There Are More Than 40 Different Types of Epileptic Seizures
Epilepsy is a condition that is often misunderstood. Although many people have come to believe that all epileptic attacks involve a violent seizure—with the person falling to the ground and convulsing—the neurological disease actually takes many different forms.
Ley Sander, medical director of the U.K.’s Epilepsy Society and professor of neurology at University College London, says that though these “tonic-clonic” seizures—formerly referred to as “grand mal”—are indeed common, there are others. “In fact, there are over 40 different types of epileptic seizures,” he adds, which include ones where a person stares blankly and doesn’t respond when someone is talking to them, and others that cause the muscles to contract so the body becomes rigid.
Epileptic seizures occur when electrical signals in the brain malfunction, and they fall under two broad categories: generalized, which involve the entire brain, or focal, which affect only part of the organ. While some people experience only one seizure in their lifetime, which can be triggered by a brain illness, stroke or tumour, at least two seizures not linked to these health issues are generally required for an epilepsy diagnosis.
Fifty million people worldwide have epilepsy, and the condition can affect anyone—particularly when it runs in the family. Children will sometimes outgrow it, but for those who continue to have seizures into adulthood, there are treatments and medications to minimize its impact.
“For two thirds of people with epilepsy, their seizures will be controlled by medication,” says Sander, explaining that there are more than two dozen drugs for the condition, with newer ones having fewer side effects. In cases where the patient fails to respond to treatment, and the area of the brain responsible for the seizures can be identified, surgery can be performed. “We have pioneered functional MRI at Epilepsy Society to accurately map the brain in order to guide safer surgery,” says Sander. Seventy per cent of those who have surgery, which often involves the removal of a portion of the temporal lobe of the brain, become seizure-free, while 20 per cent find their seizures are reduced; for 10 per cent, there is no improvement.
Patients with severe epilepsy may benefit from a vagus nerve stimulator implant, says Sander. Like a pacemaker that regulates the heart’s rhythm, this device, which is placed in the neck, can deliver mild pulses of electricity to prevent epileptic seizures when they are coming on.
What Sander finds most promising, though, is the use of whole genome sequencing in treating epilepsy. “Although this is still in its infancy, we are beginning to pinpoint areas of our DNA that contribute to epilepsy and which ones may then indicate a different course of medication, particularly for people with some of the most severe cases,” he says.
The good news is that many forms of epilepsy are treatable, says Sander, and lots of people with the condition lead normal lives. Often, they can control their epilepsy through lifestyle modifications, whether that’s avoiding alcohol or minimizing triggers such as stress and sleep deprivation. (Follow these daily habits for a better night’s sleep.)
If you witness a convulsive epileptic seizure, he suggests you “calm, cushion and call”—relax the person using a gentle voice, support their head with your hands or a piece of clothing, and phone for help if the seizure lasts more than five minutes.
Next, find out how epilepsy could be treated with medical marijuana.