Understanding Epilepsy

The disorder has a variety of potential causes

By Dr. Joseph Sirven, Neurologist, Mayo Clinic

Epilepsy is a surprisingly common neurological disorder. It affects 1 in 26 Americans, including men and women of all races, ethnic backgrounds and ages. Yet many people don’t understand epilepsy unless they have first-hand experience with it.

After spending my entire medical career focused on treating patients with epilepsy, I want more people to have a basic understanding of it. It’s also important to know that there are many reasons to have hope, including advancements in treatment.

Epilepsy and seizures

Epilepsy is a neurological disorder that causes an imbalance in the brain’s electrical activity, which in turn causes seizures for some patients. The seizures can last from a few seconds to a few minutes, with varying frequency.

However, not everyone with epilepsy experiences strong seizures or muscle contractions. Some simply stare blankly for a few seconds during a seizure or experience temporary confusion, fear or anxiety.

Seizures may be caused by multiple factors, including low blood pressure, heart problems or convulsions from fever. Only seizures that originate in the brain are considered epileptic seizures.

Causes, diagnosis and treatment

Epilepsy has a variety of potential causes, including brain injuries, tumors, stroke, infectious diseases, developmental disorders or even prenatal injuries. High fevers sometimes can be linked to seizures in children, and dementia can increase the risk of epilepsy for adults. While research has found a genetic link to some types of epilepsy, genetics likely are only part of the cause.

Generally, at least two unprovoked seizures are required for an epilepsy diagnosis. Doctors often start with a neurological exam and blood tests. They may also recommend different types of brain scans in hopes of gaining insight into brain abnormalities.

Here’s the good news: about 80% of people with epilepsy can control their seizures with one of the dozens of medications now available. Treatment also may include surgery, implantable devices and special ketogenic diets.

The effects of epilepsy do not last forever for all patients. Some require lifelong treatment to control seizures, but for others, the seizures eventually go away. Children with epilepsy may even outgrow the condition with age.

Living with epilepsy

Living with epilepsy can take an emotional and psychological toll. It can be frightening both to have or witness a seizure, especially if there are strong convulsions. A stigma still exists around epilepsy, not only because of the physical effects, but because people don’t always understand the difference between a brain or neurological disorder and a mental illness. Both types of condition can be misunderstood and feared. 

Things are changing, however, and I believe this is a time of great hope. Our society is becoming more accepting of people with medical conditions, and quality of life for people with epilepsy has never been better. Many patients treated by specially trained epilepsy teams are showing significant, encouraging improvements.

Reducing risk of seizures

If you think you may have experienced a seizure, make an appointment to see your doctor immediately for diagnosis and treatment. If diagnosed with epilepsy, be sure to wear your medical alert bracelet at all times—and follow these simple steps to help reduce your risk of seizures:

Take all medications exactly as prescribed

Get plenty of sleep

Avoid smoking and limit alcohol intake

Eat healthfully and drink plenty of water

Get regular exercise to boost your strength—and spirits

Try to manage stress as best you can

Join an epilepsy support group