What Causes Epilepsy?

Seizures are scary, no matter how severe or the length of time that elapses. Repeated seizures, known as epilepsy, can be even more problematic considering their widespread nature. 

According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder. As of 2015, an estimated 3.4 million Americans partake in the daily fight against active epilepsy. Active epilepsy is defined as adults with epilepsy or a seizure disorder who are taking medication or had one or more seizures in the past year; or a child who has epilepsy or a seizure disorder confirmed by a physician.

Your view of epilepsy may consist of seeing a loved one suffer from spasms or losing control of muscle functions. But, in some cases, repeated epileptic seizures can be fatal. In honor of Epilepsy Awareness Month in November, we’re breaking down what you need to know about epilepsy, how it can become fatal, the types of seizures to be aware of and how you can treat it.

What is epilepsy? 

The Mayo Clinic describes epilepsy as a neurological disorder that causes abnormal brain activity leading to seizures or periods of unusual behavior, sensations and sometimes loss of awareness. 

Epilepsy affects people of all shapes and sizes, regardless of age, race or ethnic background. Some seizures are worse than others and affect different areas of the brain and, thus, produce different symptoms.

There is no need to immediately panic if you’ve had a seizure. It takes two or more seizures without a known cause to receive an epilepsy diagnosis. But you should still be aware of the symptoms, causes and potential areas of treatment to stay ahead of the curve.

There isn’t a cookie-cutter answer on epilepsy’s effects as they vary by person. Some seizures are easy to spot, with a person shaking or collapsing. Other times, they may be unaware of their surroundings or have a blank stare on their face. 

Epileptic seizures are unpredictable, so consider getting an evaluation and diagnosis if you’ve experienced symptoms of a seizure. They can be especially dangerous if you have a seizure while you’re driving a car or operating machinery. 

What causes epilepsy?

In some cases, it’s hard to pinpoint what triggers epilepsy. In fact, the cause of epilepsy is unknown in six out of every 10 people. But, there are several risk factors that can lead to the development of epilepsy, ranging from age and family history to injuries and infections. Below are some common things to be aware of.

• Age — While epilepsy can occur at any age, it’s most common in children and older adults. Older adults who develop dementia are at risk of epilepsy. Children who have long seizures or nervous system conditions are at a greater risk of developing epilepsy later in life. Birth defects and brain damage during pregnancy can put your children at higher risk for epilepsy or cerebral palsy.
• Family history — Much like any other disease, having a family history of epilepsy can put you at a higher risk.
• Head injuries — Trauma to your head can lead to seizures and epileptic episodes. 
• Stroke and other vascular diseases — When you have a stroke, it can cause brain damage that produces epilepsy. This is a leading cause of epilepsy in adults over the age of 35.
• Brain infections — Such infections cause inflammation and swelling in your brain the same way a traumatic physical experience would. Meningitis is a common brain infection. AIDS and other infectious diseases also play a role.

As a result, the best way to avoid developing epilepsy is to prevent traumatic brain injuries. Accidents happen, especially in the car or on bikes, but you can be proactive by always wearing your seatbelt and wearing a helmet.

Stay on top of vaccinations as a heightened risk of infection can sometimes cause epilepsy. Additionally, limiting the risk of stroke and heart disease can prevent epilepsy later in life.

Sleep deprivation, stress and a poor diet (low blood sugar) can also lead to seizures. Remember to carry out the little daily details in life, such as properly washing your hands. We may take these things for granted but lowering the risk of germs is key. 

Cysticercosis is one of the most common causes of epilepsy. This infection occurs when tapeworm eggs get into muscle and brain tissue. The eggs are spread through food or surfaces contaminated with feces, which is why we stress the importance of always washing your hands and practicing proper hygiene.

Types of epilepsy

There are two types of seizures associated with epilepsy: generalized seizures, which affect both sides of the brain, and focal seizures, which affect only one area of the brain.

Types of generalized seizures

• Absence seizures — The symptoms aren’t as severe or as long-lasting here, usually limited to less than 30 seconds. You may stare into space or notice rapid eye blinking. These often occur in children.
• Tonic seizures — Muscles in your body, mainly in the back, arms and legs, become stiff, which may cause you to fall.
• Atonic seizures — You lose control of your muscles and they relax too much to the point where you may collapse.
• Clonic seizures — Your body will shake or jerk in repeated or rhythmic movements. 
• Myoclonic seizures — These are brief periods of shaking or jerking in your arms or legs.
• Tonic-clonic seizures — Referred to as a grand mal seizure, you can lose consciousness and fall to the ground with a combination of stiff muscles, muscle jerks and spasms.

Types of focal seizures 

• Focal seizures without loss of consciousness — These affect a small area of the brain and are generally limited to twitching or jerking of the body and can result in a change in sensory functions such as taste or smell.
• Focal seizures with impaired awareness — You lose consciousness or awareness as you become dazed or confused. It can take several minutes to respond to questions or directions, and you may produce repetitive movements.

If you experience any of these symptoms, contact your physician to discuss your medical history and any factors that may have caused the seizures, such as drug or alcohol use, head trauma, a genetic abnormality or a fever or infection. Your doctor can perform many tests to formulate a plan. They may request a neurological exam, blood tests, MRI, CT scan or a spinal tap.

Can epilepsy kill you?

While rare, epilepsy can be fatal. Sudden unexpected death in epilepsy (SUDEP) is responsible for one death for every 1,000 people who have epilepsy. These are considered deaths not caused by injury or other causes. Most times, SUDEP occurs after a seizure develops and the person is found in bed, either face down or on their side. 

The main cause of SUDEP is unclear. You may be at a higher risk if you have breathing and heart rhythm problems. You’re also 15 times more at risk for SUDEP if you have three or more uncontrolled seizures a year.  Those who had seizures at an early age or are between the ages of 20 and 40 also are more likely to experience SUDEP. 

Additionally, you may suffer from status epilepticus. This occurs when a seizure lasts more than five minutes or you have recurring seizures without much time passing between them. The frequency and length of these episodes puts you at risk of permanent brain damage or death

Since a seizure affects your muscles — either from tightening or stiffening — and causes convulsions, it can have a domino effect on your breathing. These spasms can cause obstructed airways. Pauses in your breathing patterns that last longer than normal are also problematic. In rare cases, seizures can cause heart rhythm problems or even heart failure. 

To lower the risk of SUDEP, make sure you take medication as prescribed. Sleep is crucial, as is learning how to deal with your seizures. You should also refrain from drinking alcohol. The Centers for Disease Control provides more information on managing epilepsy.

Epilepsy treatments

A diagnosis of any type of disease or disorder is a difficult blow to deal with. But you should know that you can still have a positive outlook if you take the proper treatment steps. There isn’t a cure for epilepsy, but a reported 70 percent of patients can control epilepsy with medication or surgery. 

First, you’ll visit a primary care doctor or a neurologist to discuss the next course of action to control your seizures. Some medications will work for certain types of seizures. Others won’t. Your doctor will come up with the best course of action. Once you find the right medication, you should be persistent with your dosages and frequency. A failure to do so could result in more seizures or complications.

Track your episodes by keeping a log of seizures. This can help you outline patterns and learn how to better handle certain triggers. You can help manage your epilepsy with a good night’s sleep (at least seven or eight hours), exercise and a well-balanced diet. Refrain from tobacco use and excessive alcohol consumption.

If you’re a parent with a child who has epilepsy, create a solid support structure and foundation so your child feels comfortable with their disease. Make sure they understand epilepsy and how to cope with it.

Don’t lose hope if medication isn’t working. You can work with your physician to look into dietary therapies, behavioral therapies and possibly surgery. There are also certain devices that use electrical stimulation (neuromodulation) to send signals to change what a nerve or the brain does.

Surgery is an option for patients who suffer from seizures in one area of the brain. A surgeon will remove the part of the brain where the seizures start in an attempt to eliminate or minimize the episodes.

The team of physicians and neurologists at INTEGRIS is well-versed in treating epilepsy. Find an INTEGRIS physician near you to set up an appointment to discuss seizures or epilepsy.