epilepsy
- Article
- 2021-03-09
Epilepsy is a spectrum of brain disorders ranging from serious, life-threatening and disabling to much more benign. In epilepsy, the normal pattern of neuronal activity is disrupted, leading to strange sensations, emotions and behavior or sometimes convulsions, muscle spasms and loss of consciousness. The epilepsy has many possible causes and there are different types of seizures. Anything that disrupts the normal pattern of neuron activity - from illness to brain damage to abnormal brain development - can lead to seizures. Epilepsy can arise from an abnormality in the brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or a combination of these and other factors. Having a single seizure due to a high fever (called febrile seizures) or head injury does not necessarily mean someone has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy.
Therapy
Once epilepsy has been diagnosed, it is important to start treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medications and surgical techniques. Some medications are more effective for specific types of seizures. Someone with seizures, especially those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets can help control seizures when medications are ineffective or cause serious side effects. In November 2019, the Food and Drug Administration approved cenobamate tablets for the treatment of partial-onset seizures in adults (seizures in which people may have impaired consciousness or lose consciousness completely).
Prognosis
Although epilepsy cannot be cured, in some people seizures can be controlled with medication, diet, equipment, and / or surgery. Most seizures do not cause brain damage, but persistent uncontrolled seizures can cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems along with seizures. Problems can also arise due to the stigma associated with epilepsy, which can lead to embarrassment and frustration or bullying, teasing, or avoidance in school and other social situations. For many people with epilepsy, the risk of seizures limits their independence (some states deny driver's licenses to people with epilepsy) and recreational activities.
Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death from epilepsy.
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