Exploring Epilepsy


by Dan (A student of Murry Jensen)


Welcome to my Exploring Epilepsy web page. Here you will find a lot of information on epilepsy. The information ranges from what epilepsy is, what triggers seizures, what is used to treat epilepsy, to my own personal experience with epilepsy. Below is the outline to my web page. Feel free to browse from begging to end, or from topic to topic. All you need to do is click the mouse on the highlighted blue text in which area you are interested in.




An overview of epilepsy.


It is amazing that people don't realize how common epilepsy is. It may be that people simply choose to ignore the possibilities of its presence or it may be that people are just too scared to admit that they have a disorder. The fact is, epilepsy effects about 1 out of every 100 people. There have been about two million cases of epilepsy reported in the united states alone.


Epilepsy has been very common throughout history. Until this century it was usually kept in secret if someone had it. So, therefore, many famous people that we have read about in history have had epilepsy and we never knew it. People such as Napoleon Bonaparte, Alexander the Great and Julius Caesar. Some researchers also have evidence that Socrates, the renowned Greek philosopher; Vincent van Gogh, the famous painter; and the apostle Paul had epilepsy.


As you can see, even the most prominent people can have this disorder and through their achievements you can see that epilepsy is not disabling, though in severe cases it can be, and people with epilepsy can lead productive lives. So please, I invite you to read on and learn as we Explore Epilepsy.



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What is epilepsy?



The word epilepsy comes from a Greek word that means "to possess, seize, or hold." In medicine it describes short-lived bursts of uncontrolled energy in the brain. Epilepsy is not a disease. It is a symptom of a neurologic disorder, a disorder that affects the brain and shows itself in the form of seizures. The seizures stem from overly active nerve cells (neurons) in the brain. The strong and rapid bursts of electrical signals emitted from these hyperactive neurons temporarily disrupt normal functioning, much like a lightning storm can disrupt electrical power in a neighborhood.


A good way to look at the brain is to look at it like a computer. Like a computer, the brain runs on electrical currents. The electric signals in the brain are very small, but they are enough for one neuron to switch on another neuron. Epilepsy is a description of what happens when these cells "misfire." A seizure happens when a large group of neurons misfire. So, in other words, a temporary "short circuit" of the brain. (also see, What happens during a seizure...)


The misfire may occur for different reasons. In patients with epilepsy, sometimes stress, not eating right or lack of sleep may lead to a neuron misfire. At other times, the neuron misfire occurs because the brain has been hurt in an earlier accident or at birth. The hurt area of the brain interrupts the normal flow of cell firings. When routine firings are excessively altered, a seizure my happen. (To find out more about triggers of seizures see, Triggers...)


The hallmark of epilepsy is recurring seizures - sometimes as many as several hundred a day - under normal circumstances. Therefore, in order to have epilepsy, you need to have more than one confirmed seizure.



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What happens during a seizure?



First, lets get the pathway of the nervous system laid out. Nerves throught the body act like telephone lines, allowing the brain to send signals to the rest of the body. These lines are called the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS, includes the brain and the spinal cord and is like the interstate or highway of the nervous system. The PNS is made up of the nerves that sense and control movement, they are like the back streets and roads of the nervous system. Signals travel down the CNS through the spinal cord until they reach their branch of the PNS. Then the signals go through the PNS to their particular nerve endings.


Now that we have a good idea how the nervous system works we can define what goes on during a seizure. When a seizure occurs, out-of-sync signals from the brain travel along the nervous system pathway to sensors, like the nerves that flex muscles. These out-of-sync signals may cause keep the brain from understanding what the eyes see, or may cause a leg muscle to become weak and cause a person to fall. This explains why people may stare or why people loose balance and fall during a seizure. Some people may even loose consciousness entirely. So, now you can see, seizures are caused by neurons that are either firing when the shouldn't or not firing when they should.



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Types of seizures.



To understand this part fully, you need to understand how the brain and the pathway of the nervous system works, so if you need to, please feel free to see....What happens during a seizure.


Now that we understand how the brain and the central nervous system work, and what happens during a seizure, we can now define the two different types of seizures. The first is the generalized and the second is the focal.


A generalixed-onset convulsive seizure is what most people think of when they think about epilepsy. These seizures occur in about 90 percent of all people with epilepsy, either as the only seizure or along with other seizures. This seizure is caused when a neurons' discharge begins in one area, but spreads throughout the brain. The term "generalized onset" refers to the fact that the entire brain is involved in the seizure, unlike a partial seizure. These types of seizures cause people to have muscle twitches, or convulsions; they may cause a person to grow rigid, salivate, urinate, or make other uncommon movements. These seizures can last as long as five minutes or more. A person who has this type of seizure will usually go unconscious during the episode but usually wake up shortly afterward. He or she will be unaware of having a seizure but will wake up dazed and confused.


Tonic-clonic, also known as grand mal, seizures are a type of generalized-onset convulsive seizure. They occur when most of the neurons in the brain fire simultaneously. (The seizure is tonic if the body stiffens, clonic if it jerks, or tonic-clonic if it stiffens, then jerks.) This usually involves convulsion, stiffening, jerking of the body, and loss of consciousness. (But when only one part of the body is affected, it is focal epilepsy.)


A generalized-onset absence seizure, is also known as a petit mal or nonconvulsive seizure, the part of the brain that keeps a person aware can't communicate with the brain cortex. The person may initially lose awareness for a few seconds but regains it. The person may lose muscle control and make perpeditive motions, like chewing or fumbling with clothing. It also can look like he or she has just "spaced out" for a moment.


Myoclonic seizures involve unusual neuron discharges in the motor cortex (a region of the brain that controls movement) and cause slight, involuntary jerking of the arms and legs. Many people have this disorder and don't know they have it. This is because it is often passed off as a nervous tic.


A partial or focal, seizure takes place when an abnormal electric discharge occurs in only a small part of the brain. Other neurons prevent the excess discharge at the focus from spreading to other parts of the brain. If such a seizure occurs without a change of consciousness, it is a simple partial (also sometimes called jacksonian or focal,) while those seizures with a change, but not loss, of consciousness are called complex partial (also called pychomotor or temporal lobe.)


A simple partial seizure generally lasts only a short time. In that time, the person having the seizure might smell an odd odor, feel a tingling, see flashing lights, jerk an arm or hand, or hear voices that he or she can't understand. The person remains conscious through this type of seizure. If the electric discharge of a simple partial seizure covers a small area, the person may feel only a slight sensation but have no visible reaction. This sensation is an aura .(SeeAuras...) The aura often comes before a larger, convulsive seizure.


Complex partial seizures a person may appear to be conscious but will lose contact with the outside world. The person may behave strangely at the beginning of the seizure - rubbing hands, fidgeting with an object, smacking lips, or grating teeth - this behavior is called an automatism. During the seizure some people may see or hear things that aren't there. Others remember events from the past. These seizures can vary in length from under a minute to around an hour. Afterward, the person may be confused and have a hard time talking with others.



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Auras?



an aura is like an early warning sign. It occurs before having a seizure. It most often occurs before having a convulsive seizure. An aura is a strange sensation or feeling. It might be a buzzing in the ear, dizzieness, sickness to the stomach, or a powerful emotion. In fact, just about any sensation, if it regularly occurs just before a seizure, can be an aura. Auras, if sensed can be used to take quick precautions to ensure your safety while you have your full convulsive seizure. Auras themsesves are actually simple partial seizures. (See Partial or focal seizures.)



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Things that can trigger seizures...



Having a seizure is virtually unpredictable. You can never predict when you are going to have one, except when an aura occurs. As much as a seizure is unpredictable, so are the things that can cause seizures. There are hundreds of things that can cause seizures. Things as simple as not getting enough sleep to getting epilepsy for hereditary reasons. Though there are some major triggers that can make a persons chances to have a seizure more likely.


Stress is one of these factors. Everybody has stress, but too much stress in the body can help bring on seizures. A single stressful moment cause the release of the hormone adrenaline. This hormone increases blood circulation and breathing rate. Thus a rush of adrenaline can cause a dysfunction in the brain and can cause a seizure. Another factor is sleep. Too little sleep or irregular sleep can cause the body to go into overload and therefore cause a seizure.


Some other things that can cause seizures are flickering lights and sounds can be triggers for seizures. The two best sources for these are television and video games. Another cause can be severe damage to the head. When getting hit, like in a football game, it can cause minute damage to the brain, thus causing you to have seizures. Other ways to have seizures can simply be just because there is an imbalance of chemicals in your body and they cause your brain to react in a seizure.


More common triggers



Menses and pregnancy - hormonal changes reduce seizure threshold



Drug use, withdrawal



Caffeine - New research indicates that caffeine depletes the brain of a natural

 chemical that stops seizures once they have started



Alcoholics have a higher rate of epilepsy than non-alcoholics due to increased

 incidence of head trauma



Cocaine - may "kindle" seizures (also other street drugs)



Marijuana - THC in marijuana lowers seizure threshold (increases seizures), other

substances in it might have some anti convulsant effects.



Hypoglycemia - low blood sugar



Fever



Hydration - drinking huge quantities of water



Allergies


One thing to keep in mind when thinking about what triggers a seizure is that 60 percent of seizure victims don't know what caused their seizure. Although all seizure victims have one thing in common -- in most cases they can be treated with medicine and other methods.



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Treatments...



There are many treatments that doctors use to treat epilepsy. The most common are anti-epileptic drugs, or anti convulsants. Then there are some alternative things that they can do if the medications do not work, such as brain surgery, if the seizures are focal, and the Ketogenic diet.


Anti-epileptic drugs are given by doctors to treat epilepsy. These drugs are taken every day, sometimes several times a day, for many years. The drugs do not cure epilepsy, but they help control the seizures. There are many anti-epileptic medications used to treat seizures. Some of them are as follows:



Carbamazepine (Tegretol)

Clonazepam (Klonopin)

Enthousuximide (Zarontin)

Phenobarbital

Phenytoin (Dilantin)

Primidone (Mysoline)

Valproic acid (Depakene)

Divalproex sodium (Depakote)


There are many other excellent drugs that are used less commonly. Remember, all anti-epileptic medications are effective, or they would not be licensed, but some are more effective than others for controlling other types of seizures.


Surgery can also help cure seizures, but only if they are focal and start from just one part of the brain. Then that part of the brain has to be determined if it can be safely removed or not. Most doctors use surgery as the last resort. They try out many medications and different methods before operating on the most important part of the human body.


There is one thing to keep in mind when trying to prevent seizures from happening. Maintaing good general health is one of the best treatments for epilepsy. Eating right to exercising daily are to be apart of every epileptics life. Along with medication or surgery, it doesn't matter, every doctor will tell you that taking care of your body and maintaining good physical health is the best preventative for curing seizures.


Another way of treating epilepsy is the Ketogenic Diet. This, though it is somewhat experimental, can be an effective way of treating epilepsy. The diet must be done under close medical supervision because it involves many facets. It involves fasting and then after the fast the person goes on a no sugar very high fat diet. This causes the body to produce ketones instead of glucose for its energy. This diet is highly controversial because of its results and because of the meticulous diet program. Therefore, doctors don't usually suggest this diet as a way of treating epilepsy.


Here is a link to a great site on the Ketogenic Diet.....The Ketogenic Diet.



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A personal experience with epilepsy....



In January 1995 I had my first seizure. I was in the lunchroom at my high school when it happened. I had just picked up my tray and dumped that gross lunchroom slime in the trash and returned to my chair to talk with some friends when I started to feel a bit weird. As I sat down, I began to get dizzy and everything that I looked at was spinning and it seemed like everything was in slow motion. This was only the first part of my aura, I soon then began to feel my hands tingle. Then my arms started to raise to the ceiling. It was at this point that I started asking myself "what the heck is going on." I even started to look to God for the answer, but by then I heard someone screem "Oh my gosh!!!" and then I passed out. I don't remember anything after that until I awoke in the ambulance. From friends telling me, I guess that I shot out of my chair like a spring board. I flew back about 10 feet and hit the table behind us with my head. Then I fell to the floor and began to convulse for about 5 - 10 minutes. During this time I had slammed my head twice, once against the table, and another against the floor, and acquired two major bumps on my head. Then I also had bitten two quarter size chunks out of my tongue, like most grand mal seizure victims do. From there the whole lunch room gathered to watch me as I convulsed on the floor and bleed from my mouth. From what I here it took 4 guys to hold me down while I was convulsing.


Then I awoke in the ambulance and all I could here was the beeps of the heart monitor and the bumps of the road. I was very scared so I grabbed all the cords that were hooked to the machine and the mask that was for the oxygen and I yanked them out and sat up. The paramedic was laughing and pushed me back down and told me what had happened. From there I was sleeping in and out the rest of the day and don't remember much.


After all the commotion had died down I had to visit numerous doctors and neurologists. They ran me through an MRI and took numerous EKGs. It really stunk. I got put on Tegretol and I took it twice a day and was supposed to continue till further notice. By the second day I was sleeping about 16 hours a day because my body couldn't handle Tegretol. So then the doctors put me on Depakote and I have been on that ever since.


The doctors never really pinpointed what caused my seizures, but they have told me to stay in good health by eating right and exercising and to stay on my medication. I have had only one other seizure since the first one and that came when I hadn't taken my medication for a couple of months. So I guess you could say that I learned my lesson. I haven't had any other problems, though sometimes I feel a little giddy and jumpy, but other than that I have been doing good so far. I expect that I will probably be on the medication for another couple of years and then the doctors will diagnose me again. So now I leave you at the end of my epilepsy testimony and the rest is yet to come because I am still living.



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Links to some good sites.



Here are some links to get some more information on epilepsy....


Here is a great site at Washington University. This site has links to great articles and foundations having to do with epilepsy.

Washington University Comprehensive Epilepsy Program

This site is an evolving source of medical information for epileptics and those interested in the medical and scientific aspects of epilepsy in man.

Mike's Epilepsy Home Page

Here are some poems that people have written about epilepsy... enjoy!

The Beast
Walking The Tracks

The Epilepsy Foundation of America has probably the best web page for epilepsy on the net...

Epilepsy Foundation of America



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The Grand Finale...



Now that I have come to the end of this web page I want to thank you - the Explorer - for Exploring Epilepsy with me. As you can see, epilepsy is a very complicated disorder, and there are many different fields of study that can spring out of just one thing. I found it amazing how much material and help there is for those who have epilepsy. It also amazed me how little epilepsy is talked about when medical discussions come about. I hope that this web page and the things on it were informative and helpful.


Thanks again.....




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Exploring epilepsy

Last updated: March 4, 1997

Web page created by Dan for a project in GC 1132

Professor of GC 1132 Murry Jensen

University of Minnesota

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