What is epilepsy?

A look at the different types of seizures, what triggers them and how to respond when someone has an epileptic fit.

What is epilepsy?

A disorder that makes a person suffer repeated seizures over time, caused by abnormal electrical disturbances in the brain.

Seizures are episodes of disturbed brain activity that cause changes in attention or behaviour.

Categories of epilepsy

Primary or idiopathic epilepsy occurs spontaneously without a clear cause and can be inherited. Brain scans are usually clear but an electroencephalogram (EEG) will usually identify irregular electric activity in the brain. More than two thirds of epilepsy cases worldwide fall under primary epilepsy.

Secondary, or symptomatic epilepsy, occurs when there is a medical condition or injury affecting the brain, such as a stroke or tumour. A brain scan, typically magnetic resonance imaging, will usually identify where the lesion is and treatment will be prescribed accordingly.

Types of seizures

Petit mal seizures is the term commonly given to a staring spell, most commonly called an absence seizure. It is a brief – usually about 15 seconds – disturbance of brain function due to abnormal electrical activity in the brain.

Generalised tonic-clonic seizure  is a seizure that involves the entire body. It is also called a grand mal seizure. The terms “seizure”, “convulsion” or “epilepsy” are most often associated with generalised tonic-clonic seizures. Many patients experience vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This is called an aura.

Partial (focal) seizures occur when the electrical activity remains in a limited area of the brain. The seizures may sometimes turn into generalised seizures, which affect the whole brain. This is called secondary generalisation.

Triggers

These vary between patients depending on the type of epilepsy they have, but common triggers can include lack of sleep, excessive alcohol intake, stress and long exposure to video games.

What to do if someone has a seizure

Once a seizure starts, nothing can be done to stop it. But a few precautions can be taken to protect patients from harm:
• Try to put the patient's head to the side so that the tongue is not retracted and does not obstruct breathing. Do not place anything in the patient's mouth.
• Remove any solid objects
surrounding the patient. If possible, smoothly place the patient on the ground.
• Immediately seek medical help.

Sources: MedlinePlus; International League Against Epilepsy; Dr Iyad Khoudeir, consultant neurologist, Al Noor Hospital