Main
- Epilepsy — repeated unprovoked seizures due to excessive electrical activity of brain cells.
- A seizure ends on its own, but afterwards drowsiness, weakness or confusion remains.
- Causes include head injury, brain infections, a tumour, stroke, lack of sleep and heredity.
- Examination includes electroencephalography, magnetic resonance imaging and blood tests.
- The condition is managed by a neurologist; if behaviour and mood change, a psychiatrist is involved.
What is epilepsy
Epilepsy is a condition in which seizures recur in the brain because of excessive electrical activity of nerve cells. Below we explain what happens in this condition, what causes it and who is affected more often.
What happens in the body
The brain controls the body through weak electrical signals that are constantly transmitted between nerve cells. In epilepsy this usual order is sometimes disrupted: a group of cells begins to become excited too strongly and all at once. Such a wave of excitation covers an area of the brain or spreads wider and for a short time changes the work of the body. Externally this looks different: a person may freeze for a few seconds and not respond, or may fall with convulsions of the whole body. After a seizure drowsiness, confusion or weakness often remain, and the person does not remember what happened to them. The seizure ends by itself, because the brain is able to return the cells to a calm state. If seizures recur, it is important for the doctor to understand their character, so it is useful for relatives to remember and describe what they saw.
What causes it to develop
- Hereditary predisposition: in some people a tendency to seizures is passed down in the family, so the doctor is told about similar cases in relatives.
- Head injury: serious damage to the brain, especially with loss of consciousness, increases the risk of seizures months and years after the event.
- Brain infections: inflammatory processes affect the nervous tissue and may leave behind an area with altered cell activity.
- Tumour or stroke: a space-occupying formation and impaired blood supply damage an area of the brain that begins to work differently from neighbouring areas.
- Lack of sleep and overwork: lack of sleep and severe stress reduce the stability of the nervous system and in some people become a trigger for a seizure.
- Missing doses of medicines prescribed by the doctor: if a person stops taking what the specialist selected for them, control over seizures is lost, so the regimen is followed strictly.
Who is affected more often
Epilepsy occurs in people of any age, but the distribution across groups is uneven and depends on the causes. In children seizures are often associated with a hereditary tendency and features of brain development, and some of these forms stop troubling over time. In older people the proportion of cases where a stroke, tumour or past infection became the trigger is higher, as well as accumulated head injuries. In adults of working age the consequences of road and domestic injuries play a noticeable role, as well as lack of sleep and overwork with a busy schedule. A separate group is people who interrupt the prescribed follow-up or change the regimen at their own discretion, and their seizures return more often. Sex and place of residence by themselves are not decisive, although access to follow-up by a specialist affects how early the condition is recognised. If seizures have already occurred, it is reasonable to discuss with the doctor which circumstances should be taken into account in your case.
What symptoms can there be?
The manifestations of epilepsy depend on which area of the brain is involved, so seizures look different in different people. Below we look at how the first signs are noticed, which symptoms are most common, and in which cases help is needed immediately.
How it is noticed at the very beginning
At the beginning, epilepsy manifests as short episodes that the person themselves often does not remember and learns about from loved ones. Those around them notice that the person freezes for a few seconds, as if listening, and does not respond when addressed. Sometimes before a seizure unusual sensations, smells or sounds appear that no one nearby has. Involuntary twitching of an arm, leg or face is also sometimes the first noticeable sign. Such moments are often put down to tiredness, lack of sleep or absent-mindedness and are not linked to the brain's activity. After an episode, weakness, drowsiness or confusion remains, and the person does not understand where several minutes went. If something similar happens again, it is worth writing down how it looks from the outside and showing the notes to a neurologist.
Signs that are most common
- Brief loss of consciousness with convulsions: the person falls and does not react to those around them, and after the seizure does not remember what happened.
- Freezing and a blank stare: for a few seconds the person becomes still and does not respond, which is easily mistaken for inattentiveness.
- Involuntary twitching of an arm, leg or face: the muscles contract without the person's will, and this is noticeable from the outside.
- Unusual sensations, smells or sounds before a seizure: such a warning sign helps to understand that an episode is about to begin.
- Confusion or drowsiness after a seizure: consciousness returns gradually, and the person needs time to come round.
- Involuntary urination during a seizure: this sign often indicates that the episode was not a faint but a seizure.
When to seek help urgently
Examinations and tests
Examinations for epilepsy are needed to clarify the form of the disease and select suitable treatment. Below is a breakdown of what exactly is prescribed and what information helps the doctor.
How the examination begins
The examination for epilepsy begins with a detailed questioning about the seizures and an appointment with a neurologist. The doctor asks to describe what the seizure looks like according to those around, what the person was doing before it and how they came round. It is important to recall whether the person lost consciousness, whether there were convulsions, freezing or strange sensations before the seizure. Separately, they clarify how often this repeats and in what circumstances it happens. Such details are often more important than the results of the devices themselves, because a description of the seizure from the outside gives the doctor a key to understanding the picture. Additional examinations help to clarify the form of epilepsy and select suitable treatment. Therefore, it is worth coming to the first appointment with notes from relatives, rather than relying only on your own memory.
What is prescribed and what it shows
What is worth preparing for the appointment
- Seizure diary: records with dates, times and a description of each episode help the doctor see patterns that are difficult to recall at the appointment.
- Description of the seizure by relatives: an eyewitness account of what happened from the outside is often more accurate than the words of the person themselves, who does not remember the seizure.
- Previous examination results: old films and reports give the doctor the opportunity to compare the picture and not prescribe again what has already been done.
- Discharge summaries from hospitals: if the person has already been treated in hospital, these documents show how the examination went before and what was found then.
- List of all medications taken: it is important to list everything the person takes regularly, including what they do not consider serious.
- Questions for the doctor: questions written down in advance help not to forget anything and to get clear answers about the next steps.
Which doctor should I see?
In epilepsy, care is provided by a neurologist, and under certain circumstances a psychiatrist joins the follow-up. Understanding who manages the condition and how treatment is structured helps you calmly choose a specialist and build regular follow-up.
Which specialist manages this condition
Epilepsy is managed by a neurologist, and when seizures are combined with changes in behaviour and mood, a psychiatrist joins in. The neurologist assesses the nature of the seizures, their frequency and their impact on the person's daily life. A psychiatrist joins in when emotions, thinking and behaviour are affected, and this is noticeable to those close to the person. If there is no specialised specialist nearby, you can start with an appointment with a neurologist at your place of residence. They will gather information about the seizures, question those close to the person and determine whether the help of a second specialist is needed. At the first appointment it is important to tell how often the seizures occur and what precedes them. Such a detailed account noticeably speeds up the selection of suitable care and reduces the number of trial decisions.
What treatment consists of
- Selection of therapy by the doctor: the specialist selects care individually, taking into account the nature of the seizures and the person's characteristics, rather than following a general template.
- Regular follow-up with a neurologist: scheduled visits allow changes in the condition to be noticed in time and care to be adjusted without waiting for deterioration.
- Surgery when indicated: in certain cases a surgical solution is discussed if other areas of care do not give the needed effect.
- Keeping to a sleep and rest routine: a consistent daily routine and sufficient rest reduce the load on the nervous system and support the overall condition.
What depends on the patient themselves
A stable result in epilepsy largely rests on the regularity of follow-up and honesty at the doctor's appointment. A person should come to scheduled visits even when there have been no seizures for a long time and the condition seems calm. It is important to tell the doctor about any changes: how often the seizures occur, what precedes them, how the person sleeps and rests. If something in the prescribed care does not suit them or raises doubts, this is discussed at the appointment, rather than decided on their own. It is useful for relatives to record observations so that nothing is forgotten at the visit and the picture is complete. Missed visits and fragmentary information make the selection of care more difficult and stretch out the time until improvement. Calm and consistent follow-up gives the doctor more support for accurate decisions.
What helps prevent an exacerbation?
The risk of epilepsy worsening largely depends on the everyday decisions of the person themselves. Below is a breakdown of which habits are worth changing, what is important to monitor, and why regular visits to the doctor remain necessary even when you feel well.
What to change in your habits
Sleep routine is one of the most significant factors that a person can control independently. Lack of sleep and a disrupted schedule often become the background against which how you feel changes. Alcohol can also affect the course of the condition, so its amount is best limited. Overfatigue, whether heavy physical work or prolonged nervous tension, increases the strain on the body. When playing sports, cycling and other activities with a risk of falling, the head is protected with a helmet. Taking the prescribed medicines according to a regimen agreed with the doctor remains the basis of a stable condition. If a person notices that after certain situations they feel worse, this should be told to the doctor.
What to keep under control
- Sleep routine: a constant time for going to bed and getting up helps avoid lack of sleep, which often precedes a deterioration in how you feel.
- Alcohol consumption: even rare episodes with a large amount of alcohol can disrupt sleep and affect the course of the condition.
- Degree of fatigue: overfatigue accumulates unnoticed, so it is important to reduce the load in time and find time for rest.
- Head protection: a helmet when cycling, rollerblading and in contact sports reduces the risk of head injury.
- Regularity of taking the prescribed medicines: missed doses and independent changes make the condition less predictable, so everything is reported to the doctor.
How often to see the doctor
Regular visits to the doctor are needed even when there have been no seizures for a long time and you feel completely well. The specialist assesses how the person tolerates the prescribed treatment and whether there are any unwanted reactions. At the appointment, sleep, loads, alcohol consumption and other circumstances that may have changed are discussed. The doctor also checks whether new complaints have appeared that the person themselves has not noticed in the everyday bustle. If something in the condition changes, this allows the approach to be adjusted in time, without waiting for a serious deterioration. Planned visits should not be skipped even with a stable course, because some changes are noticed precisely by the doctor. Write down your observations between appointments so that the conversation is substantive and nothing is forgotten.
What is worth remembering
Epilepsy is a condition in which the brain periodically responds to stimuli with seizures, and a discussion of it should end with what remains with a person after reading. Below are conclusions that help make the right decision and not harm yourself.
Main conclusions
Epilepsy does not make a person helpless, but it requires careful attention to one's own condition and regular supervision by a specialist. Seizures occur due to excessive electrical activity of brain cells, and their appearance cannot be explained by weakness of character or upbringing. Epilepsy can be noticed by sudden lapses in consciousness, convulsions or brief staring spells that recur. Many forms of epilepsy are well controlled if a person follows the doctor's recommendations and does not stop supervision on their own. The most dangerous thing is abruptly stopping the prescribed treatment: this often leads to the return of seizures and worsening of the condition. Another common mistake is hiding episodes from loved ones and the doctor, although it is precisely their description that helps select the right care. A person with epilepsy needs to decide in advance whom nearby they trust to know about their condition and what to do during a seizure. Epilepsy is a reason for calm, consistent control, not for giving up study, work and ordinary life.
