What causes epilepsy, and can seizures be stopped?
By David Miller, MD
Neurology in Stoneham, Mass.
Epilepsy can be unpredictable. Some of my patients have multiple seizures every day, while others go years without having a seizure, only to have one out of the blue.
Obviously this is frustrating for people with epilepsy and their families. So, it’s probably no surprise that one of the most common questions I hear from my patients is: Does epilepsy go away? The short answer is, sometimes.
David Miller, MD, treats patients with epilepsy in Stoneham, Mass.
What is epilepsy, and what causes it?
Epilepsy is a neurological disorder characterized by malfunctioning neurons – the brain’s nerve cells that send messages to the rest of the body with electric signals. Epileptic seizures happen when clusters of neurons send signals rapidly and abnormally.
Epileptic seizures can cause involuntary movements, convulsions, changes in behavior and emotions, and other symptoms depending on which parts of the brain are affected. Some experts have started calling epilepsy “the epilepsies” to better reflect the wide spectrum of symptoms and causes for this disorder, which affects about 3 million people in the U.S., according to the Epilepsy Foundation.
Epilepsy symptoms also vary in the frequency of seizures, particularly between children and adults. It’s not uncommon for children with an epilepsy condition to experience 100 seizures or more per day, which can be debilitating and cause severe mental effects. Generally, the more seizures someone has, the worse it is for their brain.
If seizures are interfering with your life, find a neurologist near you.
Genetics, brain injuries and tumors, infections, strokes, and other conditions that affect the brain can cause epilepsy to develop. But about half of epilepsy cases are idiopathic, meaning we don’t know the cause.
A number of tools and tests can aid in the diagnosis of epilepsy, including:
- Blood tests: These tests can determine if epilepsy has a genetic origin or if a seizure was triggered by a condition such as low blood sugar.
- EEGs: An electroencephalogram uses small, circular electrodes placed on the scalp to measure the brain’s electrical activity.
- MRIs: Magnetic resonance imaging scans help us see physical abnormalities that could be causing epilepsy, such as a brain tumor.
- Neurological/behavioral testing: We use this method to figure out how a person’s epilepsy affects how they think and behave.
Determining the cause of epilepsy and how it affects brain function helps us tailor an effective treatment plan. For example, if we know a person suffers from focal epilepsy – caused by damage to a specific part of their brain – we often can treat it with surgery. In the case of a generalized epilepsy – in which there is no specific part of the brain responsible for seizures – certain medications work well to stop them.
Can seizures be stopped?
It isn’t common for epilepsy to go away on its own. Some people have seizures during childhood that resolve as they mature, and it’s difficult to say whether their seizures are gone for good. That’s especially true if we don’t know what caused them in the first place.
Long-term, recurring seizures usually can be controlled with treatment, which often includes taking medication. About 70 percent of people with epilepsy can control their seizures with medications or surgery.
If your doctor recommends medication, take the recommended dosages. Your doctor likely won’t consider changing or ceasing medication until you’ve experienced several seizure-free years, or if the side effects are problematic. Ask your doctor before you make any changes to your treatment regimen.
Living with epilepsy
Epilepsies can be intractable – meaning they don’t respond to treatment. Finding an effective treatment for these epilepsies can take a long time. Unfortunately, some people will continue to have seizures even after trying a number of different medications.
However, the landscape for epilepsy treatment has changed in recent years. Epilepsy patients who previously may have had few viable options now have access to several advanced treatments that stimulate the brain with electric currents to stop seizures. These treatments, such as responsive neurostimulation, show promise in successfully treating people with epilepsy that hasn’t responded to medication.
Living with recurring seizures is a challenge, and while we try to find a treatment that works, people having epileptic seizures should make some lifestyle adjustments. One of the most important is to avoid driving. Under Massachusetts state law, you aren’t allowed to operate a motor vehicle if you’ve had a seizure within six months. These laws vary from state to state. Here’s a great tool to compare them.
Also, be mindful of potentially dangerous situations, such as unsupervised swimming or soaking in the tub when no one else is home. In general, it’s best for people with recurring seizures to avoid activities that could cause severe harm if they were to lose control of their body.
If you or a loved one is dealing with intractable epilepsy, don’t give up. I’ve seen people with epilepsy go from treatment to treatment for months until they find a medication that reduces or eliminates their seizures. Controlling seizures can be frustrating, but hang in there. As with many things in life, persistence is key to living seizure-free.
Tags: epilepsy, neurology, seizure