Part III Epilepsy – symptoms , etiology or causes, complication to life threatening ones, & how its diagnosed by a neurologist!

Symptoms of Epilepsy:

Seizure symptoms vary depending on the type of seizure. Because epilepsy is caused by certain activity in the brain, seizures can affect any brain process. Seizure symptoms may include:

  • Temporary confusion.
  • A staring spell.
  • Stiff muscles.
  • Uncontrollable jerking movements of the arms and legs.
  • Loss of consciousness.
  • Psychological symptoms such as fear, anxiety or deja vu.

Sometimes people with epilepsy may have changes in their behavior. They also may have symptoms of psychosis.

Most people with epilepsy tend to have the same type of seizure each time. Symptoms are usually similar from episode to episode.

Warning signs of seizures = AURAS for some not all people diagnosed with Epilepsy.

Some people with focal seizures have warning signs in the moments before a seizure begins. These warning signs are known as aura.

Warning signs might include a feeling in the stomach. Or they might include emotions such as fear. Some people might feel deja vu. Auras also might be a taste or a smell. They might even be visual, such as a steady or flashing light, a color, or a shape. Some people may experience dizziness and loss of balance. And some people may see things that aren’t there, known as hallucinations.

Seizures are classified as either focal or generalized, based on how and where the brain activity causing the seizure begins.

Etiologies or Causes of Epilepsy:

Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including:

  • Genetic influence. Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent.For most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures.
  • Head trauma. Head trauma as  a result of a car accident or other traumatic injury can cause epilepsy.
  • Factors in the brain. Brain tumors can cause epilepsy. Epilepsy also may be caused by the way blood vessels form in the brain. People with blood vessel conditions such as arteriovenous malformations and cavernous malformations can have seizures. And in adults older than age 35, stroke is a leading cause of epilepsy.
  • Infections. Meningitis, HIV, viral encephalitis and some parasitic infections can cause epilepsy.
  • Injury before birth. Before they’re born, babies are sensitive to brain damage that could be caused by several factors. They might include an infection in the mother, poor nutrition or not enough oxygen. This brain damage can result in epilepsy or cerebral palsy.
  • Developmental conditions. Epilepsy can sometimes occur with developmental conditions. People with autism are more likely to have epilepsy than are people without autism. Research also has found that people with epilepsy are more likely to have attention-deficit/hyperactivity disorder (ADHD) and other developmental conditions. Having both conditions may be related to genes.


Having a seizure at certain times can be dangerous to yourself or others.

  • Falling. If you fall during a seizure, you can injure your head or break a bone.
  • Drowning. People with epilepsy are 13 to 19 times more likely to drown while swimming or bathing than people without epilepsy. The risk is higher because you might have a seizure while in the water.
  • Car accidents. A seizure that causes either loss of awareness or control can be dangerous if you’re driving a car or operating other equipment.Many states have driver’s license restrictions related to a driver’s ability to control seizures. In these states, there is a minimum amount of time that a driver must be seizure-free before being cleared to drive. The amount of time may range from months to years.
  • Trouble with sleep. People who have epilepsy may have trouble falling asleep or staying asleep, known as insomnia.
  • Pregnancy complications. Seizures during pregnancy pose dangers to both mother and baby. Also, certain anti-seizure medicines increase the risk of birth defects. If you have epilepsy and you’re considering becoming pregnant, get medical help as you plan your pregnancy.Most women with epilepsy can become pregnant and have healthy babies. You need to be carefully monitored throughout pregnancy. Your medicines may need to be adjusted. It’s very important that you work with your healthcare team to plan your pregnancy.
  • Memory loss. People with some types of epilepsy have trouble with memory.

Emotional health issues

People with epilepsy are more likely to have mental health conditions. They may be a result of dealing with the condition itself as well as medicine side effects. But even people with well-controlled epilepsy are at increased risk. Emotional health problems that may affect people with epilepsy include:

  • Depression.
  • Anxiety.
  • Suicidal thoughts and behaviors.

Other life-threatening complications of epilepsy are not common but may happen. These include:

  • Status epilepticus. This condition occurs if you’re in a state of continuous seizure activity lasting more than five minutes. Or it may occur if you have seizures without regaining full consciousness in between them. People with status epilepticus have an increased risk of permanent brain damage and death.
  • Sudden unexpected death in epilepsy (SUDEP). People with epilepsy also have a small risk of sudden unexpected death. The cause is unknown, but some research shows that it may occur due to heart or respiratory conditions.People with frequent tonic-clonic seizures or people whose seizures aren’t controlled by medicines may be at higher risk of SUDEP. Overall, about 1% of people with epilepsy die of SUDEP. It’s most common in those with severe epilepsy that doesn’t respond to treatment.

How Epilepsy is Diagnosed with a Epilepsy Assessment:

There are several different types of epilepsy, characterized by seizures, with symptoms causing changes in awareness, muscle tone, emotions, behavior and sensory experience. Proper treatment starts with a careful assessment of the person’s seizures, which may include:

  • Medical and seizure history and neurological examination, particular a neurological doctor-a neurologist and in some cases with the neurologist being the attending doctor a neurosurgeon may be following also as a consulting doctor, if needed.  Remember having a neurologist, particularly one majored in epilepsy is what you want!  This is so nothing is over looked in the care for you or your family, you want only the best.
  • Neuroimaging: magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), functional MRI (fMRI)
  • Electroencephalogram (EEG), including outpatient video-EEG monitoring and long-term video-EEG monitoring-The diagnosis involves conducting a careful neurological history, a 30-minute brain wave study (electroencephalogram or EEG), and imaging of the brain (magnetic resonance imaging or MRI).Sometimes we need a longer period to monitor the brain. For example, we sometimes request a 72-hour EEG which usually is performed at home. If the diagnosis is unclear, we’ll admit the patient to an epilepsy monitoring unit (EMU), where we use video and EEG to observe the patient’s seizures. Once we fully understand the patient’s type of epilepsy  the neurologist chooses the right treatment medication but if doesn’t work than the alternative treatment best for that patient.
  • Wada testing
  • Neuropsychological, speech and hearing evaluations
  • Physical and occupational therapy
  • Counseling and support services for patients and caregivers




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