Epilepsy

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Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. Furthermore, it is also known as a seizure disorder because the tendency is to have recurrent seizures. Epileptic seizures vary in severity and frequency, and even in the time of day they occur. While some people may experience no more than two or three seizures during their entire lifetime, others will have several seizures in one day.

Epilepsy is a disorder with many possible causes. Anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development - can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, or some combination of these factors. Having a seizure does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. EEGs and brain scans are common diagnostic test for epilepsy.

Absence Epilepsy - People with absence epilepsy have repeated absence seizures. Absence epilepsy tends to run in families. The seizures frequently begin in childhood or adolescence. If the seizures begin in childhood, they usually stop at puberty.

Temporal lobe epilepsy (TLE) is the most frequent cause of partial seizures and aura. The temporal lobe is located close to the ear. It is the part of the brain where smell is processed and where the choice is made to express a thought or remain silent.

Frontal Lobe Epilepsy - The frontal lobes of the brain lie behind the forehead. They are the largest of the five lobes and are thought to be the centers that control personality and higher thought processes, including language and speech.

Occipital Lobe Epilepsy - The occipital lobe lies at the back of the skull. Occipital lobe epilepsy is like frontal and temporal lobe epilepsies, except that the seizures usually begin with visual hallucinations, rapid blinking, and other symptoms related to the eyes.

Parietal Lobe Epilepsy - The parietal lobe lies between the frontal and temporal lobes. Parietal lobe epilepsy is similar to other types in part because parietal lobe seizures tend to spread to other areas of the brain.

Sources:
eHealthMD: http://www.ehealthmd.com/library/epilepsy/EPI_kinds.html
WebMD: http://www.webmd.com/epilepsy/guide/types-of-seizures-their-symptoms 

Epilepsy has so many causes and can be linked to a number of other conditions, it is sometimes very difficult to determine the cause of a particular case. They include:

Brain Chemistry - Epilepsy may develop because of an imbalance in those chemicals in the brain that help the nerve cells in the brain transmit electrical impulses. These chemicals are called neurotransmitters.

Hereditary Causes - Many types of epilepsy tend to run in families, and some have been traced to an abnormality in a specific gene. These genetic abnormalities can cause subtle changes in the way the body processes calcium, potassium, sodium, and other body chemicals.

Other Disorders - Epilepsy can be triggered by brain damage caused by other disorders (such as stroke, heart attacks, Alzheimer's disease, etc). Epilepsy can sometimes be stopped by treating these underlying disorders. In other cases, epileptic seizures will continue after the underlying cause is treated.

Head Injuries can cause seizures. If the head injury is severe, the seizures may not begin until years later. If the injury is mild, the risk is slight.

Prenatal Injuries - In a fetus, the developing brain is susceptible to prenatal injuries that may occur if the pregnant mother has an infection, doesn't eat properly, smokes or abuses drugs or alcohol. These conditions may cause cerebral palsy.

Environmental Causes - Environmental and occupational exposure to lead, carbon monoxide, and certain chemicals. Other environmental causes include the use of street drugs and alcohol, lack of sleep, stress, or hormonal changes, and withdrawal from certain antidepressant and anti-anxiety drugs

Epilepsy is caused by abnormal activity in brain cells, seizures can affect any process your brain coordinates. A seizure can produce temporary confusion, complete loss of consciousness, a staring spell, or uncontrollable jerking movements of the arms and legs.

The main treatment options for people with epilepsy are medications, surgery and vagus nerve stimulation. The ketogenic diet is a treatment option for some children and, increasingly, for some adults. The same treatment does not work for every patient because the type and severity of epilepsy varies.

Medications - More than a dozen medications are currently approved to treat epilepsy. Each medication has benefits and side effects, and different medications are appropriate for different types of epilepsy. No single medication has proven to be the best treatment for epilepsy. Only a complete evaluation can determine which medication will work best for each patient.

Surgery for Partial Seizures - Patients who have partial seizures that originate in one part of the brain may be candidates for surgery to remove that part. This surgery is done only if it does not jeopardize normal function, and if the seizure origination point can be pinpointed. A technique developed at Mayo Clinic called SISCOM accurately locates seizure "hot spots," allowing the neurosurgeon to remove them safely.

Surgery for Generalized Seizures - Patients who have generalized seizures (affect both sides of the brain) usually are not candidates for surgery. However, if the seizures result in falls and injuries, a procedure called corpus callosotomy may be considered. This procedure involves separating the nerve fibers that connect the two halves of the brain. While this surgery does not cure epilepsy or completely stop seizures, it can reduce the number and severity of seizures and related falls and injuries.

Vagus nerve stimulation (VNS) is approved to treat partial seizures in patients 12 and older. VNS can reduce seizure frequency and intensity in some patients. Approximately 30 to 50 percent of patients can be expected to have less seizure activity with VNS.

Ketogenic Diet - The ketogenic diet has traditionally been used primarily in treating childhood epilepsy. The diet, especially less strict versions (a modified Atkins diet or a low glycemic diet), is now also being used in treating adults and may be an option for some patients.

Investigational Medications - New medications not yet approved by the Food and Drug Administration (FDA) are an option for patients whose seizures are not controlled by the common, FDA-approved medications.

Investigational Brain Stimulation Device - Mayo Clinic investigators are enrolling patients in a national multicenter clinical trial to test the effectiveness of brain stimulation in treating epilepsy. Carefully selected patients with medically resistant partial epilepsy are candidates for this clinical trial.

Sources:
MayoClinic: http://www.mayoclinic.org/epilepsy/options.html
WebMD: http://www.webmd.com/epilepsy/treating-epilepsy 

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