Epilepsy - what is epilepsy? Epilepsy is currently defined as a tendency to have recurrent seizures (sometimes called fits). A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. This disruption results in the brain's messages becoming halted or mixed up.
The brain is responsible for all the functions of your body, so what you experience during a seizure will depend on where in your brain the epileptic activity begins and how widely and rapidly it spreads. For this reason, there are many different types of seizure and each person will experience epilepsy in a way that is unique to them.
What causes epilepsy? Sometimes the reason epilepsy develops is clear. It could be because of brain damage caused by a difficult birth; a severe blow to the head; a stroke; or an infection of the brain such as meningitis. Very occasionally the cause is a brain tumour. Epilepsy with a known cause is called 'symptomatic' epilepsy. For most people - six out of ten, in fact - there is no known cause and this is called 'idiopathic' epilepsy.
How is epilepsy diagnosed? There is no conclusive test for epilepsy, although tests such as the electroencephalogram (EEG) - which records brainwave patterns - can give doctors useful information. Epilepsy should be diagnosed by a doctor with specialist training in epilepsy. An epilepsy specialist will use their own expert knowledge, along with test results and the patient's or witness's accounts of the seizures, to make the diagnosis.
Because epilepsy is currently defined as the tendency to have recurrent seizures, it is unusual to be diagnosed with epilepsy after only one seizure. In the UK around one in 20 people will have a single seizure at some point in their life, whereas one in 131 people have epilepsy.
Lifestyle restrictions - it is important for people with epilepsy to try to get over any fear of seizures and live their lives as normally as possible. However, there are a number of restrictions such as those outlined below.
- To hold a civilian driving licence in the UK you need to have been seizure-free for 12 months, or only had seizures at night while asleep.
- Activities such as climbing and diving are best avoided if you are still having seizures and if you decide to go swimming it is best to go with a friend who can keep an eye on you, and help out if necessary. Inform the lifeguard when swimming in a public pool.
- Flickering lights, such as strobe lights in nightclubs, can trigger seizures in some people. If this is the case, clubs with strobes are best avoided. It is also sensible to avoid playing computer games for long periods of time as the flickering screen has been associated with seizures in some susceptible people with epilepsy.
Some people's seizures can be brought on by lack of sleep, or by drinking alcohol the night before. This calls for a more moderate lifestyle, which can be particularly difficult for teenagers for whom this is more commonly a problem.
Rigid guidelines are impossible as each person's epilepsy is different. For example, it makes a big difference whether the fits are unpredictable or whether they always occur at the same time. Always discuss your own particular circumstances with your specialist.
Treatment of epilepsy - epilepsy is usually treated with anti-epileptic drugs (AEDs). They act on the brain, trying to reduce seizures or stop seizures from happening. Lots of people with epilepsy find that when they take their AEDs properly, they have fewer or no seizures.
If AEDs don't work very well for a person, there are some other treatments that may be helpful. These include brain surgery, vagus nerve stimulation and the ketogenic diet.
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