A seizure is caused by abnormal electrical activity in the brain resulting in a short disturbance of consciousness, muscle function, sensations, behaviour, emotions, or a combination of these.
Seizures can be classified as generalised (where the electrical activity affects all of the brain) or focal (where the electrical activity stays in one part of the brain).
High temperatures, low oxygen levels, low blood sugar levels or poisons can cause a seizure.
Epilepsy however is defined by having at least two unprovoked seizures more than 24 hours apart. 1 in 100 people have epilepsy in the UK.
In generalised seizures the symptoms tend to involve the whole body and are accompanied by impaired consciousness. Types of generalised seizure are defined by their symptoms:
Focal seizures depend on which part of the brain they start in:
People often experience symptoms after seizure including drowsiness, memory-impairment, injury and aching arms or legs.
In many people no cause for epilepsy can be identified.
Some people with epilepsy are susceptible to seizures after specific triggers including:
In addition to a thorough history and examination other investigations are useful in helping diagnose epilepsy as other conditions may mimic seizures.
Blood tests and cardiovascular assessments such as ECGs, blood pressure monitoring and an echocardiogram can help rule out cardiac and metabolic causes for loss of consciousness.
An Electroencephalograph (EEG) can be used to record electrical activity of the brain. A normal test does not rule out epilepsy.
Brain scans using computer tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) can all be used to examine for specific underlying brain abnormalities.
Epilepsy – Adult/Child Treatment
GPs are encouraged to refer to a neurology specialist with expertise in epilepsy to instigate treatment. The mainstays of treatment are anti-epileptic drugs (AEDs).
The type of epilepsy, age, biological sex and other medications affect the first-line AED for each person. More specialist treatments can include surgery and vagal nerve stimulation.
Medicinal cannabis can be considered when first line therapies have not achieved adequate seizure control.