Seizure Disorder—Adult
(Epilepsy—Adult)
See also:
Definition TOP
A seizure is sudden and abnormal electrical activity in the brain. A seizure disorder is when a person has two or more seizures that are not due to illness or another trigger. This is also known as epilepsy.
Seizures are classified into two groups:
- Generalized seizure disorder—affects both sides of the brain
- Partial seizure disorder (focal seizure)—affects only one area of the brain
Brain Cells (Neurons)Copyright © Nucleus Medical Media, Inc. |
Causes TOP
Seizures happen because of abnormal brain activity. For many people, it is not known why this happens. Some known causes are:
- Stroke
- Head trauma
- Alcohol use disorder
- Degenerative diseases, such as Alzheimer disease
- Brain damage
- Brain tumors
- Infections, such as bacterial meningitis
- Genetic problems
- Problems with the immune system
Risk Factors TOP
Things that may raise the risk of this disorder are:
- Cerebrovascular disease in older adults
- Parasitic diseases, such as malaria or cysticercosis
- Alcohol use disorder
Symptoms TOP
Symptoms depend on the type of seizures that a person has.
Generalized seizures may cause:
- Eye blinking or staring into space
- Crying out
- Loss of consciousness
- Falling to the ground
- Muscle jerking or spasms
- Feelings of tiredness after the seizure has ended
Partial seizures may cause:
- Muscle twitching
- Sensing a strange taste or smell
- Confusion or a dazed feeling
- Inability to respond to questions or directions
Diagnosis TOP
The doctor will ask about symptoms and past health. A physical exam will be done. An appointment with a doctor who treats the nervous system and brain may be needed.
Brain activity may be tested. This can be done with an electroencephalogram (EEG). Images of the brain may be taken with:
- MRI scan
- CT scan
- Positron emission tomography (PET)
- Single photon emission computed tomography (SPECT)
Treatment TOP
The goals of treatment are prevent further seizures with fewest side effects. This may mean treating an underlying cause or avoiding triggers.
Medicine
Anti-seizure medicines may be given. More than one may be needed. It may take some time to find the right medicine and dosage.
Implanted Devices
Devices can help to interrupt signals that cause seizures. They are placed just under the skin and attached to brain or large nerve. The devices may be used alone or with medicine. Implanted devices include:
- Vagus nerve stimulation (VNS)—implanted in the chest to stimulate the vagus nerve to decrease seizures
- Responsive nerve stimulator (RNS)—implanted in the brain to detect and stop seizures
- Deep brain stimulation (DBS)—implanted in the brain and attached to a device implanted in the chest to stop signals that trigger a seizure
Ketogenic Diet TOP
A ketogenic diet is a strict diet that is low in carbohydrates and rich in fats. For some people, this diet may reduce seizures. It is not known why it helps.
This diet is very strict and may be hard to stick to. Other low carbohydrate diets like Atkins or low glycemic diet may have some benefit.
Avoiding Triggers TOP
Learning and avoiding triggers can help some. Triggers can differ from person to person. Some common triggers are:
- Lack of sleep
- Flashing bright lights
- Excessive alcohol use
- Drug use
- Stress
Surgery TOP
Surgery may be done for seizures that are not helped by medicine. The area that is causing the seizures will be removed or destroyed. It is only an option if the seizures start in one specific spot in the brain.
RESOURCES:
Epilepsy Foundation
http://www.efa.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov
CANADIAN RESOURCES:
Center for Epilepsy and Seizure Education
http://www.esebc.ca
Epilepsy Ontario
http://www.epilepsyontario.org
REFERENCES:
Antiepileptic drugs (AEDs) for seizure disorders. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/antiepileptic-drugs-aeds-for-seizure-disorders-in-adults. Accessed January 27, 2021.
Epilepsy in Adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/epilepsy-in-adults. Accessed January 27, 2021.
Geller EB, Skarpaas TL, Gross RE, et al. Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia. 2017;58(6):994-1004.
Serafini A, Lukas RV, VanHaerents S, et al. Paraneoplastic epilepsy. Epilepsy Behav. 2016;61:51-58.
Thijs RD, Surges R, et al. Epilepsy in adults. Lancet. 2019 Feb 16;393(10172):689-701.
Last reviewed January 2021 by
EBSCO Medical Review Board
Rimas Lukas, MD
Last Updated: 1/28/2021