- 65 million people around the world have epilepsy.
- 3.4 million people (including 470,000 children and 1 million older adults ages 55+) in the United States have epilepsy.
- 35,000 people on Long Island live with epilepsy.
- 1 in 26 people in the United States will develop epilepsy in their lifetime.
- 150,000 people are diagnosed with epilepsy in the United States each year.
- About 1 out of 3 people with epilepsy live with uncontrolled seizures because no available treatment works for them.
- For 6 out of 10 people with epilepsy, the cause of epilepsy is unknown.
DEFINITION OF EPILEPSY:
Epilepsy is a neurological condition, which means it affects the brain, the main part of the nervous system. Epilepsy may also be called a “seizure disorder.” People are usually diagnosed with epilepsy if:
- They have had 2 or more unprovoked seizures.
- They are likely to have more seizures.
- The seizure wasn’t provoked or caused by another treatable medical condition like an infection or diabetes.
Seizures seen in epilepsy are temporary changes in behavior caused by problems with the electrical and chemical activity of the brain. A seizure occurs when there is a temporary change in the way the brain sends electrical signals. When a seizure happens, there is a “short circuit” in the way messages are sent between brain cells. Seizures may look and feel different from one person to the next. What happens during a seizure depends on the area of brain affected.
Epileptic seizures may be caused by:
- Brain injury at birth
- Brain lesions
- Brain infections
- Brain trauma
- Changes in brain development
- Most of the time, however, the cause is unknown.
Epileptic seizures can result in a change in:
Seizure types are characterized by where they start; whether or not awareness is affected; and whether or not they involve other symptoms such as movement.
GENERALIZED TONIC–CLONIC SEIZURES (previously called GRAND MAL) – characterized by loss of consciousness, falling, convulsions, muscle rigidity, jerking, vomiting, and loss of bladder control. These seizures generally last one to five minutes followed by periods of confusion, headaches, or the need to rest/sleep.
GENERALIZED ABSENCE SEIZURES (previously called PETIT MAL) – characterized by blank staring, rapid blinking, chewing motions. These seizures only last five to ten seconds but can happen often during one day. The person is unaware of what has happened during the seizure.
FOCAL SEIZURES – WITH ALTERED AWARENESS (previously called COMPLEX PARTIAL)– characterized by staring, chewing movements, picking at clothing, random, robotic body movement and wandering, impaired consciousness, being out of touch with surroundings and an inability to respond to questions or commands. These seizures usually last between one and three minutes followed by a period of confusion, unawareness, and the need to rest/sleep.
FOCAL SEIZURE – NO CHANGE IN AWARENESS (previously called SIMPLE PARTIAL SEIZURES) –characterized by jerking of one or more parts of the body, arms, legs, or face, seeing or hearing things that aren’t there, feeling scared, sad, angry, or happy for no reason. These seizures generally last a few seconds to a few minutes. These are the only seizures where the person is fully aware and knows what is happening.
ATONIC SEIZURES (previously called DROP ATTACKS) – characterized by sudden collapse and brief loss of consciousness. These seizures generally last 10-60 seconds, after which they become fully aware and conscious.
MYOCLONIC SEIZURES – characterized by sudden, brief, massive jerks involving all or part of the body, spilling or dropping things. These seizures usually last a few seconds with complete return to awareness.
INFANTILE SPASMS – characterized by sudden body movements, if sitting up, head and arms falling forward, if lying down, knees folding up and arms and head lifting up. These seizures happen in babies, typically between 3 and 24 months old.
FEBRILE SEIZURES – these seizures are not generally considered to be epileptic. Children aged 3 months to 5 or 6 years old may have tonic-clonic seizures when they have a high fever. Febrile seizures occur in 2% to 5% of all children. There is a slight tendency for them to run in families. The vast majority of children with febrile seizures do not have seizures without fever after age 5.
TREATMENT FOR EPILEPSY:
The majority of epileptic seizures are controlled by medication, particularly anti-epileptic drugs. The type of treatment prescribed will depend on several factors, including the frequency and severity of the seizures and the person’s age, overall health, and medical history.
- Anti-seizure medications control seizures in 2 out of 3 people
- Implanted stimulation devices such as Vagal Nerve Stimulation and Responsive Neuro-Stimulation
- Medically prescribed dietary therapy such as the Ketogenic Diet; Modified Atkins Diet; Low Glycemic Index Diet
- Epilepsy Surgery
Evaluation by an epilepsy specialist (epileptologist) is critical when medicines are NOT working!
FIRST AID FOR SEIZURES:
I. GENERALIZED TONIC-CLONIC SEIZURES (also known as GRAND MAL):
1. If possible, notice when the seizure begins. Keep track of time.
2. Keep Calm; the person is usually not suffering or in danger.
3. Help the person into a lying position.
4. Turn the person’s head to one side.
5. Clear the area of hard or sharp objects. If possible, put something soft under the head.
6. DO NOT PUT ANYTHING IN THE PERSON’S MOUTH
7. Do NOT hold the person down.
8. Remove glasses. Loosen tight clothing.
9. Stand by until the person fully recovers consciousness and explain what has happened.
10. Allow the person to rest.
11. Do NOT offer food or drink until the person is fully alert.
WHEN TO CALL 911:
1. If the seizure lasts more than 5 minutes
2. If the person has more than one seizure in a brief period of time
3. If the person in injured, pregnant, or has diabetes
4. If the seizure occurred in water
5. If the person does not start breathing after the seizure, check the airway and begin mouth to mouth resuscitation immediately.
II. GENERALIZED ABSENCE SEIZURES (also known as PETIT MAL):
1. Notice the length of the seizure and behavior which occurs during the seizure.
2. If the person is a child, notify a parent or guardian.
3. Repeat information, instructions, etc., since the person won’t be aware of their surroundings or able to process information during the seizure.
III. FOCAL SEIZURES WITH ALTERED AWARENESS (also known as COMPLEX PARTIAL):
1. Do not forcefully restrain or grab the person.
2. Speak calmly to the person and explain what is happening to others; keep crowds from forming.
3. Gently steer the moving person away from potential danger.
4. Stay with the person until he or she is fully alert.
5. Keep track of time.
WHEN TO CALL 911
1. If the person is injured during the seizure
2. If the seizure is prolonged (more than 5 to 10 minutes of impaired consciousness). The period of recuperation after the seizure is known as the post-ictal phase. This can last much longer than the seizure itself.
3. If there are two or more complex partial seizures without return of consciousness between seizures.
4. If the seizure occurred in water.
IV. FOCAL SEIZURE – NO CHANGE IN AWARENESS (also known as SIMPLE PARTIAL SEIZURES):
1. Give care and comfort.
2. Keep track of time.
3. Protect the person from injury.
4. Keep onlookers away and explain to others what is happening.
5. Stay with the person until the seizure is over.
6. Be sensitive and supportive.
V. ATONIC SEIZURES (also known as DROP ATTACKS):
1. Give care and comfort.
2. Follow first aid for seizures with altered awareness.
VI. MYOCLONIC SEIZURES:
1. Give care and comfort.
2. Follow first aid for seizures with no change in awareness.
VII. INFANTILE SPASMS:
1. Take infant to doctor or emergency room if this is the first time this has happened.
VIII. FEBRILE SEIZURES:
1. Record the time the seizure started
2. Place the child on their side, preferably on a soft surface
3. Remove any hazards from around the child
4. Remove any excessive clothing to help cool the child
5. If this is a first-time seizure, call 911
6. Contact pediatrician immediately for further assistance.