Epilepsy

What is epilepsy?

Epilepsy is a neurological condition that makes people susceptible to recurrent seizures or fits. A seizure is a change in sensation, awareness, or behavior brought about by a brief electrical disturbance in the brain. It may vary from a momentary disruption of the senses, to short periods of unconsciousness or staring spells, to convulsions. Some people have just one type of seizure. Others have more than one type. Although they look different, the same thing causes all seizures: a sudden change in how the cells of the brain send electrical signals to each other. See: http://www.epilepsy.com

What is the frequency of epilepsy in Ireland?

30 000-40 000 people in Ireland are estimated to have epilepsy; that is approximately 1 in 200 adults suffer from recurrent seizures.

How is it diagnosed?

Epilepsy is usually suspected from the clinical story. Investigations performed include:

  1. Electroencephalogram (EEG): this records the brainís electrical rhythms by placing electrodes on the scalp and recording on a computer.
  2. Computed Tomography Brain: this X-ray examines the brain and allows exclusion of tumors, strokes or structural abnormalities
  3. Magnetic Resonance Imaging Brain: this may be required in certain types of seizures to look for abnormalities not detectable on CT brain

Risk factors for epilepsy

More than half of all seizures are unprovoked, that is no cause is ever found. However, certain factors have been recognized as possible triggers/risk factors: febrile convulsions in infancy, head injury, infection of the brain or its linings (encephalitis/meningitis), alcohol, illicit drug usage, metabolic disturbance, inherited instability and occasionally may result from a brain tumor.

Documenting Seizures/ Seizure Diary

This is useful as it may help a person to remember when they have had seizures and to identify whether there are any specific triggers. Information recorded will help to guide the doctor to the type of seizures, efficacy of treatment and to plan future treatment. View seizure diary.

How is epilepsy treated?

The main stay of treatment of epilepsy is medications and in a small proportion of patients in whom medication is ineffective, brain surgery.

Other forms of treatment documented of benefit in children includes the ketogenic diet:

Epilepsy in Pregnancy

There is a small but definite risk of malformations in babies of mothers treated with anti-epileptic medications during pregnancy. However this must be weighed against the risk of hypoxic injury (lack of oxygen) to the fetus during uncontrolled tonic-clonic seizures. The main risk is the drugs may interfere with the development of the nervous system. There is evidence to suggest that taking folic acid supplements prior to conception and during pregnancy may decrease the risk of conditions such as spina bifida. Due to the action of anti epileptic drugs, women with epilepsy are recommended to take 5mg of folic acid daily compared to the 400mcg normally recommended. See The Republic of Ireland Epilepsy and Pregnancy Register (Free Phone: 1800 320 820)

Epilepsy and Driving

Refer to Road Traffic Regulations (Licensing of Drivers) (Amendment) 2004 Statutory Instrument number 705 of 2004

Sudden Unexpected death in epilepsy (SUDEP)

Most people with epilepsy live full and active lives. There is, however, an increased risk of death due to accidents, suicide and other medical conditions. There are also cases where the death appears to be directly related to epilepsy itself, usually referred to as Sudden Unexpected Death in Epilepsy (SUDEP). SUDEP is when a person with epilepsy dies suddenly and no other cause of death is revealed Research indicates that there are around 500 cases of SUDEP in the UK every year. When reading this, it is important to bear in mind that in the UK there are around 456,000 people with epilepsy. See http://www.epilepsy.org.uk/info/sudep.html

Other Useful Epilepsy Links:

Brainwave Ireland