What is epilepsy?
Epilepsy is a long-term brain condition where a person has repeated seizures. It is thought to affect about 3 in every 100 Australians.
Having just one seizure is not considered to be epilepsy — about half the people who have one seizure never have another seizure. Other conditions such as fever, diabetes, heart conditions and alcohol withdrawal can also cause seizures.
Epilepsy is not one single condition; rather it is a range of different conditions that can cause seizures.
If you witness a seizure, you can go to Epilepsy Australia's seizure first aid resources. Seizures usually last 1 to 3 minutes. If someone has a seizure that lasts for more than 5 minutes, call an ambulance on triple zero (000).
What are the symptoms of epilepsy?
The symptom of epilepsy is seizures. These are episodes of disrupted electrical activity in the brain and can vary greatly depending on the part of the brain involved.
Seizures can cause symptoms such as a loss of consciousness, unusual jerking movements (convulsions) as well as other unusual feelings, sensations and behaviours.
There are many different types of seizures. Generalised seizures involve the whole brain and therefore the whole body is affected. Focal seizures involve only part of the brain.
Generalised tonic-clonic seizures
Previously known as 'grand mal seizures', these types of seizures are the most well recognised. The seizure begins with a sudden loss of consciousness, the body then becomes stiff followed by jerking of the muscles. Turning red or blue, tongue-biting and loss of bladder control are common. Confusion, drowsiness, memory loss, headache and agitation can occur on regaining consciousness.
Generalised absence seizures
Previously known as 'petit mal seizures', these types of seizures usually start in childhood, but can occur in adults. These seizures are brief and involve staring, loss of expression, unresponsiveness and stopping activity. Sometimes eye blinking or upward eye movements are seen. The person usually recovers immediately and resumes their previous activity, with no memory of the event.
Previously known as 'partial seizures', start in one area of the brain and affect the parts of the body controlled by that area of the brain. The seizure may involve unusual movements, feelings, sensations or behaviours. People can have different levels of consciousness during focal seizures.
Febrile convulsions are common seizures occurring in about 3 in 100 healthy children up to the age of 6 years. The seizures are generally harmless and associated with an illness causing a fever, such as a viral infection.
Management includes treating the seizure if necessary, as well as treating the underlying cause of the fever.
In the absence of any risk factors for epilepsy, children with febrile convulsions have a similar risk of developing epilepsy to the general population.
What causes epilepsy?
The cause of epilepsy is unknown in half of cases. We know that genetics (family history) play an important role.
Seizures or epilepsy can also be caused by anything that causes damage to the brain, including:
- head injury or trauma
- stroke or brain haemorrhage
- brain infection or inflammation, such as in meningitis, encephalitis or a brain abscess
- brain malformations or tumours
- brain diseases, such as Alzheimer’s disease
- chronic alcohol or drug use
- genetic factors
- high or low blood sugar and other biochemical imbalances
However, seizures may not develop for years after the damage to the brain occurs.
When should I see my doctor?
Always see a doctor if:
- this is your first seizure
- you have repeated seizures
- you have seizures more often than normal
- you’re not sure if you’ve had a seizure
You should seek medical attention after a seizure if you are injured or if you are pregnant or have diabetes.
How is epilepsy diagnosed?
A diagnosis of epilepsy is based on your history of seizures. Your doctor will ask you what you can remember and any symptoms you may have had before it happened, such as feeling strange before the seizure or experiencing any warning signs. It may be useful to talk to anyone who witnessed your seizure and ask them exactly what they saw, especially if you cannot remember the seizure.
Even with normal findings on EEG and brain scans a person may still have epilepsy, however, abnormal findings can help classifying the type of epilepsy involved.
If your child or someone you know has a seizure, it can be helpful to video it on your mobile phone. This can help your doctor make a more accurate diagnosis.
How is epilepsy treated?
Most people with epilepsy are able to control their seizures with antiepileptic medicines and by avoiding triggers. The type of antiepileptic therapy you need depends on factors such as how old you are and what types of seizures you are having. Many antiepileptic medications require blood tests to make sure the levels in your blood are not too low or too high or causing other medical problems.
Several new treatments are being explored. These include:
- surgery on the area of the brain causing the seizures
- vagus nerve stimulation — nerves in the neck are stimulated by a device placed under the skin
- a strict medically supervised diet used in some children with epilepsy, called a ketogenic diet
- medical cannabis, which has been shown in some studies to help people control seizures. You can read more about medical cannabis and epilepsy on the Epilepsy Action Australia website
You also may need different treatment for the underlying cause of the epilepsy, depending on what it is.
Keeping a seizure diary can help you monitor how well your epilepsy is being managed as well as help you identify what your triggers are. Your doctor may also help you develop an epilepsy management plan which can be useful for schools, employers and health professionals.
It's important to work with your doctor to gain the best control over your seizures.
Ask your doctor if it is safe for you to drive or do other high-risk activities like operating heavy machinery. Depending on the type of epilepsy they have, most people will be able to return to driving after being seizure-free for 6 months.
Can epilepsy be prevented?
You can help prevent seizures by taking your medication and avoiding the triggers. These often include:
- lack of sleep
- missed or too much antiepileptic medication
- physical and emotional stress
- hormonal fluctuations
- alcohol or drug use
- flashing lights
- missing meals
- being ill or having an infection,
- vomiting, diarrhea or constipation
- severe changes in temperature
Complications of epilepsy
Having epilepsy puts you at greater risk of injury. During a seizure you might fall, knock yourself, or breathe in food or saliva. You should avoid jobs using heavy machinery, working at heights or under water. You may also be stopped from driving unless your seizures are controlled. Precautions may be required around water, such as when swimming or bathing.
Children with epilepsy may find it harder to learn or to concentrate.
Epilepsy can affect your life and you will need to pay more attention to your health. Some people may feel quite anxious or depressed when they are first diagnosed. To read more about staying healthy and avoiding complications, visit the Epilepsy Action Australia website.
If you become pregnant, talk to your doctor about adjusting your medication.
Resources and support
You can find more epilepsy information on these websites:
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Last reviewed: December 2019