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What Is Epilepsy?

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

Epilepsy is a neurological (brain) disease that causes people to have seizures. In some people it is chronic, which means long-term. However, it is possible for epilepsy to resolve. This means the person with epilepsy no longer needs treatment.1,2

Epilepsy is a type of seizure disorder in which clusters of nerve cells, or neurons, behave abnormally. Neurons normally create tiny electrical signals in a regular rhythm. These signals tell other parts of the brain and body what to do. With epilepsy, neurons create too many electrical signals, too quickly.

Epilepsy and the brain

A brain, zoomed in on a brain cell with sparks, indicating an electrical storm

Some doctors describe this as an “electrical storm” in the brain. This storm causes a wide variety of physical and mental changes, such as:

  • Loss of consciousness
  • Muscle spasms
  • Loss of muscle tone
  • Changes in senses and emotions
  • Sudden stillness
  • Staring
  • Repetitive movements like lip smacking

Not all seizures are harmful. One person may have seizures that are always the same, while another person can have multiple seizure types.

How often someone has seizures varies widely too. Some people have seizures many times a day, while others have them once a year or less. Not all seizures are caused by epilepsy. Seizures can also be caused by many other health conditions.

Someone is thought to have epilepsy if they have 2 or more unprovoked seizures more than 24 hours apart. Unprovoked means the seizures were not caused by some other condition. These conditions can include alcohol withdrawal, drug overdose, hormone imbalances, or very low blood sugar.

What are the signs and symptoms?

Many people think of epilepsy as someone falling down and jerking wildly. This is a tonic-clonic seizure. Some people may know it by its old name: grand mal seizure.2,3

However, seizures take many forms. Some people shake a bit in just 1 arm or 1 part of their face. Others stop and stare for a few seconds then go back to what they were doing. Some people are aware of their surroundings during a seizure, and others are not. Some people lose consciousness during a seizure. Others can remember the entire event.

Some people can feel a seizure coming on. They get a certain feeling or notice a certain smell. This is called an aura.

Who gets epilepsy? What causes it?

People of all ages can develop epilepsy. Only about half of those with epilepsy ever find a cause. The most common causes are:2,4,5

  • Brain damage from low birth weight or delivery issues
  • Inherited conditions
  • Serious head injury
  • Stroke
  • Infections like meningitis or encephalitis
  • Brain tumor

How common is epilepsy?

Epilepsy is the fourth most common neurological disease in the United States after migraine, stroke, and Alzheimer’s disease. In the United States, about 3 million adults and half a million children have epilepsy. One in every 26 people will have epilepsy in their lifetime. About 50 million people worldwide have epilepsy.4,6,7

Doctors estimate that about 1 in 4 cases of epilepsy could be avoided by:6

  • Preventing head injuries
  • Improving prenatal care
  • Quickly lowering fevers in children
  • Reducing stroke risk by controlling diabetes, high blood pressure, and obesity
  • Reducing parasites that cause infections

How is epilepsy diagnosed?

It can be hard to tell if someone is having seizures because they have epilepsy or because they have another health condition. To diagnose epilepsy, your doctor will conduct a physical exam, go over your medical history, ask about the seizure event, and run many tests. The tests may include:8

Generally, a person is diagnosed with epilepsy if they have at least 2 unprovoked seizures more than 24 hours apart and not caused by another medical condition.

How is epilepsy treated?

There are many types of epilepsy, and how it is treated can vary from person to person. There are 3 goals in treating epilepsy:9

  • Controlling seizures
  • Avoiding side effects
  • Improving quality of life

Treatments may include:9

  • Anti-seizure drugs
  • Surgery
  • Lifestyle changes
  • Diet and nutrition
  • Supportive devices such as a service dog or smartwatch

Keeping a seizure journal is recommended. It can be helpful for loved ones to record videos of these events. This record of when seizures happen, what seems to trigger them, and what they look like will help your doctor diagnose and treat you.

The World Health Organization estimates that 7 out of 10 people with epilepsy could become seizure-free with treatment. Some people may be able to stop taking anti-seizure drugs if they go 2 years without a seizure.4

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