What Is Epilepsy? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Epilepsy is a chronic neurological disorder in which the normal chemical and electrical activities between nerve cells in the brain (neurons) become disturbed. This disturbance causes the neurons to fire abnormally, resulting in seizures.
Seizures are the best-known symptom of epilepsy.
People often think epileptic seizures cause muscle spasms or loss of consciousness, but some seizures can instead cause sudden emotions, sensations, or behaviors that may seem inappropriate and may not be initially recognized as caused by epilepsy.
Some people with epilepsy stare off into space or make strange sounds during a seizure. Some people may undress, laugh, or walk in circles.
Depending on the part of the brain affected and the severity of the disturbance in the brain, epileptic seizures can range from relatively benign events that happen rarely to recurrent, disabling, life-threatening emergencies.
Regardless of the seizure type, a person generally must have had at least two “unprovoked” seizures at least 24 hours apart to be diagnosed with epilepsy. For a seizure to be unprovoked, it can’t have another known cause aside from the disturbed brain activities that are considered epilepsies.
In discussing epilepsy, doctors often refer to seizure types, epilepsy types, and epilepsy syndromes.
Seizure type is classified based on the initial manifestation of the seizure as generalized, focal, or unknown, depending on the extent of the seizure’s activity in the brain.
The symptoms of the seizures will vary depending on the part of the brain affected.
People having a generalized seizure are generally not aware of their surroundings, so observers should try to be alert to the person’s safety.
Some types of generalized seizures include:
If you see a person having an apparent seizure of any kind, do what you can to ensure the person’s safety, and make note of the time. Tonic-clonic seizures lasting more than 5 minutes are considered to be a medical emergency, and you should call 911 if you observe one.
People having a tonic-clonic seizure may lose control of their bladder or bowels, and they will feel exhausted and sore after the seizure (known as the “postictal” period).
Many focal epilepsies have an “aura,” or warning symptoms of an upcoming seizure. The person experiencing the aura is conscious.
Focal seizure symptoms are subdivided into motor (movement), sensory, autonomic, and psychic.
A focal seizure with motor symptoms typically causes jerking movements of a foot, the face, an arm, or another part of the body, while a focal seizure with sensory symptoms affects a person’s hearing or sense of smell or may cause them to experience hallucinations.
A focal seizure with autonomic symptoms affects the part of the brain responsible for involuntary functions, causing changes in blood pressure, heart rate, or bowel or bladder function. Finally, focal seizures can strike the parts of the brain that trigger emotions or memories, causing feelings of fear, anxiety, or déjà vu (the feeling that something has been experienced before).
Because focal seizures only involve part of the brain, symptoms are often not as extensive as generalized seizures. Focal symptoms often involve only one side of the body instead of both.
Focal seizures are further classified by level of awareness: aware, impaired awareness, or unknown awareness.
Some seizures start as a focal impaired awareness seizure and then progress to a generalized tonic-clonic seizure.
Remember, any tonic-clonic seizure lasting over five minutes should prompt a call to 911.
Learn More About Dravet Syndrome
Epilepsies are often grouped by a complex set of characteristics that mark a type as a known “syndrome.” They are also sometimes described by their symptoms or by the part of the brain affected.
Here are some of the most common epilepsy syndromes:
Because different parts of the brain perform different functions, seizure activities in different areas can have distinct symptoms.
Here are some examples of epilepsy syndromes characterized by the regions of the brain that are affected:
Causes of epilepsy are not the same as triggers. Seizure triggers don’t cause epilepsy, but they can lead to an epileptic seizure in someone who is already susceptible.
Common seizure triggers include stress, sleep deprivation, dehydration or missing meals, and consumption of or withdrawal from alcohol or drugs.
A significant proportion of epilepsies of childhood causes are genetic, metabolic, or the person was born with a structural problem in the brain. Epilepsy in adults is more likely to be caused by structural changes acquired over time, like tumors or strokes.
It’s important to note that not all seizures are caused by epilepsy. Acute neurological problems, such as a stroke or head injury, can also cause a seizure. Metabolic problems, such as hypoglycemia — a common side effect of insulin therapy — and drug intoxication can sometimes cause seizures.
In infants and children, a high fever can cause seizures. And even stress, missing meals, or sleep deprivation can bring on seizures in some individuals.
Psychogenic nonepileptic seizures (PNES) are believed to be a type of disorder called a conversion disorder, in which physical symptoms don’t have an underlying physical cause. People with PNES look like they’re having epileptic seizures, but their symptoms are not caused by abnormal brain electrical discharges, as in epilepsy. Instead, they have a psychological cause. People who have epilepsy can also have PNES simultaneously. PNES can be treated by a knowledgeable mental healthcare professional.
Many of the same tests used to diagnose epileptic seizures are also used to diagnose nonepileptic seizures.
A variety of tests are used to look for evidence of epilepsy and to rule out other possible causes of seizures.
Sometimes brain imaging is done using MRI or computed tomography (CT) to look for structural abnormalities in the brain that may be causing seizures.
A person’s medical history also provides important clues to the underlying cause of seizures.
Learn More About Diagnosing Epilepsy
Epilepsy is a potentially life-threatening condition, and it carries a risk of premature death if it’s not properly diagnosed and treated.
Children and young adults diagnosed with the condition — roughly half of all cases of epilepsy are diagnosed in people age 25 years or younger — aren’t likely to see any reduction in their life expectancy from epilepsy, particularly if they’re on a medication that effectively controls their seizures.
How long you will experience epilepsy symptoms depends on the type of epilepsy you have and what’s causing it.
In general, most doctors will consider lowering the dose or even discontinuing your seizure medication if you’ve been seizure-free for two to four years. But many people with epilepsy will need to remain on medication for longer periods in order to keep their symptoms under control.
You shouldn’t stop taking your seizure medication without consulting with your doctor.
The first type of treatment usually offered for epilepsy is an antiseizure medication (ASM) or anti-epileptic drug (AED), of which there are more than 20. Typically, antiseizure drugs are started at a low dose, and the dosage is gradually increased to find the proper dose for the person.
Most people with epilepsy can become seizure-free by taking an antiseizure medication. Some may need to take a combination of ASMs to control their seizures.
Finding the right medication and dose can be difficult. In helping you find the right ASM, your doctor will consider your condition, the frequency of your seizures, your age, and any other health conditions you may have, as well as any medications you may be taking for them.
To start, your doctor will prescribe a single medication at a relatively low dose, increasing the dose gradually until your seizures are controlled.
Depending on the medication, ASMs can have side effects. Among the most common mild side effects are:
More serious, but rare, side effects include:
To get the most from your drug treatment — and to maximize control of your seizures — you should take medications as prescribed and call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs, or herbal remedies for your epilepsy or other health problems.
Don’t discontinue your ASM without talking to your doctor, and contact your doctor as soon as possible if you experience feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors.
In June 2018, the U.S. Food and Drug Administration (FDA) approved the drug cannabidiol (Epidiolex), which is derived from the cannabis plant, for the treatment of Lennox-Gastaut syndrome and Dravet syndrome.
Epidiolex is made from purified cannabidiol (CBD), an ingredient found in marijuana. The medication does not contain THC, the primary psychoactive component in marijuana that causes the “high” associated with its use.
Epidiolex has been found to reduce seizure frequency in children and young adults with these epilepsy syndromes.
More than half of those newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don’t work, your doctor may recommend surgery.
Surgery can be beneficial if scans of your brain reveal that your seizures originate in a small, well-defined area of your brain, and its removal won’t interfere with speech, language, motor function, vision, or hearing.
In most epilepsy surgeries, the neurosurgeon removes the area of your brain causing your seizures. Traditional surgery requires opening up the skull to access the part of the brain to be removed. A newer type of surgery, called stereotactic laser ablation, can be done through a small hole in the skull. “Stereotactic” refers to the use of medical imaging technologies that allow the surgeon to precisely place a medical instrument in the brain.
In stereotactic laser ablation, the surgeon uses CT or MRI images to guide a laser through the brain to the cells causing the seizure. The laser is then used to burn, or “ablate,” these cells.
Even after successful surgery, some people may need to continue taking an antiseizure medication to prevent seizures, but they may be able to take fewer drugs at reduced doses.
An alternative to surgery for some people with epilepsy is neurostimulation, in which either the vagus nerve or parts of the brain are stimulated with electrical pulses to stop seizures and possibly prevent them.
Ongoing research suggests that long-term use of the device may also reduce the likelihood of seizures occurring in the first place.
Continuous Stimulation Researchers are also experimenting with a technique called continuous stimulation. In this approach, an electrical charge is applied to the seizure onset zone, or the area of the brain where seizures originate, to interrupt them.
Some people with epilepsy try alternative and complementary therapies, including:
Although the research supporting the effectiveness of these approaches is limited, some people say they have helped them manage their seizures.
Although most herbal supplements are generally safe, some can make your seizures worse, cause side effects, or affect how your epilepsy medicines work. Talk to your doctor before taking any herbal supplement.
Depending on what triggers your seizures, stress reduction may help limit their frequency — and help improve your overall health and sense of well-being at the same time.
Physical activity such as walking, swimming, or bike riding has been shown to help people with epilepsy, as exercise also calms the abnormal electrical brain activity that triggers seizures. Talk to your doctor before starting a new exercise program to make sure it’s right for you and your epilepsy.
In general, you should avoid activities that could be dangerous if you have a seizure — like skiing. And, if you’re out and about exercising, be sure to wear a medical alert bracelet, just in case you have a seizure.
Yoga can also help reduce stress, as it combines exercise with deep breathing and meditation to strengthen your body and calm your mind.
Meditation can redirect your mind away from stress and the specific thoughts causing it. In particular, mindfulness meditation may help reduce seizures and improve mood in people with epilepsy.
Music therapy may help children with epilepsy. In the 1990s, researchers discovered that children with epilepsy had less abnormal brain activity and fewer seizures when they listened to a Mozart sonata called K448. This is referred to as the Mozart effect.
But some forms of music may trigger seizures, so talk to your doctor before experimenting with music therapy for yourself or your child.
Finally, the so-called keto diet — a high-fat, low-carbohydrate diet — has been shown to control seizures in some people with epilepsy, according to the Epilepsy Foundation. You shouldn’t start the diet on your own — it must be prescribed by your doctor and monitored by a dietitian, because it requires careful measurement of calorie, fluid, and protein intake.
The diet has proved most effective in children with seizures that don’t respond to antiseizure medications, the Epilepsy Foundation says.
Its full name is the ketogenic diet because it causes your body to produce ketones, or acids that are formed when the body uses fat as its source of energy. Higher blood ketone levels are believed to lead to improved seizure control.
An infection called cysticercosis is thought to be the most common cause of epilepsy globally, and it’s transmitted to humans from a parasite, the CDC says. It’s most common in areas of Latin America, Asia, and Africa with poor sanitation, and it’s relatively uncommon in the United States and Europe. You can reduce your risk of infection by practicing good personal hygiene — such as washing your hands regularly — and using safe food preparation practices, including regularly cleaning surfaces in your kitchen.
Another common cause of epilepsy is traumatic brain or head injuries. Of course, you can’t prevent all accidents, but you can reduce your risk for head injuries by wearing a helmet when playing sports such as hockey or when riding a skateboard or bicycle, for example.
Wearing seatbelts while riding in the car and making sure to use child safety seats for babies and younger children can also help.
Reducing your risk of heart attack and stroke can also help lower your risk of developing epilepsy later in life, as some epilepsies are caused by these serious health events. Following a healthy diet, exercising regularly, and reducing stress can help you maintain heart and blood vessel health.
Finally, some epilepsies have been linked with complications during pregnancy and childbirth, according to the CDC. Developing a prenatal care plan with your doctor can minimize the risks to your newborns.
Once you’ve been diagnosed with epilepsy, the best way to prevent seizures and reduce their frequency is to stick with the treatment prescribed by your doctor. If you feel your treatment isn’t working, and seizures are affecting your quality of life, talk to your doctor about other options. Do not stop medications without guidance from your doctor as quitting “cold turkey” can not only cause an increased risk of seizures but also serious withdrawal symptoms.
A product that can help adults and children age 6 and older is the Embrace2, a sort of smartwatch for epilepsy that senses electrodermal activity — variations of the electrical conductance of the skin in response to sweating — and physical motion that may indicate a seizure. The device can be programmed to send an alert to a caregiver via smartphone when it senses signs of a likely seizure, so the wearer is not alone when a seizure happens.
Most people with epilepsy can live long, productive lives, provided they’re diagnosed early and are treated effectively.
But the condition may cause fatal complications.
For example, people who continue to experience seizures are at increased risk of sudden unexpected death in epilepsy (SUDEP), even if they’re otherwise healthy. Often, in cases of SUDEP, a person with epilepsy is found dead, with no apparent evidence of having had a seizure.
In one in three cases of SUDEP, there are signs of a recent seizure close to the time of death, an episode that may have caused heart or breathing problems.
More than 1 in 1,000 people with epilepsy die from SUDEP annually, making it the leading cause of death in people with uncontrolled seizures.
Another potential cause of death in people with epilepsy is status epilepticus, defined as a single seizure or multiple seizures that last for more than five minutes, causing lung, heart, or neurological complications.
Up to 30 percent of the people who experience status epilepticus die within 30 days of doing so.
Unfortunately, people with epilepsy are 5 times more likely to die by suicide than the general population. This may be due to the stress of managing the condition, or because of the social stigma surrounding the condition.
Historically, people who experienced seizures were linked with witchcraft and demonic possession, among other folk beliefs.
Epilepsy can also be isolating, for children and adults. Friends, family, colleagues, and neighbors may not understand the condition or know how to respond when you have a seizure. Also, if those with epilepsy can’t drive it can make accessing friends and family more difficult.
There have also been incidents of police arresting — and even tasering — people with epilepsy who have seizures in public, mistaking convulsions for erratic or violent behavior or as a sign of drug use.
In general, the lack of understanding and support can lead to feelings of loneliness, which is why joining a support group — either in person or online — may be a good idea.
Those with the condition are also at increased risk for accidents — burns, car accidents, drowning, falls — that occur during or immediately after a seizure. These incidents, too, can be fatal.
Researchers are studying many potential new treatments for epilepsy, as well as refinements and new applications for existing treatments.
The prevalence of epilepsy among Black adults is 1.8 percent, compared with 1.9 percent for white adults, the CDC says. But Black adults are slightly more likely to have active epilepsy than white adults.
Roughly 1 percent of Hispanic American adults have epilepsy, the CDC notes. Just over half of them have active epilepsy, the agency says.
Studies have found that Black Americans and Hispanic Americans are less likely to receive state-of-the-art diagnostic approaches, be prescribed anti-epileptic drugs, and undergo surgery to control seizures than white people with the condition. This could be due to unconscious bias by healthcare workers or Black and Hispanic Americans being more likely to lack health insurance than their white counterparts, making such care more challenging to pay for.
Epilepsy may increase a child’s risk for a mood disorder, such as depression, or a learning disorder, such as attention deficit hyperactivity disorder (ADHD), according to the Epilepsy Foundation.
Children with epilepsy may also experience more headaches, including headache caused by migraine.
Individual risk for these related conditions — or comorbidities — varies, and depends on a number of factors, including how often the child has seizures, how much (and which) medication the child is taking, and the child’s age when seizures started.
Depression is thought to be the most common comorbidity with epilepsy, as it affects about 1 in 4 children with the condition, according to the Epilepsy Foundation. Depression is a serious condition, and it can lead to thoughts of suicide.
Depression is treatable, either through cognitive behavioral therapy, medication, or the two in combination.
In addition to depression, people with epilepsy are more likely to have anxiety disorder and bipolar disorder, research suggests. Although the links between bipolar disorder and epilepsy remain unclear, it’s likely that worries over seizures may contribute to feelings of anxiety.
If you or your child is experiencing anxiety, talk to your doctor.
As many as one-third of all children with epilepsy show the signs or symptoms of ADHD, the Epilepsy Foundation says. Most children with epilepsy and ADHD have difficulty paying attention or focusing, rather than being hyperactive.
©2025 sitename.com All rights reserved