Epilepsy

GENERAL INFORMATION:

What is epilepsy? Epilepsy is a brain disorder involving repeated seizures (convulsions). The brain contains many neurons (nerve cells). Normally, the neurons send small electrical signals to each other and to your body. With epilepsy, there is an abnormal and sudden change in how the neurons send electrical signals. This causes short periods of symptoms that may affect how you move, think, or feel. Normal brain function cannot return until the abnormal electrical periods stop. Epilepsy may develop at any time but is more common in early childhood and old age.

What causes epilepsy? Any of the following may cause epilepsy:

• Brain diseases: Some conditions affecting the brain may be present at birth or develop later in life. This may include having scar tissue in the brain, a head injury, stroke, or a brain tumor. Alzheimer's disease may be another cause of epilepsy.
  
  
• Congenital conditions: These are problems caused by the brain not developing normally before birth.
  
  
• Family history: You have a greater chance of having epilepsy if you have a parent or a sibling with epilepsy.
  
  
• Infections: Germs, such as bacteria and viruses, may irritate the nerve cells and cause epilepsy.
  
  
• Environmental: Being around toxins, such as carbon monoxide and lead, increase risk for epilepsy.

What are the signs and symptoms of epilepsy? Signs and symptoms of epilepsy depend upon what part and how much of the brain is affected. An epileptic seizure usually lasts a few seconds to a few minutes. You may have one or more of the following:

• Confusion (problems thinking clearly).
  
  
• Wide open eyes that may have a blank stare or are constantly blinking.
  
  
• Jerking of hands, legs, or face.
  
  
• Slow breathing or breathing may stop. Your lips, nail beds, and face may turn blue.
  
  
• Stiff arms or legs.
  
  
• Strange or small constant movements, such as picking at clothes or lip smacking.
  
  
• Loss of consciousness (pass out).

What are the types of epileptic seizure? The type of epilepsy you have depends upon what part and how much of the brain is affected.

• Generalized seizures: These seizures affect both sides of the brain. You always lose consciousness with generalized seizures.
  
  
• Partial seizures: Partial seizures are the most common type of seizure. These are limited to a specific area of one side of the brain.

How is epilepsy diagnosed? You may have one or more of the following tests:

• Blood tests: A blood sample may be collected and sent to the lab for different tests.
  
  
• CT scan:
  
  
  • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
    
    
  • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
• EEG: This test is also called an electroencephalogram. Many small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain. Caregivers look at the tracing to see how your brain is working.
  
  
• Lumbar puncture: This procedure may also be called a spinal tap. During a lumbar puncture, you will need to lie very still. Caregivers may give you medicine to make you lose feeling in a small area of your back. Caregivers will clean this area of your back. A needle will be put in, and fluid removed from around your spinal cord. The fluid will be sent to a lab for tests. The tests check for infection, bleeding around your brain and spinal cord, or other problems. Sometimes medicine may be put into your back to treat your illness.
  
  
• MRI: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. You will need to lay still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.
  
  
• Positron emission tomography scan: This test is also called a PET scan. A PET scan shows the areas of the brain that are causing the seizures. It also shows how much blood and oxygen is flowing to an area of the brain.

How is epilepsy treated? You may have any of the following:

• Anticonvulsant medicine: Anticonvulsants are given to control seizures.
  
  
• Surgery: Brain surgery may be done to treat epilepsy.
  
  
• Vagus nerve stimulation: A small device sends electrical energy to the brain through the vagus nerve. The vagus nerve is a large nerve in the neck.

What should be done during an epileptic seizure? When an epileptic seizure occurs, the following should be done to prevent injury:

• Do not hold or tie the person down.
  
  
• Do not place anything in the person's mouth or try to force the teeth apart. The person is not in danger of swallowing his tongue.
  
  
• Do not pour any liquid into the person's mouth or offer food or medicines until he is fully awake.
  
  
• If possible, turn the person on his side during the seizure.
  
  
• Place something soft under the person's head, loosen tight clothing, and clear the area of sharp or hard objects.
  
  
• Stay with the person until the seizure ends. Let the person rest until he is fully awake.
  
  
• Use a watch to time how long the seizure lasts.
  
  
• Watch the type of movement and position of the person's head or eyes during the seizure.

Where can I get support and more information? Epilepsy is a life-changing disease for you and your family. Accepting that you have epilepsy is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join an epilepsy support group. This is a group of people who also have epilepsy. Contact the following for more information:

• Epilepsy Foundation
  4351 Garden City Drive
  Landover, MD 20785-7223
  Phone: 1-800-332-1000
  Web Address: http://http://www.epilepsyfoundation.org
  

• American Epilepsy Society
  342 North Main Street
  West Hartford, CT 06117-2507
  Phone: 1-860-586-7505
  Web Address: http://www.aesnet.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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