Epilepsy – Symptoms, Diagnosis and Treatment

Epilepsy is a neurological disorder

characterised by recurrent and unpredictable seizures, which can vary in intensity and presentation. These seizures result from abnormal electrical activity in the brain, leading to temporary disruptions in normal brain function. Epilepsy is a common condition that varies in severity. According to the Australian Institute of Health and Welfare, almost 150,000 Australians live with epilepsy. Aboriginal and Torres Strait Islander people are twice as likely to develop epilepsy as non-indigenous Australians. At 24-7MedCare, we provide accessible healthcare services including virtual consultations, to assist individuals with epilepsy. Our experienced GPs can offer guidance, diagnosis, and treatment options within the convenience of your own home.
 

What is Epilepsy?

Epilepsy is a medical condition that affects the brain and can cause recurring seizures. These seizures happen when there's a sudden burst of electrical activity in the brain, which can lead to various symptoms, like convulsions, loss of consciousness, or unusual sensations. People with epilepsy might have different types of seizures, and the frequency and severity can vary.

Types of Epilepsy

Epilepsy can manifest in various ways, and there are several common types of epilepsy, each with its own set of symptoms and characteristics. It's important to note that epilepsy is a complex condition, and the specific type of epilepsy a person has can vary greatly. Seizure types can also change over time, and the treatment may differ depending on the type and the individual's response to medications. Here are some of the most prevalent types [2]:

• Generalised Tonic-Clonic Seizures (Grand Mal Seizures): These are perhaps the most well-known type of seizure. They involve loss of consciousness and stiffening of the body (tonic phase), followed by jerking and convulsions (clonic phase). These seizures typically affect the whole brain.
• Absence Seizures (Petit Mal Seizures): These are brief, often barely noticeable seizures where a person may appear to stare blankly for a few seconds. They usually involve a brief loss of awareness and can occur frequently.
• Complex Partial Seizures: These seizures affect a specific area of the brain and can lead to altered consciousness or strange behaviors, like lip smacking or repetitive movements. People experiencing them often don't remember the episode afterwards.
• Simple Partial Seizures: These seizures also affect a specific part of the brain but don't impair consciousness. They can lead to unusual sensations, movements, or emotions, depending on which part of the brain is involved.
• Myoclonic seizures: These involve sudden, brief muscle jerks or twitches. They can affect specific muscle groups or the entire body.
• Atonic seizures: These are often called "drop attacks" because they cause a sudden loss of muscle tone, leading to a person collapsing or falling.

 
 

Epilepsy Signs and Symptoms

Epilepsy signs and symptoms are the things you might notice when someone has this condition. These signs and symptoms can be different for everyone, and not everyone with epilepsy will have every symptom. If you or someone you know is experiencing these signs, it's essential to seek help from a doctor or healthcare professional to figure out the best way to manage and treat the condition. They can vary from person to person, but here are the common ones [3]:

• Seizures: The most common symptoms are seizures. This involves shaking and jerking and just staring blankly for a moment. It depends on the type of seizure.
• Unusual Sensations: Some people with epilepsy might experience unusual sensations before a seizure, like tingling or strange tastes or smells.
• Confusion: After a seizure, a person might become confused or disoriented, not knowing where they are or what just happened.
• Memory Problems: Some people with epilepsy might have trouble remembering, especially after a seizure.
• Loss of Consciousness: In some seizures, a person might black out or lose consciousness.
• Emotional Changes: Seizures can also affect a person's emotions, making them feel really anxious, happy, or scared.

 
 

What Causes Epilepsy?

Epilepsy has a number of causes. In some instances, it can be difficult to determine the cause. Common reasons why people develop epilepsy are [4]:

• Brain Injuries: If you've had a head injury from something like a car accident or a fall, it can sometimes lead to epilepsy.
• Genetics: Sometimes, epilepsy can run in families. If your relatives have it, you might be more likely to become diagnosed.
• Infections: Infections like meningitis or encephalitis can negatively impact the brain and trigger epilepsy.
• Brain Abnormalities: Some people are born with unusual brain structures, and that can make them more prone to epilepsy.
• Tumours: Tumours and growths can disrupt normal brain activity and lead to seizures.
• Strokes: A stroke can damage the brain, and this damage might result in epilepsy.
• Developmental Disorders: Certain conditions that affect brain development, like autism or neurofibromatosis, can increase the risk of epilepsy.
• Metabolic Disorders: Some rare metabolic disorders can also lead to epilepsy.

 
 

Epilepsy Diagnosis and Testing

Epilepsy testing is important to ensure an accurate diagnosis and appropriate treatment. Your GP may recommend a series of tests to confirm the diagnosis. Patients are encouraged to work closely with their healthcare providers to receive the most suitable care and support for their condition [5].

Clinical Evaluation

The diagnostic process typically begins with a detailed clinical evaluation by your GP. Patients or their carers provide a comprehensive medical history, including the description of seizure episodes, triggers, and any relevant family history. Neuropsychological testing may also be recommended to assess cognitive and memory functions, as epilepsy can sometimes affect these areas.

Electroencephalogram

One of the primary diagnostic tools used is the electroencephalogram, which records electrical activity in the brain. A patient may be asked to have an electroencephalogram to detect abnormal brain wave patterns associated with epilepsy.

MRI (Magnetic Resonance Imaging)

Magnetic resonance imaging is often performed to rule out structural brain abnormalities that could be causing seizures. MRI can provide detailed images of the brain, helping to identify lesions, tumors, or other issues.

Blood Tests

Blood tests may be conducted to check for underlying medical conditions, such as metabolic disorders, infections, or electrolyte imbalances that can mimic epilepsy symptoms.

Specialist Referral

Epilepsy diagnosis often involves a multidisciplinary team of medical professionals, including neurologists, epileptologists, neurosurgeons, and neuropsychologists. Your GP may refer you to these specialists for thorough testing and treatment. They work together to determine the most accurate diagnosis and develop an appropriate treatment plan.
 
 

Epilepsy Treatment

Epilepsy treatment aims to manage and control seizures effectively. The following treatments may be recommended by your doctor or other healthcare professional [5]:

Medication Management

The first-line treatment for epilepsy often involves antiepileptic medications (AEDs). Patients should work closely with their doctors to find the most appropriate medication, considering factors like seizure type, potential side effects, and individual patient needs. Regular medication reviews and adjustments are essential to optimizing treatment.

Lifestyle Modification

Patients are encouraged to make lifestyle modifications that can help reduce seizure frequency. This may include maintaining regular sleep patterns, managing stress, and avoiding potential seizure triggers like alcohol or certain drugs.

Ketogenic Diet

In some cases, a ketogenic diet may be recommended, especially for children with medication-resistant epilepsy. This high-fat, low-carbohydrate diet can be effective in reducing seizure frequency.

Surgery

For patients with medication-resistant epilepsy and focal seizures that originate from a specific area of the brain, surgical options may be explored.

Vagus Nerve Stimulation (VNS)

VNS therapy is an option for some individuals with drug-resistant epilepsy. It involves implanting a device that stimulates the vagus nerve to reduce seizure activity.

Patient education and support

Patient and carer education is a crucial part of epilepsy treatment. Support groups and educational resources are available to help patients manage their condition and cope with the challenges it may present.
 
 

Epilepsy Complications

Epilepsy can lead to various complications that affect individuals. Common complications associated with epilepsy include:

• Seizures can result in physical injuries such as falls, head trauma, and fractures.
• Psychosocial Challenges: Living with epilepsy can lead to psychosocial challenges, including stigma and discrimination.
• Cognitive and Learning Difficulties: Epilepsy, especially in children, can be associated with cognitive and learning difficulties.
• Mental Health Issues: Individuals with epilepsy may be at a higher risk of developing mental health issues such as depression and anxiety.
• Medication Side Effects: The use of antiepileptic medications may lead to side effects, which can vary in severity.
• Driving Restrictions: Strict driving regulations apply in Australia for individuals with epilepsy.
• Pregnancy and Family Planning: Managing epilepsy during pregnancy and family planning is a complex consideration. It's essential for women with epilepsy to work closely with healthcare providers to ensure a safe and healthy pregnancy.
• Status Epilepticus [6]: This is a life-threatening condition where seizures occur continuously without recovery between them. Urgent medical intervention is necessary to prevent complications and potential brain damage.

 
 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

To make a telehealth appointment booking, simply click on the button below.