The term epilepsy applies to a group of nervous
system disorders characterized by recurrent seizures, which are sometimes
called convulsions. A seizure occurs when there are abnormal bursts of electrical
activity in the brain. Although head trauma, strokes, brain tumors, brain
infections, and withdrawal from drugs (including alcohol) can cause seizures,
the recurrent seizures of epilepsy are usually idiopathic (of unknown cause). The February 4, 2004, issue of JAMA includes an article about treatments for epilepsy.
Seizures can affect vision, speech, or movement
and can affect only part of the brain (a partial seizure) or the entire brain (a generalized seizure).
Seizures usually last a few seconds to a few minutes
and may or may not cause loss of consciousness.
Some people experience an aura, a sensation that they are about to have a seizure.
Seizure activity varies for different persons with
epilepsy. Absence seizures (formerly called petit mal) involve staring off into space for a few moments. Complex partial seizures involve unresponsiveness and sometimes
subtle movements of the face, arms, and legs lasting 1 or 2 minutes. Generalized tonic-clonic seizures (formerly called grand mal) involve sudden loss of consciousness and falling
down (sometimes causing injuries) with rapid jerking of the arms and legs.
A careful description of the nature and timing
of seizures is very important.
If epilepsy is suspected, your doctor may recommend seeing a neurologist
(a doctor specializing in the brain and nervous system).
The neurologist will perform a neurological examination
to see how well your brain and nervous system are working.
An electroencephalogram (EEG), a test that measures brain electrical activity, may
be used to look for changes in brain activity typical of various types of
Images of the brain may be taken using computed tomography (CT) scans—computerized
x-rays—or magnetic resonance imaging (MRI)—use of magnetic fields to visualize tissues—to
look for abnormalities such as tumors.
Medication is the first approach for treating epilepsy.
A number of different medications are available that can prevent seizures
Vagus nerve stimulation (VNS) uses a device to prevent seizures by sending a small,
regular pulse of electricity to the vagus nerve, a large nerve in the neck.
Brain surgery is sometimes an option for people
whose seizures cannot be controlled by medications.
The Epilepsy Foundation800/332-1000http://www.epilepsyfoundation.org
National Institute of Neurological Disorders and
To find this and other JAMA Patient Pages, go to the Patient Page link
on JAMA's Web site at http://www.jama.com.
A Patient Page on traumatic brain injury was published in the June 11, 2003,
Sources: American Epilepsy Society, National Society for Epilepsy, National
Institute of Neurological Disorders and Stroke, The Epilepsy Foundation
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are appropriate in most instances, but they are not a substitute for medical
diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page
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TOPIC: BRAIN DISORDERS
Parmet S, Lynm C, Glass RM. Epilepsy. JAMA. 2004;291(5):654. doi:10.1001/jama.291.5.654