BY SANDRA GUY
We’ve all heard about, and perhaps even witnessed, someone having an epileptic seizure.
But other types of seizures, which may look like epileptic seizures, are more common than people realize — and they are triggered by factors outside of the brain.
In fact, low blood sugar or a change to the way the heart is working can prompt jerking movements. One in 10 people may experience a seizure at one time in their lives, according to the Epilepsy Foundation.
November — National Epilepsy Awareness Month — provides the perfect opportunity to learn more.
So what is epilepsy, and who is at risk?
It’s a neurological condition that affects the nervous system.
Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures (or after one seizure with a high risk for more) that were not caused by some known medical condition.
Seizures seen in epilepsy are caused by electrical activity disturbances in the brain. The seizures in epilepsy may be related to genetics, a brain injury or an immune, brain structure or metabolic cause.
Seizures can cause uncontrolled movements, abnormal sensations and abnormal thinking or behavior. Movements can be violent, and changes in consciousness can occur. Seizures occur when clusters of nerve cells (neurons) in the brain undergo uncontrolled activation. A partial-onset seizure begins in a limited area of the brain.
The International League Against Epilepsy (ILAE), comprising the world’s leading professionals, has grouped seizures as follows, depending on where they start in the brain (see https://pubmed.ncbi.nlm.nih.gov/28276060/)
- Generalized Onset Seizures:
These seizures affect both sides of the brain or groups of cells on both sides of the brain at the same time.
- Focal Onset Seizures:
The term focal is used instead of partial to be more accurate when talking about where seizures begin. Focal seizures can start in one area or group of cells in one side of the brain.
When a person is awake and aware during a seizure, it’s called a focal aware seizure. This used to be called a simple partial seizure.
When a person is confused or their awareness is affected in some way during a focal seizure, it’s called a focal impaired awareness seizure. This used to be called a complex partial seizure.
- Unknown Onset Seizures:
When the beginning of a seizure is not known, it’s now called an unknown onset seizure.
Seizures can be controlled for most people so that epilepsy has little or no impact on their lives. It’s important to consult a doctor to see which option best suits one’s situation.
One option is anti-epileptic drugs, including the newest, XCOPRI, or cenbamate tablets, that the U.S. Food and Drug Administration approved in 2019.
Surgeries can be another possibility, with different surgeries aimed at varying types of epilepsy. Among the options is surgery to remove a small part of the brain that’s causing the seizures. Another procedure involves puting a small electrical device inside the body that can help control seizures.
People have also found relief in a ketogenic diet that’s been around since the 1920s. It’s a high-fat, low-carbohydrate, controlled protein diet. With this diet, the body mostly uses ketones — chemicals made when the body uses fat for energy — rather than glucose for its energy source. In other words, instead of the body using glucose from carbs such as bread, pasta and candy, it’s forced to use fat instead.
Cannabis has started to grab headlines as another natural relief, but right now, the FDA has approved only EPIDIOLEX to treat seizures associated with two epilepsy syndromes — Lennox-Gastaut syndrome and Dravet syndrome — in people age 2 and older.