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Epilepsy

Epilepsy is an ongoing disorder of the nervous system that produces sudden, abnormal bursts of electrical activity in the brain. This upsets normal brain function and causes seizures, which may briefly affect muscle control, movement, speech, vision or awareness. People with epilepsy have repeated seizures, usually occurring without warning and often for no clear reason. If epilepsy is not treated, seizures may occur throughout a person's life and in some cases become more severe and more frequent over time.

According to the Epilepsy Foundation of America, about 3 million people in the United States are afflicted with epilepsy and approximately 25% of these cases are children. About 200,000 new cases of seizure disorders and epilepsy are diagnosed each year.

Causes

In approximately 70% of cases, there is no known cause of epilepsy. However, several conditions may cause epilepsy, including a serious head injury, stroke, hardening of the arteries in the brain, brain tumor, brain infection (meningitis or encephalitis) and Alzheimer's disease.

Children are more likely than adults to develop the disorder from an unknown cause. A family history of epilepsy may sometimes be a factor, although experts are not sure how the disease is passed from parent to child.

Diagnosis

Diagnosing epilepsy can be difficult and making an accurate diagnosis is vital in determining the best treatment plan. A detailed medical history often provides the best clues about epileptic seizures and may help rule out non-epilepsy conditions that might have caused the seizures. Routine tests may include:

  • Complete blood count (CBC) to check for infection, abnormal electrolyte levels (such as magnesium, potassium and calcium), and signs of kidney or liver malfunction;
  • Lumbar puncture (sometimes called a spinal tap) to rule out infections, such as meningitis and encephalitis
  • Toxicology screening for poisons, illegal drugs or other toxins
  • Electroencephalalography (EEG) to record electrical activity in the brain
  • Video monitoring can be done at the same time as the EEG to visual the body's reaction before, during and after a seizure
  • Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be used to evaluate the cause and the location of a possible source of epilepsy within the brain.

Treatment

For most people with epilepsy, treatment may reduce or prevent seizures and allow many patients to remain seizure-free for the rest of their lives. Treatment that controls one kind of seizure may have no effect on other kinds of seizures. Age, health and lifestyle are also important factors in planning treatment. Available treatments include:

  • Medication. This is the first and most common approach to treating epilepsy. Antiepileptic medications do not cure epilepsy, but they help prevent seizures in well over half of the people who take them.
  • Brain surgery. Some patients with partial epilepsy do not respond to medication but have great success with surgery.
  • Vagus nerve stimulator. This device is used with medication or surgery to reduce seizures.
  • Ketogenic diet. A high-fat diet has been used with some success to treat people, especially children, who have severe, uncontrolled seizures. However, some doctors may not support its use.

Please visit the Cedars-Sinai Epilepsy Program for recent developments in epilepsy treatment and research.

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For an appointment, a second opinion or more information, please call 1-800-CEDARS-1 (1-800-233-2771) or e-mail us.