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.