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 April 27, 2011, issue of JAMA includes an article about adherence to treatments for epilepsy. This Patient Page is based on one published in the February 4, 2004, issue of JAMA.
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 epilepsy.
Images of the brain may be taken using computed tomography (CT) scans or magnetic resonance imaging (MRI) 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 from occurring.
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 Foundationhttp://www.epilepsyfoundation.org
National Institute of Neurological Disorders and Strokehttp://www.ninds.nih.gov
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 epilepsy surgery was published in the December 3, 2008, issue.
Sources: American Epilepsy Society, National Society for Epilepsy, National Institute of Neurological Disorders and Stroke, The Epilepsy Foundation
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page 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 may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: BRAIN DISORDERS
Parmet S, Lynm C, Golub RM. Epilepsy. JAMA. 2011;305(16):1722. doi:10.1001/jama.305.16.1722