What are Seizures?

What are Seizures? Seizure–Provoking Factors • Irregular eating and sleeping habits particularly when associated with severe mental stress and anxiety. • Physical exhaustion • Emotional upsets, more so for persons emotionally very sensitive. • Fever, particularly in children • Pregnancy • Epilepsy has been known throughout history. It observes no cultural, geographical, racial or economical boundaries. It can occur to anybody at any age. Approximately 1 in every 100 suffers from it. 70-75% have their first attack in childhood. If not treated properly and at the right time, epileptic attacks recur and can hamper growth and development. Epilepsy thus poses a widespread major problem. • Missed medication. • Lack of sleep. • Illness (both with and without fever). • Severe psychological stress. • Use of cocaine and other recreational drugs such as Ecstasy. • Over–the–counter or prescription medications or supplements that decrease the effectiveness of seizure medicines. • Alcohol over intake and alcohol withdrawal state. • Nutritional deficiencies: vitamins and minerals. • Premenstrual tension. • It may seem obvious that heredity (genetics) plays an important role in many cases of epilepsy in very young children, but it can be a factor for people of any age. For instance, not everyone who has a serious head injury (a clear cause of seizures) will develop epilepsy. Those who do develop epilepsy are more likely to have a history of seizures in their family. This family history suggests that it is easier for them to develop epilepsy than for others with no genetic predisposition. • Epilepsy in which the seizures begin from both sides of the brain at the same time is called primary generalized epilepsy. Primary generalized epilepsy is more likely to involve genetic factors than partial epilepsy, in which the seizures arise from a limited area of the brain. Are the brothers and sisters of children with epilepsy more likely to develop it? Their risk is slightly higher than usual, not because they will “Catch” it (that can’t happen) but because there may be a genetic tendency in the family that makes seizures and epilepsy more likely. Even so, most of them will not develop epilepsy. Epilepsy is more likely to occur in a brother or sister if the child with epilepsy has primary generalized seizures. Depending on the type of epilepsy and the number of family members who are affected, only about 4% to 10% of the other children in the family will have epilepsy. If I have epilepsy, will my children also have it? • Less than 2 people out of every 100 (2%) develop epilepsy at some point during their lifetime. The risk for children whose father has epilepsy is only slightly higher. If the mother has epilepsy and the father does not, the risk is still less than 5%. If both parents have epilepsy, the risk is a bit higher. Most children will not inherit epilepsy from a parent, but the chance of inheriting epilepsy is higher for some types. • If you have epilepsy, it is normal for you to be afraid that your children will have epilepsy too. However, a fear that your children will have epilepsy is not enough reason to decide against having any. The risk is low, most children outgrow epilepsy, and most people who have it are able to control their seizures by taking one medicine. • About 80% of people with epilepsy treated with seizure medicines remain free of seizures for at least 2 years. Many never have any more seizures. The chances of becoming completely seizure–free are best if there is no known brain injury or abnormality, and if the person has a normal neurological examination and EEG. • Of adults, 50–60% will be seizure–free after using their first seizure medicine. Another 11–20% will gain seizure control using the second medication, leaving 20–30% who are still having seizures. • Among those who are young when their epilepsy is diagnosed, 20% start on medication and never have another seizure after medication is stopped, even when they reach adulthood. About 50–60% of children become seizure–free with the first medication used, but 30% never stop taking seizure medicines. About 10% have a really difficult time with “Intractable seizures.” • The more time that passes without seizures, the greater is the chance of staying seizure–free. Over 50% of children outgrow their epilepsy. Twenty years after the diagnosis, three–quarters of people will have been seizure–free for at least 5 years, although some may still need to take daily medication. Will I have to take seizure medicines for the rest of my life? • Many people who are seizure–free for 2 to 4 years can stop taking their medications, under their doctor’s supervision, without having further seizures. However, about 30% of children and 30% to 65% of adults will have seizures again. You need to discuss this with your neurologist and, if the decision is made to go off medication, agree on a plan for stopping gradually over weeks or months, not all at once. Currently, most neurologists in the United States and Canada consider withdrawing seizure medicines after someone has been seizure–free for 1 to 2 years. • Whether it will be safe for you to stop taking your seizure medicine depends partly on whether you drive a car or engage in other activities that would be dangerous if you had another seizure. If your answer is “yes,” you will need to be more cautious. I’ve been taking seizure medicine but I’m still having seizures. Will I always have them? • Some people with seizures that cannot be controlled with tolerable doses of seizure medicine (who have what doctors call “Intractable epilepsy”) do eventually become seizure–free. The longer that you continue to have seizures after the diagnosis of epilepsy is made, however, the lower the chance that your seizures will stop. • Your doctor will want you to try different medications or combinations of them. The more medicines that are unable to control your seizures, however, the less likely it is that another medication regimen will fully succeed. Other kinds of treatments, such as vagus nerve stimulation or epilepsy surgery, may be very helpful for some people who continue to have seizures while taking seizure medicines. The overall life expectancy of people who have epilepsy is the same as for anybody else if they are otherwise pretty healthy. Some people whose epilepsy is caused by things like a stroke or a brain tumor may die sooner from those conditions, of course. A long–lasting convulsive seizure (called “Tonic–clonic status epilepticus”) is a medical emergency. If not stopped within about 30 minutes, it may cause permanent injury or death. In addition, people with epilepsy can also die from inhaling vomit during or just after a seizure. This can be prevented if someone will turn the person onto one side when the seizure begins and ensures that the vomit completely comes out of the mouth. In general, seizures are hardly ever fatal, even if the person loses consciousness. People who are not seizure–free need to be careful about possible accidents during a seizure. Death from drowning is more common among people with epilepsy. It can even occur in a tub with only a few inches of water, so people who have seizures probably should stick to showers instead of baths. If you have epilepsy, your doctor–and the agency in your state or province responsible for licensing drivers–will help you decide whether it is safe and legal for you to drive. You should also be careful on train or subway platforms and when walking near busy streets. However,with some planning, you should be able to lead a life that is both active and safe.