Epilepsy is a neurological condition that causes seizures. The condition most commonly starts in childhood or in people over the age of 60. Seizures occur due to excessive electrical activity in the brain. When different parts of the brain are affected, this can change the type of seizures an individual experiences. Seizures vary in severity from person to person.
The cause of epilepsy varies between individuals. For some individuals, there is no identifiable cause, whereas others may be due to structural brain changes or changes to channels that regulate the firing of neurons in the brain.
Some causes of epilepsy are genetic, with 1 in 3 sufferers having a family member with the condition.
For some individuals it is damage to the brain which causes epilepsy to occur. This includes damage from:
People may have specific epilepsy syndromes, which are normally diagnosed during childhood. Some examples include:
During an epileptic seizure, the electrical signals in the brain become disrupted.
Seizures normally occur in individuals with epilepsy; however, it is possible to experience a seizure without having epilepsy or a seizure disorder.
For those with epilepsy, there are some common triggers which increase the likelihood of experiencing a seizure for certain individuals.
Many people associate strobe or flashing lights with the onset of seizures, but this trigger is rarer than perceived.
Seizures vary from person to person depending on which part of the brain is affected. There are several different types of seizure. The different types of seizure and their characteristics are outlined below.
Simple partial seizures occur whilst awake and aware. Symptoms include:
Complex partial seizures are similar to simple partial seizures; however, they progress to cause a loss of self-awareness during the seizure. Symptoms include:
A person experiencing a complex partial (focal) seizure will not be able to respond to others during the episode and will have no recollection of having had a seizure.
Tonic-clonic seizures are probably what most people envision when they think of a seizure, and they happen in 2 stages:
This type of seizure normally lasts a few minutes but may last longer. Following a tonic-clonic seizure it is not uncommon to feel tired, confused, and/or experience a headache.
In addition, a person may experience just the tonic phase (known as a tonic seizure) or just the clonic stage (known as a clonic seizure).
Absence seizures mainly affect children but can happen to people of all ages. During an absence seizure, there is a loss of awareness and surroundings for a short period of time. The characteristics of absence seizure are:
This type of seizure can be difficult to spot as it usually only lasts around 15 seconds, though can occur several times per day.
Lasting only a fraction of a second, a myoclonic seizure is characterised by sudden body twitching or jerking. This happens most commonly after waking up. Though short, several seizures can happen in succession.
The opposite of a tonic seizure, during an atonic seizure, the muscles in the body become suddenly very relaxed which can cause collapse. These types of seizures are usually short-lived and normal muscle function is usually restored straight away.
Status Epilepticus is the name given to any prolonged seizure lasting more than 30 minutes.
Status Epilepticus is a medical emergency, and an ambulance should be called as early as possible if a person experiences longer than usual seizures which don’t respond to rescue medications.
The first time a person has a seizure their GP will usually refer them to a neurologist to find out the cause. Neurologists are specialists in conditions affecting the brain and nerves.
They will ask questions about previous seizures, any family history of seizures, lifestyle, previous health conditions and any other relevant questions to get an overview of the person’s health and lifestyle. Additionally, they may refer the person for tests such as an electroencephalogram (EEG).
The diagnosis of epilepsy is made if it is determined that there is a likelihood of developing further seizures and that the cause isn’t due to another condition which will reduce the likelihood of seizures once treated (i.e. an acute infection).
Specific syndromes and causes of epilepsy may require more in-depth testing, including an individual’s genetics or specialist imaging of the brain.
Knowing what triggers the seizures can help to prevent them, so it is worth keeping a diary that might pinpoint certain triggers.
There are several anti-epileptic medicines that can be taken to reduce or even stop seizures altogether.
Surgery is an option for some individuals as well. However, only a small proportion of individuals are eligible for surgery. In particular, those with treatment-resistant epilepsy are often not suitable candidates.
For those not suitable for a surgical resection, the implantation of a neurostimulation device might be appropriate.
For others, a ketogenic diet might prove successful, particularly in those with an underlying metabolic disorder causing their epilepsy. However, some people do find a ketogenic diet difficult to adhere to.
The specialist and patient will work together to decide on the best treatment plan.
Research into the effect of medicinal cannabis on epilepsy is limited. However, following the legalisation of cannabis for medical purposes in 2018, there has been a rise in people looking towards medical cannabis. When first-line therapies have not proved effective at reducing symptoms, medical cannabis may be considered an option for epilepsy.
For further information and to find out more about medical cannabis, click here to discover more about our award-winning Sapphire Access Scheme. Alternatively, complete an eligibility assessment now. Once complete, one of our clinicians will review your application and advise whether you are eligible for progression to an appointment.
Tuberous Sclerosis Complex is a rare genetic disorder which causes the development of benign tumours. The most common symptom of the condition is epilepsy, however, affecting 90% of those with tuberous sclerosis complex. The condition can severely affect the quality of life of sufferers and those who care for them alike. In January 2023, it was confirmed that the NHS will be able to prescribe a cannabidiol preparation called Epidyolex® to those living with TSC with ‘clinical trials showing that when used alongside standard patient care such as typical antiseizure medications, Epidyolex® reduces the frequency of seizures by almost a third (30%), increasing the number of days patients can go without a seizure compared with placebo, and lowering the risk of sudden death.’ (source: https://www.england.nhs.uk/2023/01/nhs-to-offer-licensed-cannabis-based-medicine-to-treat-rare-genetic-condition/).
Fewer and less severe seizures with higher levels of predictability give patients and families the confidence to leave the house and enjoy normal social and leisure activities, as well as attend school and other educational or work environments.
Most people with epilepsy can live a normal life once a suitable treatment plan has been implemented. Testing, medicines, and precise surgical procedures to prevent seizures are constantly evolving and have greatly improved the lives of those with epilepsy. It is important to know that people with epilepsy who drive should inform the DVLA of their condition and how it affects them to decide if they are safe to use their vehicle.
The cause of epilepsy varies between individuals. For some individuals, there is no identifiable cause, whereas others may be due to structural brain changes or changes to channels that regulate the firing of neurons in the brain. Damage to the brain can cause the condition to develop, common causes include:
For others, it may be genetic.
The seizures associated with epilepsy vary in severity and frequency. For some, epilepsy is a life-changing condition that severely impacts their quality of life and can be life-limiting in rare cases. For others, the seizures are easier to manage and control using preventative medication or lifestyle changes.
Yes. Epilepsy is considered a disability in the UK under the Equality Act 2010. Not all who have epilepsy will consider themselves disabled, however. The severity and frequency of the seizures, and the impact they have on a person’s life will likely determine how they view their condition.
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Eligible patients can provide us with their healthcare records or we can obtain these through your GP. This is to confirm that a patient’s condition has been fully assessed and all other treatment options have been attempted. We will ensure that the primary care provider receives all treatment communication to maintain the highest level of clinical governance.
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