Epilepsy

Epilepsy is a symptom of a brain disorder. It is NOTcontagious and people with epilepsy are NOT "crazy." The word "epilepsy"comes from a Greek word meaning "to possess, seize or hold." Since thebrain uses electrochemicalenergy, any disruption of the electrical processes in the brain willcause abnormal functioning. Unfortunately, this is just what happensduring epilepsy - neurons in the cerebral hemispheres misfire and createabnormal electrical activity. People with epilepsy have seizures that happen repeatedly. It is a bit like anelectrical brainstorm. The seizure prevents the brain from: interpreting and processing incoming sensory signals (like visual,somatosensory and auditory information). controlling muscles. That is why people with epilepsy may fall downand twitch.

Epilepsy is a fairly common neurological disorder. It occurs in about 1in every 100-200 people. Throughout history there have been many famouspeople who have had epilepsy:
Famous People withEpilepsy
	Julius Caesar - Roman Statesman (100-44 B.C.)	Napoleon Bonaparte - Emperor of France (1769-1821)
	George Frederick Handel - Composer (1685-1759)	Vincent van Gogh - Painter (1853-1890)
	Fyodor Dostoevski - Writer (1821-1881)	Pius IX - Pope (1792-1878)
	Peter the Great - Russian Czar (1682-1725)	Lord Byron - Poet (1788-1824)
More famous peoplewith epilepsy

Types of Epilepsy There are many types of epilepsy. Each type of epilepsy has differentbehavioral effects and is treated with different methods. In some cases,people know they are about to have a seizure because they see or hearsomething, or feel dizzy, nauseous, or "strange." This is called anaura. An aura can act as an "early warning system" telling a person that a seizure is about to happen. The personcan therefore minimize a possible injury by taking precautions such as sitting down. Generalized seizures -uncontrollable discharge of neurons on BOTH sides of the brain. This isthe most common type of epilepsy. The seizure starts in one area of thebrain and spreads across the brain. These seizures produce muscletwitches, convulsions and loss of consciousness. People with this type ofepilepsy do not remember having a seizure. There are several types ofgeneralized seizures: Tonic-clonic ("grand mal") seizure - Thisseizure occurs when there is a massive discharge of neurons on bothcerebral hemispheres. The body becomes rigid and there is also jerking ofthe body. "Tonic-clonic" means "stiffness-violent." "Grand mal" means"great sickness." Absence ("petit mal") seizure - This seizure isnonconvulsive. However, a person may become unaware of his or hersurroundings and may stare off in space or freeze. This seizure lastsonly 5-30 seconds. Myoclonic seizure - This seizure involves themotor cortex and causes twitching or jerking of certain parts of thebody. Atonic seizure - This seizure is characterizedby the loss of muscle tone and causes a person to fall down. Status epilepticus - This seizure ischaracterized by frequent, long-lasting seizures without regainingconsciousness between attacks. This condition requires immediate medicalattention. Partial Seizures - This type ofseizure is characterized by abnormal electrical activity involving only asmall part of the brain. Sometimes a partial seizure can spread to thewhole brain. Two types of partial seizures are: Simple partial seizures (also called "Jacksonian" or"focal" seizures)- Short-lasting seizures without loss of consciousness. People with thesekinds of seizures often see, hear or smellsomething strange. Also, only part of the body may jerk. Complex partial (psychomotor) seizures - Aseizure with a change, not a loss, in consciousness. People mayhear or see things or memories may resurface. Feelings of deja vumay also occur.

Causes Many (50-70%) cases of epilepsy have no known cause. For the remainingcases, there are many other events that may cause epileptic seizures: Head injuries, such as a car accident or a fall. Brain tumor Stroke Arteriosclerosis (fatty plague build-up in arteries) Brain injury before birth caused by infection or lack of oxygen to thebrain Infection, such as meningitis or encephalitis Brain damage resulting from these events may cause a "scar" on the brain. This is where an epileptic seizure starts. At this time it is not known why a scar will start a seizure. There may be a geneticlink for some types of epilepsy, but this is usually NOT the case.Sometimes a seizure will be started ("triggered") by: stress lack of sleep flashing lights or sounds (like from a video game or TV) low blood sugar

Diagnosis A doctor will want to find out several things before a diagnosis ofepilepsy is made. The doctor may want to know the answers to thefollowing questions: How often do the seizures occur? When was the first seizure? Was there a head injury? What are the seizures like? Were there any unusual sensations (smells, sounds, lights)? Is there any memory of the seizures? An electroencephalogram(EEG) is often used to help in the diagnosis of epilepsy. The EEG ofpeople with epilepsy often shows large spikes. Sometimes the EEG must berecorded for a whole day in the hospital or at home because a short testdoes not always pick up the abnormal activity. However, the EEG does notalways work because about 5% of people without epilepsy have"abnormal" EEG activity and about 20% of people with epilepsy havenormal EEG activity. Brainimaging methods (magnetic resonance imaging [MRI] or computertomography [CT] scanning) may also be used to find the location of a scaror damaged brain tissue. Sometimes positron emission tomography [PET] isused to examine brain blood flow.

Treatment for Epilepsy Drugs Sometimes seizures stop without treatment. In most cases,antiepileptic (also called "anticonvulsant") drugs are used to controlseizures. These drugs, however, do not cure the disorder. Rather, thesedrugs control the symptoms and are effective in 60-80% of the cases. Antiepileptic drugs work by reducing the abnormal firing of corticalneurons. These drugs may change the activity of neurotransmittersresponsible for seizures or alter the way ions flow in and out of neurons. Unfortunately, many of these drugs have side effects such as drowsiness,dizziness and nausea so doctors must balance these undesirable effectswith seizure control. It is also important to remember that differentdrugs are used to treat different types of seizures. Frisium Antiepileptic Drugs Chemical Name CommonTrade Name Carbamazepine Tegretol Clobazam Clonazepam Rivotril Diazepam Valium Divalproexsodium Depakote Ethosuximide Zarontin Phenobarbital many names Phenytoin Dilantin Valproicacid Depakene Surgery When medication fails and the area of the brain where the seizure occursis known, surgery may be performed to treat epilepsy. There are severaltypesof surgery that have been used: Temporal Lobe Surgery - This is performed to remove brain tissue wherethe epileptic seizure starts. This type of surgery often removes part ofthe cortex of the temporal lobe, hippocampus and amygdala. [Brainmapping during surgery] Corpus Callosotomy ("Split Brain"operation) - The corpus callosum is cut to separate the right and leftcerebral hemispheres. This procedure is done to prevent the spread of theseizure from one side of the brain to the other. Hemispherectomy - One cerebral hemisphere is removed. The procedureis not performed very often. Children who have this surgery CAN functionquite well although they often have trouble using their arm on the side ofthe body opposite to the surgery. In somesurgeries, only specific lobes of the brain are removed. Find out more about surgical treatment of epilepsy from a site at NIHand Beth Israel Medical Center Hemispherectomy Experimental Treatments Several treatments for epilepsy are still under investigation. How andif they work is still controversial. KetogenicDiet - a high fat, low protein/carbohydrate diet Biofeedback - people trained to control EEG patterns to shortenseizures Counterstimulation Exercise Relaxation Techniques Vagus NerveStimulation - an electrical stimulator is implanted to stimulate thevagus nerve (cranialnerve X) Vitamin and Mineral Supplements