The brain is dependent upon billions of nerve cells acting in concert to coordinate myriads of bodily functions.
Much of the function of the brain works through the creation of electrical impulses. When this electrical activity is altered, and becomes excessive and uncoordinated, a seizure may result, and this can cause changes in awareness, loss of consciousness and generalized uncontrolled motor activity. Epilepsy is a condition in which a patient has an ongoing risk of having a seizure occur.
There are different types of seizures. Perhaps the one most people think of this the tonic-clonic or grand mal seizure; in lay terms this is sometimes called a convulsion. The most dramatic of all seizures, the tonic-clonic variety is characterized by loss of consciousness, collapse and a rhythmic jerking of all muscle groups. Other seizures may be characterized by simple local muscle shaking, a spell of staring and unresponsiveness or atypical sensations of touch or smell.
Patients with tonic-clonic seizures have no memory for the event; this may occur in other seizure types. After the seizure has subsided, patients may have a variable period of confusion or non-specific symptoms such as headache and nausea. Also, depending on the seizure type and the etiology, a patient may be at risk for another seizure in the near future.
There are multiple causes of epilepsy, all having an underlying abnormality affecting the brain’s electrical functioning. Injuries from tumor, stroke, trauma or infection are common causes. Sometimes, the cause is not discovered. There are also several causes of seizures, which are not epilepsy; drug withdrawal (alcohol), drug stimulation (cocaine) and very low blood sugar are examples.
Neurologists are specialists in epilepsy and seizures. The most common tests they will utilize to evaluate a seizure are spinal taps, EEGs and brain imaging (CT and/or MRI). Spinal taps are usually performed if there is a concern about an underlying brain infection, which would be suspected in the presence of fever, headache and a stiff neck. EEGs measure the electrical activity of your brain, and may help in determining the risk of recurrence, or help differentiate seizures from other conditions. Finally, a CT scan or MRI provides a picture of the brain to see if there are any structural lesions such as tumors or scars; most patients with epilepsy have normal brain imaging results.
There are multiple medication options available to help normalize the brain’s electrical activity in patients with epilepsy. Some patients require more than one medication to optimally control the condition. There are also other issues which need to be discussed, ranging from the safety of driving, to whether alcohol should be minimized or eliminated, to the interaction of antiseizure medications with other prescriptions. The coordination between your primary care physician and the neurologist who manages epilepsy is essential, because the vast majority of patients can live a normal, healthy life.
To make an appointment with a NuHealth neurologist specializing in seizures please call 516-572-6262.