Epilepsy affects 3 million Americans

National Epilepsy Aware­ness Month in Novem­ber presents med­ical pro­fes­sion­als with the per­fect oppor­tu­nity to edu­cate the pub­lic and dis­pel myths about a dis­or­der that affects nearly 3 mil­lion Americans.

Epilepsy is char­ac­ter­ized by unpro­voked seizures — strong surges of elec­tric­ity that affect the brain. Seizures can be fright­en­ing because they can include con­vul­sions, loss of con­scious­ness, blank star­ing, lip smack­ing or jerk­ing move­ments of the arms and legs. But the aver­age seizure lasts only 90 sec­onds and car­ries a very low risk of sud­den death.

Epilepsy is often thought of as a child­hood dis­or­der, but it can occur at any age. The dis­or­der is most com­mon in peo­ple under the age of two and more than the age of 65. Of the 200,000 new cases diag­nosed each year in the United States, about 30 per­cent are in child­hood, espe­cially early childhood.

Each year 300,000 peo­ple expe­ri­ence their first seizure, but hav­ing a seizure does not always mean some­one has epilepsy. Some seizures are caused by injury or ill­ness. In some cases, faint­ing, migraine headaches or mus­cle tics are mis­taken for seizures.

Epilepsy has a list of risk fac­tors such as gen­der — males are slightly more sus­cep­ti­ble — age, fam­ily his­tory, head injuries, stroke and other vas­cu­lar dis­eases, brain infec­tions and high fevers in child­hood. In most cases, how­ever, the cause of epilepsy is unknown.

A diag­no­sis is made via a com­bi­na­tion of brain wave records — with an elec­troen­cephalo­gram, or EEG — imag­ing and fam­ily his­tory, all of which give us infor­ma­tion about the elec­tri­cal activ­ity of the brain. Sim­ply talk­ing to your physi­cian about the his­tory and nature of your seizures is a vital com­po­nent of our diagnosis.

Med­ica­tion is our first line of treat­ment. More than 25 dif­fer­ent seizure med­i­cines enable us to tai­lor treat­ment to seizure types and patient needs.

Vagus nerve stim­u­la­tion (VNS) improves seizure con­trol in 50 per­cent of patients. Some­times used in com­bi­na­tion with med­ica­tions, VNS implants a small device that directs short bursts of energy to the brain through a large nerve in the neck.

Brain surgery usu­ally is rec­om­mended for patients who have tried two or three dif­fer­ent seizure med­ica­tions over a period of two to three years with­out suc­cess­ful out­comes. Surgery can be the right option for some patients. It has been per­formed since the 1950s and has an 80 per­cent chance of ren­der­ing the patient seizure-free.

Free­dom from seizures is not always pos­si­ble, but our treat­ment goal is to con­trol seizures so peo­ple can inde­pen­dently engage in every­day activ­i­ties such as work­ing and dri­ving and that they don’t let the fear of hav­ing a seizure keep them from social situations.

If you see a per­son who is hav­ing a seizure, stay calm and don’t force any inter­ven­tions. You might gen­tly guide the per­son to the floor so he/she doesn’t fall, remove fur­ni­ture and other objects that could pose the risk of injury, and, if the patient is on the floor, gen­tly roll patient to the side. If the seizure per­sists for five min­utes, call 911.

Dr. Denise Cam­bier is a neu­rol­o­gist with Delaware Neu­rol­ogy and an active mem­ber of the Ohio­Health Grady Memo­r­ial Hos­pi­tal med­ical staff.

Posted by Grady Memorial Hospital on Nov 7 2012. You can follow any responses to this entry through the RSS Feed. Comments can be made below.