Epilepsy

Epilepsy

Epilepsy is a collective term for a number of different conditions that all lead to sudden and uncontrollable epileptic seizures. An epileptic seizure can be anything from small twitches in one part of the body while one is conscious, to loss of consciousness and convulsions in the whole body.

What is epilepsy?

Epilepsy is a collective term for various types of seizures caused by disturbances in the electrical activity of the brain. Epilepsy affects slightly less than 1% of the population. If one is exposed to very strong triggering factors, in principle anyone can have an epileptic seizure. However, those with epilepsy have an abnormally low threshold for having such seizures and can have them completely unprovoked.

Causes of epilepsy

Epilepsy can be caused by almost any form of injury or disease in the brain. In some cases, epilepsy can be partly explained by heredity. In approximately half of all epilepsy cases, no reason can be found as to why they have developed epilepsy.

What causes an epileptic seizure?

An epileptic seizure is caused by an abnormally large number of brain cells suddenly sending out electrical signals at the same time. This disrupts the brain's normal electrical activity and causes uncontrollable seizures.

Different types of epileptic seizures

There are many different types of epileptic seizures. It is common to divide them into generalized seizures, which start all over the brain at the same time, and partial seizures, which start in a specific place in the brain. For both seizure types, there are a number of subgroups. Status epilepticus is the most serious form of seizure. In this condition, you have repeated epileptic seizures without being conscious between seizures.

Symptoms of epilepsy

The symptoms of an epileptic seizure vary between the different seizure types.

Generalized seizures cause loss of consciousness, stiffness of the body followed by convulsions, foaming at the mouth and cessation of breathing. After a seizure, it is common for the person not to remember the seizure and to feel tired.

Partial seizures have far less obvious symptoms. Consciousness is preserved, but how conscious one is can vary from completely clear to very absent. Twitching in a body part is common, as is repetition of an action.

Good advice for epilepsy

• Try to have a regular life, a fixed circadian rhythm is particularly important

• Avoid factors that can trigger epileptic seizures: flickering lights (computers, television, cinema, discos), lack of sleep, large amounts of alcohol, low blood sugar (avoid periods of fasting) and stress

• Physical activity is beneficial and can reduce the number of seizures. However, you should avoid situations where an epileptic seizure could become dangerous, such as swimming alone or mountain climbing

• There are many aids for epileptics that can be sensible to use, for example epilepsy alarms.

Treatment of epilepsy

Epilepsy is mainly treated with medication. The treatment consists of fixed medications (seizure prevention) and possibly medications to be used only during seizures. The medication group antiepileptics are used as fixed medications. This is a large group of medicines, and which type you should take mainly depends on the type of seizure you have. Most people become seizure-free with one type of antiepileptic drug, but some have to combine several different ones to get the seizures under control. In addition, there are some who never become completely seizure-free.

In severe seizures (status epilepticus or seizures lasting more than 5 minutes), anticonvulsants are used to stop the seizure. Because you do not have the opportunity to swallow during an epileptic attack, forms of medicine are used that avoid it, for example suppositories or syringes.

Epilepsy medicine (antiepileptics)

• Epilepsy drugs, like all other drugs, can cause side effects. The side effects are most often related to the brain and typical side effects are fatigue, dizziness, concentration and learning difficulties. Some side effects depend on the dose you take, others not.

• It is not unusual to have to try different types of epilepsy medicine before finding the optimal treatment.

• An annual check-up with a specialist and a blood test to see how the medicine is taken up in the body is recommended by the Norwegian Epilepsy Association.

• Check if your epilepsy medicine is marked with a red warning triangle. Medicines with a red warning triangle can be dangerous to traffic. Be extra careful if you have recently started using such medicine. Read more about medicine and driving here.

• Use epilepsy medicine exactly as prescribed by your doctor. At the start, you first receive a low dose, which is gradually increased to an effective dose. This is for the body to get used to the medicine and to avoid side effects. It is important that you never stop epilepsy medicine suddenly. At the end of treatment, the dose must be gradually reduced in consultation with a doctor.

• Epilepsy medicine can affect many other medicines. Among other things, epilepsy medicine can reduce the effectiveness of contraceptives. Therefore, always remember to inform the doctor and the pharmacist that you are using epilepsy medicine if you are to have other medicines.

• If you want to get pregnant and have epilepsy, it is best to plan your pregnancy carefully. It is important to have good seizure control and to have the epilepsy medication adapted to reduce the risk of harm to the foetus.

When should you contact a doctor in connection with epilepsy?

• If an epileptic seizure lasts more than 5 minutes (call 113).

• In case of status epilepticus, repeated epileptic seizures without being conscious between seizures (call 113).

• If someone who has not known epilepsy has an epileptic seizure.

• If someone having an epileptic seizure appears to be seriously injured as a result of the seizure.

• If you have epilepsy and discover that you have become pregnant unplanned, you should contact a doctor as soon as possible

Sources:

Norwegian Health Information Technology, Norwegian Electronic Medical Handbook, Norwegian Epilepsy Association, Journal of the Norwegian Medical Association, GlaxoSmithKline, Pfizer and the Norwegian Institute of Public Health.