep is known to be an
important precipitating factor in causing seizures. Other factors
that can lower seizure thresholds are high fever, increased
excitement, and changes in body chemistry. It is important for
people with Epilepsy to learn what kinds of events can trigger
seizures for them.
|Can low blood sugar trigger seizures?
Hypoglycemia (low blood sugar) can induce epileptic-type seizures.
This condition can be caused by diet or by drugs such as insulin.
This is not really Epilepsy since it is not recurrent seizures
that are due to abnormal brain activity. Here the seizures are
directly caused by the blood sugar levels.
|Can Nutrasweet (Aspartame) trigger
In 1984, there were 3 reports about large amounts of Aspartame
causing a lowering of the seizure threshold and therefore increasing
seizure activity. The Centre for Disease Control in Atlanta
did a review of this and were unable to find any cause or effect
relationship at normal doses. More recently, Aspartame has been
found to be unsuitable for some children with generalized absence
Epilepsy. A Queen's University study looked at the brain-wave
patterns in 10 children and the effects of the artificial sweetener
"Nutrasweet". A 40% increase in abnormal brain-wave
activity associated with absence seizures was found in this
study. However, there was no effect on the actual number of
seizures. Research on this topic is continuing.
|Does alcohol affect seizures?
Alcohol can raise and then lower the seizure threshold, and
thus increases the tendency to have a seizure. More important
are interactions between alcohol and seizure medicines. Also,
some drugs of abuse, especially cocaine and amphetamines, can
cause seizures. Some prescription medications when taken in
large doses can also bring on seizures.
|How can I help someone who is
having a seizure?
The appropriate behaviour for helping someone who has a seizure
depends on the type of seizure it is. While a person experiencing
a tonic-clonic seizure may require some first aid, in most cases
there is little that can be done.
- Tonic-Clonic (Grand Mal)
This type of seizure is often the most dramatic and frightening,
but it is important to realize that a person undergoing
an epileptic seizure is usually unconscious and feels no
pain. The seizure usually lasts only a few minutes, and
the person does not need medical care. These simple procedures
should be followed:
- Keep calm. You cannot stop a seizure once it has started.
Let the seizure run its course. Do not try to revive the
- Ease the person to the floor and loosen clothing.
- Try to remove any hard, sharp, or hot objects that
might injure the person. It may be necessary to place a
cushion or soft item under their head.
- Turn the person on his or her side, so that the saliva
can flow from the mouth.
- Do NOT put anything in the person's mouth.
- After the seizure the person should be allowed to rest
or to sleep if necessary.
- After resting most people carry on as before. If the
person is not at home and still seems groggy, weak, or confused,
it may be better to accompany them home.
- In the case of a child having a seizure, contact a
parent or guardian.
- If the person undergoes a series of convulsions, with
each successive one occurring before he or she has fully
recovered consciousness, or a single seizure lasting longer
than 10 minutes, you should immediately seek medical assistance.
- Absence (Petit Mal)
No first aid is required.
- Complex-Partial (Psychomotor or Temporal Lobe)
- Do NOT restrain the person. Protect him or her by moving
sharp or hot objects away.
- If wandering occurs, stay with the person and talk
- Simple-Partial (Focal)
No first aid is required
|What if my child has a seizure
during his sleep?
Children are usually awakened by seizures that occur while they
sleep. Thus, a parent of a child with a known seizure disorder
is usually aware when their child has seizures during the night.
Only in those rare cases where a child vomits or experiences
other problems during a seizure is there a need to worry.
|Is my child having absence seizures
or just day dreaming?
A child having an absence seizure may appear to the onlooker
as if they are day dreaming or just staring into space. What
may be happening is a sudden period of altered consciousness.
To be able to tell the difference, close observations might
have to be done. Usual behavioral characteristics of a absence
seizure may include: eye blinking, chewing of the mouth, and
perhaps a slight rhythmic movement of the facial muscles, head,
or arms. During the seizure the child may not respond to verbal
or physical stimulation. Immediately after the seizure, the
child is able to resume normal activity. If you observe unusual
behaviour in your child, a visit to a neurologist should be
arranged through your family doctor.
|Can seizures go un-noticed?
The symptoms of seizures are not always noticeable for on-lookers
or for the person who is experiencing the seizure. Seizure may
result in rigidity in the body, convulsions, chewing of the
mouth, unusual behaviors, or loss of consciousness. Some symptoms
may be less apparent, such as disorientation or unusual sensations.
Milder symptoms do not mean that the seizure is of less importance.
|How is Epilepsy diagnosed?
The diagnosis and evaluation of Epilepsy requires the physician
to know all about the seizures - when they started, the patient's
appearance before, during, and after a seizure, and any unusual
behavioural occurrences. A background of the family's health
history is also useful. In addition, an electroencephalogram
(EEG) may help detect areas of increased nerve cell activity.
|What types of doctors can diagnose
and treat Epilepsy?
Any licensed physician is qualified to treat Epilepsy. There
are doctors who specialize in neurological disorders, and these
neurologists can be found practicing in many hospitals and private
practices. Epileptologists may work in an Epilepsy clinic, as
well as in private practices. Usually a referral is required
from another physician in order to see a Neurologists and Epileptologists.
Some people also consult alternative health practitioners who
specialize in holistic healing, acupuncture, or chiropractic
Often, the first doctor to diagnose Epilepsy is the family doctor.
Most of them have had some experience with it, and will be the
one to refer a person with Epilepsy to a specialist initially.
Pediatricians are also well aware of Epilepsy, since about two-thirds
of all Epilepsy occurs before the age of 14. A neurologist has
specialized training in the disorders of the brain and nervous
system. A neurosurgeon, psychiatrist, or psychologist may also
get involved if the circumstances require them.
|Can a person with Epilepsy have
a false negative EEG
An EEG measures the electrical activity on the surface of the
brain. An EEG may appear to be normal if the abnormal electrical
activity is occurring deeper in the brain than the EEG is able
|Can a person have a false positive
EEG for Epilepsy?
Many people who do not have Epilepsy may have some "epileptiform"
activity on an EEG. However, this does not prove that they have
a seizure disorder. Reading EEG's is a highly skilled activity,
and a diagnosis of Epilepsy is based on the clinical picture
as well as the EEG. Other tests, such as CT scans and MRI scans,
may be performed to confirm any findings.
|What conditions are sometimes
mis-diagnosed as Epilepsy?
Seizures occurring as a result of alcohol withdrawal, fever,
or hypoglycemia can be mistaken for Epilepsy. Other causes of
seizures that do not indicate Epilepsy are strokes, migraine
headaches, calcified blood vessels, narcolepsy, and psychogenic
|The neurologist said my EEG
showed epileptiform activity. What is this?
When someone has an epileptic seizure their brain activity changes.
This is sometimes called epileptiform activity. Identifying
exactly where in the brain this activity is happening can help
your neurologist to tell what type of epilepsy you have. In
some people the epileptiform activity is in just one part of
the brain (partial epilepsy). In others the activity is in all
areas of the brain (generalised epilepsy).
|How do I get a referral to
a neurologist who specialises in epilepsy?
Often a person's epilepsy will be successfully treated by a
general neurologist. If a referral to a neurologist who specialises
in epilepsy is needed, it will need to be made by the person's
GP or by their current neurologist.
|Why does the neurologist say
I have epilepsy, when I don't have convulsions?
The simple answer is that not all epileptic seizures involve
convulsions. Epileptic seizures can take many different forms.
The brain is responsible for a wide range of functions including
consciousness, awareness, movement and posture. A sudden, temporary
interruption in the way the brain is working can affect some
or all of these functions. This may be called an epileptic seizure.
Convulsions happen in some seizures, but there are lots of other
things that can happen during a seizure. More information on
|Does it matter when I take
To work properly, medication needs to be taken regularly as
prescribed. The exact timing of each dose is not crucial, but
it is recommended that the correct dose is taken at about the
same time each day.
|If my seizures get worse, can
I take extra medication?
If seizures are happening more often than before, it is helpful
for the doctor or neurologist to be aware of this. If it is
felt that a change in medication is needed the doctor can then
monitor these changes carefully. No one should take extra medication
unless advised to do so by the doctor.
|Do I need regular blood tests
if I'm taking anti-epileptic drugs (AEDs)?
Blood tests are sometimes used to find out how much AED is in
a person's body and to see if the AED is working. For most people,
the most useful guide as to whether the AED is working, is whether
they are still having seizures and whether they have any side
effects. Blood tests are only needed for certain AEDs - usually
phenytoin - or in certain situations such as during pregnancy,
or if other drugs are being started or stopped. More information
on blood tests.
|What should I do if I get side
effects from the medication?
All drugs can cause side effects in some people. Whether a person
has side effects or not depends on their reaction to the medication.
Many people are able to take anti-epileptic drugs with few,
if any, problems. However if side effects happen, are severe,
or if there is an allergic reaction to medication, for example
a skin rash, it is important to see a doctor as soon as possible.
More information on side effects.
|How long will I have to continue
to take my medication?
The length of time will vary from one person to another. It
depends partly on whether the person is still having seizures,
and whether they still have a tendency to have seizures. The
decision to stop anti-epileptic medication needs to be considered
carefully. If seizures start again, this may affect driving,
employment or leisure. If a person has not had seizures for
a number of years, the neurologist may discuss gradually withdrawing
|My 13 year old daughter's behaviour
has become more difficult since she was diagnosed with epilepsy
last year. Is this due to the medication?
Adolescence is often a time when young people are striving to
become independent. As well as having the usual anxieties about
exams, careers and relationships, young people with epilepsy
may be concerned or frustrated about the effect that seizures
are having on their lives, and this may cause a change in their
behaviour. In a few young people, medication may also affect
their behaviour; if you feel that this is the case, it may be
worth discussing this with the doctor.
|Is there a cure for Epilepsy?
There is no known "cure" for Epilepsy. Medications
can often control seizures, but they are not a cure. Some forms
of Epilepsy occur only in childhood, and the person is said
to have outgrown the seizures. In some cases there is a spontaneous
remission of the seizure disorder. Sometimes, surgery to remove
the part of the brain in which the seizures originate can produce
a complete and permanent stop to seizures.
|Is it fatal?
Epilepsy itself can cause death if prolonged repeated seizures
("status epilepticus") are not treated properly. Such
deaths are very rare, however. More common is death due to hazards
or accidents that occur when someone has a seizure unexpectedly
in a potentially dangerous situation.
|What kinds of treatments are
When a physician diagnoses Epilepsy, a specific treatment can
be recommended. The treatment prescribed by the physician is
designed to control the seizures and help the patient to carry
on a healthy life, participating in all normal activities, including
most sports. The two major kinds of treatments are drug therapy
|Are there drug treatments for
Treatment of Epilepsy is primarily through the use of special
anti-convulsive drugs. There are many different types of these
drugs, and the type prescribed will depend upon the particular
needs of the individual. The drugs are prescribed either alone
or in a combination. The various drugs or combination of drugs
control different types of seizures.
|How do drugs work to control
The drugs used to control seizures are called anticonvulsants.
How they stop the seizures, change the seizure threshold, or
prevent electrical discharges from occurring is not fully known.
The neurochemical basis for their action is also unknown. Research
has shown that some of the drugs can block the spread of abnormally
fast nerve impulses in the brain, while others can increase
the flow of chloride ions, which stabilize the nerve cells.
Research is still being done in this area.
|What drugs are used to treat
There are many different drugs used to treat Epilepsy. Some
of the more common ones are: Tegretol (carbamazepine), Dilantin
(phenytoin), Mysoline (primidone), Epival (valproate), Frisium
(clobazam), Rivotril (clonazepam), Mogadon (nitrazepam), Phenobarbitol,
Depakene (valproic acid), Zarontin (ethosuximide), Neurontin
(gabapentin), Lamictal (lamotrigine), Sabril (vigabatrin). There
are also many new drugs under development.
The choice of drug is determined by the type of seizure, the
side effects of the drugs, and the age and health of the person.
Often a number of drugs, and combinations of drugs, have to
be tried until the seizures are brought under control.
|How effective are the drug treatments?
Most epileptic seizures are controlled by special anti-convulsive
drugs prescribed by a physician. About 50 per cent of those
who take this medication will have their seizures eliminated;
30 per cent will have their seizures reduced in intensity and
frequency to the point where they can live and work normally.
The remaining 20 per cent are either resistant to the medication,
or else they require such large dosages of the drug to control
the seizures that it is preferable to accept partial control.
|When is surgery used to treat
Surgery is used only when medication fails and only in a small
percentage of cases where the injured brain tissue causing the
seizures is confined to one area of the brain and can be safely
removed without damaging personality or functions.
|What is the likelihood that my
child will outgrow a seizure disorder?
The likelihood of a child outgrowing a seizure disorder is difficult
to answer. Sometimes children do outgrow Epilepsy, while for
others the seizures may stay the same or intensify with age.
Some people experience the same type of seizures throughout
their lifetime. Some epilepsies are known to almost always remit
(for example, Benign Rolandic Epilepsy or Epilepsy with centrotemporal
spikes and rolandic seizures), some are known to usually remit
(e.g., childhood absence) and some are known to almost never
remit (e.g., Juvenile Myoclonic epilepsy). The medical community
cannot predict who will continue to have seizures and who will
not, but they feel that the sooner Epilepsy is diagnosed, the
better it can be controlled.
|Do these drugs have side effects?
Many medications for Epilepsy have side effects. These can range
from mild to severe, and will differ depending on the drug and
dosage. Some of the more common side effects of anti-epileptic
drugs are: drowsiness, dizziness, nausea, irritability, and
|What is a "blood level"?
"Blood level" refers to the amount of anticonvulsant
in the blood. It is measured with a simple blood test and is
used to help determine if a patient's symptoms may be due to
toxicity or to side effects of medication. It is also used to
determine if the patient is taking enough medication to prevent
seizures. The therapeutic range for different anti-convulsants
has been determined by testing blood levels in thousands of
patients whose seizures are controlled and who are not experiencing
|What are the symptoms of too
high a drug level?
Too high of a drug level may cause a person to experience side
effects such as drowsiness, confusion, breakthrough seizures,
unsteadiness, and nausea. This may require a reduction in dosage
or a change to a different medication.
|How much do the drugs cost?
The cost of the anticonvulsant drugs will depend on the dosage
levels needed, the drug being used, and the amount in each prescription.
There is usually a difference in price between a drug's brand
name and its generic equivalent. Ask your doctor or pharmacist
if a generic one is available for you to use, and if it is appropriate.
|Is it necessary for all people
with Epilepsy to be on medication?
Treatment of Epilepsy is primarily through the use of anticonvulsive
drugs. There are many different types of drugs and the type
prescribed will depend upon the particular seizure pattern of
the individual. If someone has been seizure free for several
years, the doctor may decide to slowly withdraw the medication.
|Do non-traditional approaches
Some people with Epilepsy have tried many different approaches
to improve their seizure control. In some cases, the person
feels that they have experienced improvement. However, scientific
studies have not been conducted into most non-traditional approaches.
Techniques known to reduce stress or improve overall health
may be helpful to some people. Other techniques that have been
tried are biofeedback, diets, acupuncture, and meditation.
|Does transcendental meditation
have any effect on Epilepsy?
The medical community has not determined if things such as transcendental
meditation have any real effect on Epilepsy. It has been shown
that when people know what is happening at a given moment, some
can influence the automatic processes of the body. With biofeedback,
some people can moderate and possibly change certain functions
thought to be involuntary, such as the rhythm of their brain
waves, blood pressure, heart rate, etc. The significance of
this for Epilepsy is not known.
|Does biofeedback help?
Biofeedback is the process of moderating, limiting or changing
certain physiological functions previously thought to be involuntary,
such as heart rate, blood pressure, brain waves, etc. For Epilepsy,
a person could be given extensive biofeedback training and taught
behavioural modification techniques through which he/she control
certain physiological functions related to seizures. Biofeedback
training can also be taught as a method of stress reduction.
This in itself can reduce the frequency of seizures in some
persons with stress related seizures. Further study is needed
to ascertain the value of biofeedback in the treatment of Epilepsy.
Non-medical approaches may improve seizure control in some persons,
but should not be undertaken without the knowledge of the physician
prescribing the anti-convulsants. Under no circumstances should
anti-convulsants be stopped suddenly as this may precipitate
prolonged and life-threatening seizures.
|Is there a special diet for people
Good nutritional habits and a healthy life style may assist
in the maintenance of optimum seizure control. Experiencing
a drastic weight change may mean that either a chemical or metabolic
imbalance is occurring, and you should consult your physician.
Though some anti-convulsants may cause nutrient deficiencies
in some people, a well balanced diet will usually prevent this.
|What is a ketogenic diet?
A ketogenic diet is very rich in lipids (fats) and oils, but
low in proteins and carbohydrates. This unusually high intake
of lipids and oils creates a condition in the body know as "ketosis".
Themetabolic shift that is created increases the seizure threshold
for some. This diet is also calory and liquid restricted. The
Ketogenic diet is mainly effective in children. It requires
careful preparation and strict adherence. Although it takes
a significant commitment to be successful, many children have
greater seizure control with this diet than with conventional
(drug) therapys. Some are able to reduce or eliminate antiseizure
medications. Careful medical supervision is essential when using
this as a therapy.
|Do I have to register as disabled?
Since the Disability Discrimination Act was introduced in 1995
there is no disability register.
|How do anti-epileptic drugs
AEDs treat the symptoms of epilepsy (that is, they try and stop
the seizures), rather than curing epilepsy itself. The drugs
act on the brain to prevent the seizures from getting started,
by reducing the tendency of the brain cells to send excessive
and confused electrical signals. This helps to raise a person's
seizure threshold, that is, their resistance to having seizures.
|Do I have to pay for my prescriptions?
In the UK, people with epilepsy are eligible to receive free
prescriptions, not only for their anti-epileptic medication,
but also for other prescribed drugs. Form FP92, available from
doctors' surgeries, hospitals or pharmacies, will need to be
completed to apply for an exemption certificate.
|I am finding it harder to remember
things since I developed epilepsy. Why is this?
Many people with epilepsy, particularly those with temporal
lobe seizures, have difficulties with memory. There can be a
number of reasons for this, related to the seizures themselves,
to anti-epileptic drugs or to their mood.
|Will the drugs I take affect
my having children?
Most women with epilepsy have straightforward pregnancies with
normal deliveries and healthy children. However, taking anti-epileptic
drugs can sometimes have an effect on a developing baby. The
risks of having seizures needs to be balanced against the risk
to the developing baby of continuing anti-epileptic medication
during pregnancy. There is no evidence to suggest any risk to
the baby from the father taking anti-epileptic medication. More
information on pregnancy.
|I have had seizures for many
years and the drugs do not help. Could surgery help?
A small number of people whose seizures cannot be controlled
by medication may be helped by surgery. Surgery can only be
carried out if seizures start in aparticular part of the brain
that can be found and operated on safely.
|Would complementary treatments
help my epilepsy?
The most successful treatment for epilepsy is anti-epileptic
medication. Other treatments are normally seen as additional
to, rather than an alternative, to medication. At the moment
there is little evidence for the effectiveness of complementary
therapies. However therapies which encourage relaxation may
help to lower the frequency or severity of seizures. Any treatment
should always be followed in consultation with a qualified practitioner.
More information on complementary therapies
|Can people living with Epilepsy
drive a car?
In Canada, the situation is that anyone with a history of Epilepsy
may drive a motor vehicle, provided the person's physician certifies
that he or she has been free from seizures for a minimum period
of a year. Each case is reviewed by a medical advisory committee.
The situation may be different in your location. Ask your physician
about it, or contact a driver examination centre.
|How long do I have to give
up my driving licence for if I have only minor seizures and
do not lose consciousness?
In the UK, the DVLA regulations apply to all types of epileptic
seizure. A driving licence will be re-issued by the DVLA when
the person has been completely free of seizures for one year.
This includes including auras / warnings, myoclonic jerks and
other seizures where consciousness is not affected. The restrictions
apply after a single seizure and do not depend on a diagnosis
of epilepsy. The regualations are slightly different for people
who only have seizures during their sleep (nocturnal seizures).
| Living With
|Can people living with Epilepsy
lead normal lives?
Experience has shown that people with Epilepsy have fewer seizures
if they lead normal active lives. This means they should be
encouraged to find jobs, either full or part-time. People with
any disabilities are now protected under amendments to the Human
Rights Code (Canada). However, some jobs, because of the nature
of technical equipment or machinery, may not be recommended
for a person with Epilepsy. It is therefore most important for
a young adult to work with the school guidance department to
establish appropriate career goals.
|What can people with Epilepsy
do to help their health?
Like any medical condition, Epilepsy is affected by the general
health and well-being of the person affected. So, anything that
can be done to improve the state of the person can have a positive
effect on Epilepsy. This includes diet, exercise, rest, reducing
stress, avoiding depression, and staying away from alcohol and
|Who should know that I have Epilepsy?
Openness and honesty about Epilepsy is important. A child's
teacher should be informed about the type of seizure, what they
look like, their frequency, and any first aid requirements.
There are advantages and disadvantages to telling an employer.
What you tell them may depend upon how comfortable you are discussing
your Epilepsy, the kinds of seizures involved, and the type
of job. An employer may ask if you have a medical problem that
would make you unable to do your job, but they may not ask generally
about your medication condition.
|Is there prejudice against people
While much progress has been made in reducing societal prejudice
against Epilepsy, discrimination or rejection may also be a
problem for the person with the seizures. In addition, family
and friends may be overprotective or impose unnecessary restrictions.
In the end, the person with seizures may lose confidence or
feel "like a second class citizen".
|Are there any problems having
Women who use seizure-controlling drugs must be careful when
it comes to having children. There have been reported cases
of birth defects for these women. While the "normal"
rate of birth defects is 2-3% , women with epilepsy who are
not taking medication have a slightly higher (1/2%) risk of
malformations. Women on a single medication have a risk of about
6-7%, with some differences due to the particular medication
involved. Multiple drug combinations drastically increase the
risk. This creates a problem because the drugs may create risks
for the baby, but the need for anti-seizure drugs remains during
pregnancy. Seizures may even be more frequent during pregnancy,
and harm both the baby and the mother. A doctor may decide to
change or reduce a woman's medication if she plans to become
pregnant. In some cases, however, the doctor may recommend that
the risks of pregnancy are too great for the mother and child.
Any changes in medication must be considered carefully, and
a woman should never adjust her own medication. There are some
special issues relating to maternal health during pregnancy
for women with Epilepsy, and this may require special attention.
Finally, some seizure medications can lead to failures of oral
birth control pills.
|Can medications for controlling
Epilepsy harm a nursing baby?
Always check with your physician if you are on anticonvulsants
and planning to breast feed. Although anticonvulsant medication
has been measured in the breast milk of mothers with Epilepsy,
the amount is usually too low to harm the child.
|Can people living with Epilepsy
It is advised that before a person with Epilepsy goes swimming,
they should consult their doctor. When a person with Epilepsy
does go swimming, they should not do it alone (common water-safety
advice for everyone). It is also recommended that swimming be
done in a supervised pool rather than beaches, lakes, or rivers.
|Can Epilepsy lead to problems
Longstanding seizure disorders may be associated with seizure-induced
brain damage and memory problems. Also, children with Epilepsy
may experience learning or concentration problems because of
the neurological disorder or the medications. If a child who
has Epilepsy is having problems at school, either academically
or socially, the teacher and the principal should be asked to
help. If you would like your child to be tested by the school
psychologist, arrange it through the principal. If your child
is having academic problems, ask to see the Special Education
Consultant for the area. In consultation with the child's teacher,
a modified program can be arranged if necessary. Children with
Epilepsy should be allowed to take part in all regular school
activities, including sports.
|Can Epilepsy cause emotional
People with Epilepsy may develop depression for both biological
and social reasons. Some longstanding poorly controlled seizure
disorders may be associated with chronic personality changes.
Also, or short durations following temporal lobe seizures some
patients may have emotional "swings" or other thinking
difficulties. While Epilepsy is a medical problem, the person
with the seizures must also make a number of emotional adjustments.
The first challenge is acceptance of the diagnosis. Initially
people with Epilepsy and their families may experience shock
or denial. Anger, fear, and depression are also common. However,
with information and support, people with Epilepsy can understand
the condition and develop positive coping strategies.
|Can Epilepsy lead to problems
It is important to remember that people with Epilepsy can, and
do, live full, productive lives. If self-esteem becomes a problem,
open discussion with supportive friends, family, or a professional
counsellor can help you develop new ways of coping and a new
sense of hope.
Will I have epilepsy for the
rest of my life?
Epilepsy is a condition that varies from one person to another.
It can be difficult to know if someone's epilepsy will go
away, or if they will always have it. With the right drug
treatment, seizures can be completely controlled in up to
75% of people. In some people the tendency to have seizures
goes away and their seizures will stop. Other people may need
to take anti-epileptic drugs for a period of years, even if
seizures have stopped, as the underlying cause of the seizures
may still be there. More information on drug treatment.
|My daughter has epilepsy and
is not allowed to take part in some activities, such as swimming.
Is this necessary?
Most children with epilepsy can take part in the same activities
as other children. Simple safety precautions can help make activities
such as swimming and cycling safer for children with epilepsy.
|I have epilepsy. Will my children
develop the condition?
This is not an easy question to answer. Inheritance and genetic
factors play some part in the development of epilepsy. However
this often depends on the type of epilepsy the parent has. For
most people with epilepsy, the chance of their child developing
epilepsy is very small. More information on inheritance.
|My son has epilepsy. Is it
safe for him to have vaccinations?
This is a difficult area. There has been some concern recently
that the MMR (measles, mumps and rubella) vaccine is linked
to the development of seizures. Current research suggests that
there is no connection between the vaccine and epilepsy.
|Is it safe for me to drink
alcohol? What about taking recreational drugs?
For most people with epilepsy, the occasional drink is not a
problem. Too much alcohol however, has been shown to cause seizures,
particularly in the hangover period. The use of recreational
drugs is not recommended. Amphetamines, ecstasy, cocaine and
heroin have all been associated with seizures.
|Is it safe for me to use a
computer and watch television?
Most people with epilepsy can safely use a computer and watch
television. Only a few percent of people with epilepsy are photosensitive,
which means that their seizures are triggered by flickering
or flashing lights. Photosensitivity can usually be detected
on an EEG, and it may cause difficulties with strobe lighting
and fluorescent lights, as well as televisions and computers.
However, for people who are photosensitive, the frequency of
flashes on computer monitors and TVs is usually high enough
not to trigger seizures. More information on photosensitivity
|Will my car insurance cost
more because of my epilepsy?
Following the Disability Discrimination Act 1995, insurance
companies in the UK should not increase the cost of insurance
simply because a person has epilepsy. However it is still helpful
to obtain several quotes, in order to find the one which is
best for you. More information on car insurance.
|I have just been diagnosed
with epilepsy. Will I be able to get and keep a job?
Nearly all jobs are open to people with epilepsy and most people
with epilepsy can work in any area they choose. The type of
jobs someone can do will depend on the type and frequency of
their seizures. There are restrictions in the armed services,
for people who are still having seizures or are taking medication
for seizures. Work involving unguarded machinery, heights, open
water or fires is not recommended if seizures are not controlled.
In the UK, the Disability Discrimination Act protects people
with epilepsy against unreasonable discrimination. More information
|My employer fired me when I
had a seizure at work. What can I do?
In the UK, under the Disability Discrimination Act (DDA) 1995,
an employer may not treat a disabled person less favourably
than another employee, because of their disability, unless there
is a justifiable reason. Employers are required to make 'reasonable
adjustments' to enable a disabled person to remain in their
job. If you feel you have experienced discrimination at work
because of your epilepsy, there are organisations that may be
able to help. More information on employment and the DDA
|Do I have to tell anyone that
I have epilepsy?
In the UK people with epilepsy are not obliged to disclose that
they have epilepsy, however there are reasons why it can be
helpful to share this information with an employer. Information
on employment and disclosing epilepsy However, it is necessary
to inform the DVLA if you hold a driving licence. Information
It is your choice who you tell about your condition. Many people
find it helpful to inform friends, colleagues and teachers,
so that they can be prepared if a seizure occurs. It may also
be helpful to carry an identity card of bracelet, which gives
information about the condition.
|What occupations are not appropriate
for people with Epilepsy?
Given that they are trained with appropriate sets of skills
and/or education, the vast majority of people with Epilepsy
are capable of performing any job. Some exceptions to the rule
are: occupations in the military, commercial airlines, and fire
brigade as the lives of others may be endangered should a seizure
occur. Consideration should be give to the type of seizures
and how well they are controlled by medication.
|Can people with Epilepsy fly
Persons with Epilepsy may not be able to fly a plane. There
are strict standards that must be met by anyone wanting to get
their pilot's license. Each person is individually assessed
and must meet a regime of standards set up by the Civil Aviation
|Is there a problem with job safety?
Employers hiring someone with Epilepsy are often concerned that
job safety will be compromised in the event of an injury caused
by a seizure in the workplace. One study revealed that the accident
rate of workers with Epilepsy was lower than those employees
without disabilities. Liability is not a factor as long as the
employee has been placed in an appropriate job and reasonable
accommodation is provided as necessary.
|Can an employer ask about Epilepsy
on a job application?
It is illegal for an employer to ask about medical problems
on the application form. A person with Epilepsy (or any other
health problem) is not required to respond to any medical related
|Can an employer ask about Epilepsy
during a job interview?
Nothing precludes the interviewer from asking questions about
your health status, however it MUST relate to your ability to
perform the essential duties of the job. They may ask "Do
you have any medical problems that would make you unable to
do the job?", but they MAY NOT ask "Do you have any
|Can I be fired because I have
The Canadian Human Rights Code does not permit employers to
fire an employee because they had a seizure at work, or have
Epilepsy. Before a person is dismissed, the employer must show
that "reasonable accommodation" has been made to help
the person keep their job. Accommodations are determined by
doing a physical demands analysis, which is a breakdown of the
exact physical requirements necessary to perform the job.
|Can people with Epilepsy get
A person who has Epilepsy may qualify for assistance to prepare
for and to obtain employment. Assistance may take the form of
vocational assessment, counselling, academic, or technical training
or job placement. Application should be made to your nearest
A person who is severely disabled by seizures, and unable to
compete in the work force, may apply for assistance. Application
should be made to your nearest office.
Two other kinds of financial assistance are available in Canada,
depending on a person's income: General Assistance, usually
referred to as welfare, is available for anyone in urgent need
of financial aid. Special Assistance is for a person who is
employed, but has extraordinary needs such as a high prescription
drug costs. Application for each of these assistance programs
should be made through the municipal social service department.
|I have just been diagnosed
with epilepsy and want to know what I can or cannot do.
This depends on what your epilepsy is like, and how you feel
it affects you. This varies from one person to another. If seizures
are controlled, then epilepsy may not stop people from leading
a full life. There are some precautions which can lower the
risk of injury if seizures do happen. It is important to consider
each situation or activity individually, taking into account
the nature of your seizures.
and Other Disorders
|Is Epilepsy related to other
Epilepsy is not necessarily associated with other neurological
problems or learning disabilities. Occasionally, the source
of the seizures may be reflected in other neurological deficits.
Also, medication for seizures may cause sedations and thus decrease
the rate of learning. People with Epilepsy have the same range
of intelligence as the general population.
|Is Epilepsy related to mental
Epilepsy is not related to mental illness. Because of the involvement
of the brain, Epilepsy has been mistakenly associated with psychiatric
disorders. Epilepsy differs from psychiatric disorders in that
seizures last for very brief periods and begin and end abruptly.
Further, when not having seizures, people with Epilepsy need
not have any changes in their mood or behaviour.
|Can Epilepsy affect intelligence?
Seizures can affect intelligence, so prompt diagnosis and rapid
control of seizures is important. There is also a risk if seizures
are prolonged and there is a significant reduction in oxygen
in the brain during seizures. However, these are extremely rare
occurrences. In the case of developmentally delayed persons
with Epilepsy, it is most likely that the cause of the developmental
delay is also the cause of the seizures. In most cases, people
with Epilepsy have normal intelligence.
|Is there a link between memory
loss and Epilepsy?
Some people with Epilepsy do experience a difficulty in recalling
distant and recent events. Often, this is caused by the medications
used to treat Epilepsy, or by regular seizure activity. People
affected in this way can learn to compensate by using lists
and reminders, and by creating an organized environment.
|Is Epilepsy related to asthma?
Asthma occurs in children with Epilepsy at about the same frequency
as it occurs in the general population. Likewise, the reverse
is also true. The drug theophylline can trigger seizures.
|Are there any diseases that persons
with Epilepsy more prone to?
People with Epilepsy who are on medications may experience side
effects that makes them more susceptible to other diseases and
disorders. One common condition is Hyperplaxia, an over-growth
of the gums caused by the drug Dilantin. Other common problems
are liver dysfunction and depression.
|Do animals get Epilepsy?
Epilepsy can occur in animals. Like humans, Epilepsy in animals
is really just abnormal electrical activity in the brain.
|Can dogs sense a seizure in humans
before it strikes?
It is possible that some dogs are able to detect pre-seizure
changes in the physiology of some people with Epilepsy before
the person becomes aware of them. In many cases, the person
with Epilepsy is aware of an aura before the onset of the main
part of the seizure. Not enough is known about how dogs can
detect seizures before their onset to know exactly what sense(s)
are involved in this detection. However, one might hypothesize
that since dogs can detect chemical changes due to fear, seizures
that are preceded by a sense of fear might also produce detectable