EPILEPSY: A SUMMARY
Epilepsy is a common neurological condition characterised by seizures which are caused by excessive electrical activity within neural networks in the brain. The disease affects over 600,000 people in the UK, equating to one in every 103 people.
By Melissa Kerr PhD, MPharm A
lthough numerous different types of seizures exist, the International League Against Epilepsy (ILAE) have categorised
seizures into three main types: generalised onset, focal onset and unknown onset. Given the numerous types of seizures, and the fact that there may not always be a clear cause, it is not classed as a single condition and its diagnosis and management can be complex.
Types and symptoms The categories of epilepsy described above are grouped based upon the seizure onset, whether or not a person's awareness is affected and whether or not seizures involve other symptoms, such as movement.
General onset seizures are the most common, affecting approximately 60 per cent of individuals with epilepsy, and affect both sides of the brain simultaneously, without warning. This seizure subset includes tonic-clonic seizures, which is the category most typically associated with
epilepsy, whereby individuals become unconscious and their body shakes and jerks as their muscles stiffen and relax. Other seizures in this subcategory include absence seizures, myoclonic seizures and tonic and atonic seizures.
Focal seizures start in, and affect, just one part of the brain. However, it is possible that the seizure may begin in one part of the brain but may spread to both sides (called a focal to bilateral tonic- clonic seizure). Focal seizures can be difficult to categorise, as the size and area of the brain affected will in turn affect the symptoms experienced by the individual. Some people will experience an ‘aura’ – a particular sound, smell, vision, or feeling that indicates a seizure is beginning, though the aura in itself is classed as a seizure. Typical motor symptoms of focal seizures include lip smacking or chewing, losing muscle tone, repetitive jerking movements, and making a loud noise such as a cry or scream. Typical non-motor symptoms include a sudden feeling of déjà vu or intense emotion,
experiencing an unusual smell or taste, stiffness, twitching, numbness or tingling in a specific part of the body, and visual disturbances.
Triggers Many individuals with epilepsy may find that their seizures are triggered by certain actions. The most common triggers for seizures are flashing or flickering lights (photosensitive epilepsy, affecting three per cent of sufferers), lack of sleep, stress, alcohol or drug misuse and failure to take medications as prescribed.
Diagnosis Typically, epilepsy is diagnosed by a specialist following at least two seizures occurring more than 24 hours apart. The specialist will rely upon a detailed description of the person experiencing symptoms, as well as any eye-witnesses where possible. Numerous diagnostic tools are available to assist with an epilepsy diagnosis, such as an electroencephalogram, MRI and CT scans, however there is no single diagnostic tool for
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EPILEPSY IS NOT CLASSED AS A SINGLE CONDITION AND ITS DIAGNOSIS AND MANAGEMENT CAN BE COMPLEX
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