November 14, 2023 // by Philip Overby, MD
November is Epilepsy awareness month.
Epilepsy is one of the most common neurological disorders, affecting people of all ages. There are roughly 470,000 children living with epilepsy in the United States alone. Some common questions about epilepsy include:
1. When are seizures considered epilepsy?
- Epilepsy is diagnosed when a person has two or more unprovoked seizures.
- There are many different types of seizures, but all are caused by abnormal electrical activity in the brain.
- Causes of epilepsy include trauma, infection, genetic abnormalities, tumors, and brain malformations.
- Genetic testing is becoming more helpful for determining the cause of the seizures, but often times the cause remains unknown.
2. How is epilepsy diagnosed?
- Some of the methods used to diagnose and treat epilepsy include EEGs (electroencephalograms), MRIs, PET scans, genetic testing and more.
- If a child, especially an infant, is experiencing odd movements or changes in consciousness, the child neurology and epilepsy team can help evaluate the cause and develop a treatment strategy.
3. What are the different types of seizures?
- Not all seizures are described as epilepsy, for example, febrile seizures are convulsions triggered by fever.
- Epilepsy is usually diagnosed if a child has had more than two unprovoked seizure, is likely to have another, and if their seizure is not directly caused by another medical condition such as fever or low blood sugar.
- Those with epilepsy can have more than one kind of seizure. Seizures are generally categorized into two main groups:
- Generalized seizures: these are caused by abnormal electrical discharges in the whole brain. Generalized seizures cause loss of consciousness but the presentation can vary from staring spells to widespread shaking, or even movements that are confused with reflux.
- Localization related (focal) seizures: these occur when only one area of the brain is affected by the abnormal electrical discharges. These may or may not impair consciousness. Focal seizures can appear as just a sensation or more typical jerking movement.
4. How are seizures treated?
There are many treatment options available that allow children with epilepsy to live a normal, active childhood. These include:
- Anti-seizure medications
- Epilepsy surgery
- In some cases a special diet (low glycemic, ketogenic or modified Atkins) can be used
What do to when someone is having a seizure:
- Make the area around the person safe by removing nearby objects, turning the person on their side, and putting a pillow under their head if available.
- Avoid trying to stop the movements or restrain the person.
- Administer rescue medication if indicated and available.
When to call 911:
- The seizure lasts longer than 5 minutes (after rescue medication given)
- There is an injury
- There is difficulty breathing
- There are repeated seizures
- The person does not return to their usual state
Witnessing a seizure can be frightening, but staying calm and following these guidelines until help arrives is important.
For more information, you can visit our pediatric neurology page, or schedule a consultation with a BCHP neurologist.