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6 Frequently Asked Questions About Epilepsy

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Epilepsy is a heterogeneous group of disorders characterized by recurrent, spontaneous seizures. The main symptom of epilepsy is epileptic seizures. What causes seizures? An epileptic seizure occurs due to disturbances in the processes of excitation and inhibition in the cerebral cortex cells. Epilepsy is polygenic. Genetic factors have an essential role in their genesis. They include pre-and perinatal lesions of the nervous system, degenerative diseases of the central nervous system, brain tumors, traumatic brain injuries, and vascular diseases of the brain.

Epilepsy is one of the most common diseases among the chronic pathology of the nervous system.  According to statistics, epilepsy occurs with the same frequency throughout the world.

Regardless of race, about 0.5 – 1% of the population suffers from this disease. The frequency of epilepsy in the child population is 0.5-0.75%, and febrile seizures – are up to 5%. The disease has a significant negative impact on development and significantly limits the possibilities of rehabilitation therapy. The child with epilepsy needs rehabilitation in the motor and psycho-speech areas. 

What does epilepsy mean?

Epilepsy is a chronic brain disease characterized by repeated spontaneous seizures (paroxysms) that result from excessive neuronal discharges. Clinically, epilepsy is manifested by convulsions and changes in consciousness (up to its loss). Epilepsy can be either an independent disease or a symptom of another pathology. 

what does epilepsy mean

  • According to WHO, approximately one in 4-10 people out of 1000 worldwide have active epilepsy – this is one of the most common neurological diseases.
  • The basis for the development of seizures in epilepsy is an imbalance in the brain’s two systems – excitatory and inhibitory. Usually, these systems work simultaneously, creating an optimal level of neuronal activity. 
  •  It is observed as an increase in excitatory activity with a lack of inhibitory activity. As a result, this leads to the fact that entire groups of nerve cells begin to produce electrical discharges of high power synchronously. These discharges can spread to other parts of the nervous system, leading to an attack.
  • People with epilepsy are more likely to get bruises and fractures associated with seizures. They are also more likely to have anxiety disorders and depression. In addition, patients with epilepsy have an increased risk of premature death from falls, drowning, and burns. 

In reflex epilepsy (a rare condition), seizures develop in response to an external stimulus, such as repeated sounds, flashes of light, video games, music, or even touching body parts.

The disease is a serious social problem. The lack of information about epilepsy contributes to misunderstanding, fear of symptoms, and discrimination against patients.

How is epilepsy diagnosed?

Examination of a patient with suspected epilepsy symptoms includes the following methods: a collection of complaints and anamnesis, neurological analysis, EEG (electroencephalography), MRI of the brain, angiography of the head vessels, and other tests. 

Epilepsy is diagnosed and treated by neurologists. Some of them specifically expand their qualifications in this direction, which allows them to act even more effectively.

how is epilepsy diagnosed

Let’s look at the diagnosis in more detail:

  • collection of complaints and anamnesis: the doctor asks the patient in detail about the symptoms that disturb him and finds out the time and circumstances of their occurrence; a characteristic sign of epilepsy is the appearance of seizures against the background of sudden sounds, bright or flashing lights, etc.; special attention is paid to heredity, past injuries and diseases, the patient’s lifestyle and bad habits;
  • neurological examination: the doctor evaluates muscle strength, skin sensitivity, severity, and symmetrical reflexes;
  • EEG (electroencephalography): a procedure for recording the electrical activity of the brain, which allows you to see the characteristic action of an epileptogenic focus; if necessary, the doctor may try to provoke overexcitation with flashes of light or rhythmic sounds;
  • MRI of the brain: makes it possible to identify pathological areas and formations: tumors, ischemic foci, consequences of a stroke, etc.;
  • angiography of the vessels of the head: the introduction of a contrast agent into the blood, followed by radiography; allows you to see areas of vasoconstriction and deterioration of blood flow;
  • ultrasound of the brain (Echo-encephalogram): used in children in the first year of life who have not yet closed the fontanel; visualizes tumors and other volumetric formations, accumulation of fluid, etc.;
  • rheoencephalography: measurement of the electrical resistance of the tissues of the head, which can be used to diagnose blood flow disorders;
  • general examinations: general blood and urine tests, blood biochemistry, tests for infections, ECG, etc. for a comprehensive assessment of the patient’s condition;
  • consultations of narrow specialists: neurosurgeon, toxicologist, narcologist, psychiatrist, etc. (prescribed depending on the alleged cause of seizures).

The list of examinations may vary depending on the patient’s age, the type of seizures, the presence of chronic pathologies, and other factors.

What causes epileptic seizures in children?

The main causes of epilepsy in children are:

  1. Heredity;
  2. Hypoxia at the stage of intrauterine development;
  3. Neoplasms of the brain;
  4. Previousneuroinfection (meningitis, encephalitis, etc.);
  5. Childbirth with complications (cord entanglement, forceps delivery);
  6. Deficiency of magnesium and zinc;
  7. Head injury.

what causes seizures

In significant terms, episyndromes are episodes of temporary loss of control over consciousness and movements. At the same time, the classic symptoms – convulsions and convulsions – are rare and are not characteristic of an attack that has begun.The disease has different forms of manifestation and implements various functions.

The first symptoms of the disease may appear in the first year of life. Diagnosis of infants during this period is complicated by the fact that the warning signs of the disease can be confused with the usual chaotic movements of babies or individual behavioral patterns. The variation in symptoms in young children is very considerable, and therefore it is not possible to say with certainty how the disease begins.

The following features should be the reason for contacting a doctor:

  1. The children scream and shudder at the same time.
  2. They can pull arms and legs spontaneously and chaotically.
  3. They focus suddenly on one point, and do not respond to stimuli.
  4. They are noticed spontaneous facial muscles contraction and then the limbs.

What causes seizures in adults?

Many epileptic seizures begin with an aura. It is the name of the complex of specific sensations that occurs shortly before the seizure. Aura manifestations can be completely different: paresthesia (pathological sensations), a specific taste, auditory, visual or olfactory hallucinations, etc.

seizures in adults causes

The most commonly described seizure provocateurs are the following. 

  • Stress

 According to different sources, emotional stress is the most common trigger for seizures (30% to 66%). Relaxation (exercises) is often used to prevent or reduce the severity of attacks.

  • Sleep deprivation

Deprivation of sleep is the second most frequent provocateur of seizures. It often accompanies hyperactivity, stress, alcohol, and stimulants. Sudden awakening is the main provoker of seizures in juvenile myoclonic epilepsy, and forced awakening is more “dangerous” than spontaneous.

  • Physical activity and fatigue

A  blood pH decrease (metabolic acidosis) is associated with the appearance of epileptiform activity on the EEG during and after exercise. Exercise-induced seizures usually occur after they stop. The risk of an attack after prolonged physical activity is significantly higher than after individual physical exercises are interrupted by rest. Prolonged hypoxia or hypoglycemia after prolonged physical exertion may also contribute to seizures.

  • Alcohol

Drinking alcohol is often associated with missed medications and sleep deprivation. Attacks usually occur during a period of a sharp drop in the concentration of alcohol in the blood, especially when a lack of sleep accompanies its excessive use.

  • Missing the drug

Missing one or two doses rarely causes seizures. At the same time, if patients decide that they are cured and stop taking the medication, the risk of attacks becomes very high. Seizures due to discontinuation of the drug are especially characteristic of the abrupt withdrawal of barbiturates and benzodiazepines, and can also be observed in people without epilepsy.

  • Metabolic disorders 

They can result from diarrhea, constipation, acute infectious diseases, liver and kidney failure, and diuretics. Hyper- or hyponatremia, hypokalemia, and hypoglycemia may precipitate seizures in patients with or without epilepsy. In diabetic patients, attacks often occur due to an overdose of insulin or sulfa drugs, as well as against the background of hypoglycemia due to the intake of large amounts of food.

  • Hyperventilation

Excessive breathing unrelated to exercise can trigger seizures in some patients. Unintentional hyperventilation may be due to anxiety, sobbing, or sexual activity in daily life.

  • Fever

An acute infection accompanied by an increase in body temperature can cause seizures in patients of any age.

  • Hormonal changes

From 10% to 70% of women note the connection of seizures with the menstrual cycle. The main reason for the increase in seizures during this period is a violation of the drug regimen. Pregnancy itself has little effect on the frequency of seizures.

How long do seizures last?

In most people, epileptic seizures last from 1-5 minutes to a few seconds. Short single seizures are relatively safe and stop on their own. In some cases, attacks can be repeated one after another. If the patient regains consciousness between epileptic episodes, such seizures are called serial. 

Suppose in the interval between attacks, consciousness is not restored, and the duration of each attack is at least 5+ minutes. In that case, this course is called “status epilepticus.” Status epilepticus is a life-threatening condition due to the possibility of cerebral edema.

how long do seizures last

It is strictly necessary to call an ambulance if:

  • The duration of the attack lasts from 3 minutes or more.
  • Breathing is disturbed, and the convulsions have already ended.
  • The convulsions have stopped, but the person does not regain consciousness.
  • Suspicion of getting into the lungs and respiratory tract of vomit, saliva, and foam.
  • First seizure in a person’s life.
  • The attack happened to a pregnant woman.
  • The patient also has diabetes.
  • The attack is observed in a child or an older person.

How many seizures can you have in a day?

how ma ny seizures can you have in a day

Seizures vary from patient to patient: from one to several a day.  Do all people who have seizures have epilepsy? One seizure is not indicative of epilepsy (up to 10% of people worldwide experience one seizure in their lifetime).

  • Epilepsy attacks may occur with or without loss of consciousness. During an attack, we can see convulsive twitching of muscles, feel various sensations in the body, influx of thoughts, and experience vivid and not always understandable emotions. In addition, different ages have their characteristics of the occurrence and course of epilepsy.
  • The main mechanism for the appearance of seizures is the synchronization of the work of all nerve cells in a particular area. It is called an epileptogenic focus and determines the symptoms and their severity. Contrary to popular belief, the disease is not limited to convulsions with loss of consciousness. There are many types of seizures with a variety of symptoms, depending on the area of ​​the brain in which the pathological focus occurs. All of this affects the number of attacks.

Bottom Line 

Epilepsy is a chronic disease. But incurability is one of the main myths about it. In 75% of patients, epilepsy is well controlled. We can achieve the absence of attacks and bring the disease to remission. Only 30% of patients do not respond to drug treatment. But we can free 10% of patients from seizures. And that’s a pretty significant percentage. 

It is crucial to seek treatment from an experienced Lone Star neurologist as early as possible. It will help you fight the disease as soon as possible.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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