Epilepsy is a neurological disorder that affects brain activity, causing seizures or periods of unusual behaviour.
People of any age can develop epilepsy, but at least two unprovoked seizures are generally required to fulfil the diagnostic criteria.
The majority of patients with epilepsy respond well to anti-epileptic medications, while in rare cases some patients require additional treatment.
The range of symptoms varies greatly depending on the type of seizure. Seizure symptoms may include episodic confusion, loss of consciousness or awareness, jerking movements of the arms and legs, spells of staring, and psychic symptoms such as fear, anxiety, or feelings of déjà vu.
Neurologists classify seizures as focal or generalised, based on how the abnormal brain activity begins.
Focal or partial seizures result from abnormal activity in just one area of the brain:
Simple partial seizures are focal seizures without loss of consciousness. They can change the way things appear to look, smell, feel, taste, or sound or affect a patient’s emotions. These seizures might include involuntary jerking of a body part, such as a limb, and onset of issues such as tingling sensations, dizziness and issues with vision.
Complex partial seizures are focal seizures which impact a patient’s awareness or consciousness. A patient might make repetitive movements, such as walking in circles or rubbing their hands, or staring into space and not appearing fully conscious.
As symptoms of focal seizures may often be confused with other neurological disorders, such as migraine, narcolepsy or mental illness, proper assessment by an experienced neurologist is necessary.
Generalised seizures result from abnormal activity in all areas of the brain:
Absence seizures are more common in children and include periods of unusual behaviour, such as staring into space, lip smacking or eye blinking, and can cause a brief loss of awareness. They are also known as petit mal seizures.
Tonic seizures cause stiffening of your muscles, usually affecting muscles in the back, arms and legs and may cause you to fall.
Clonic seizures are associated with repeated or rhythmic jerking muscle movements, affecting the neck, face, and arms.
Tonic-clonic seizures, also known as grand mal seizures, cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes biting your tongue or loss of bladder control.
Myoclonic seizures usually appear as sudden brief jerks or twitches of arms and legs.
Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause a patient to suddenly collapse or fall down.
The diagnostic process starts with a detailed neurological examination and a medical history review. Based on the findings, the neurologist will usually indicate blood tests, a brain MRI and EEG. In more complicated cases, the neurologist may also recommend more advanced diagnostic procedures such as video EEG, genetic tests or others.