The Trouble with AEDs…

Sharing a very informative post from my friend, Phylis.


NO! I can’t believe this happened…

I received some disappointing news and shocking – it was a first. I’ve been with my Neurologist for 8 years. We’ve tried everything to get my seizures under control. We’ve consulted with the epileptologist in the group once years ago. The conclusion was that my Dr. was doing everything that he could. Over the years, I’ve been in and to so many Dr’s and different facilities due to epilepsy, it’s sickening to think about.
My current neurologist works out of a level 3 comprehensive epilepsy treatment center. At my last appointment on Tuesday when I told him about the problems I was having, he said with a heavy heart, “David, it’s not that I don’t want you here, but I need to transfer your care to a level 4 comprehensive epilepsy treatment center (which will be UCI) where you’ll be with a team of 5 epileptologists. Over there they have access to things I don’t.” It broke my heart.
Finding and developing a good relationship with a Dr. is so hard, and that’s what I had with him. I asked what are they going to do that we haven’t? I’m not interested in more medications (26 is enough) and I’m not a surgery candidate. I’ve already had a VNS, so what are they going to do that we haven’t? He explained that he feels, since my epilepsy case is so difficult, that’s where it’s best for me at this time because they’ve got access to new research programs, etc..
So, I’ll go BACK to the epileptologists at the UCI Comprehensive Epilepsy Treatment Center and see if they can do anything or make some changes that will improve my life…. I’m not hopeful. We found my first epileptologist over there when I was 19 years old.
On another note, I’ve been trying to manage some “issues” for months now. Since my mTBI in December, I have been dealing with things that are overwhelming me. Tuesday at the Dr. I was officially diagnosed with PTSD and also PCS (Post Concussion Syndrome). Although I’m glad to finally have a diagnosis so that I can move forward with treatment,  I was also saddened by the news. At times it’s been difficult just to breath.
God bless all of you that are fighting these horrible conditions.


Seizure Types (2017 UPDATED classifications)

Seizure Classification

**(UPDATE: “In 2017, the ILAE released a new classification of seizure types, largely based upon the existing classification formulated in 1981. Primary differences include specific listing of certain new focal seizure types that may previously only have been in the generalized category, use of awareness as a surrogate for consciousness, emphasis on classifying focal seizures by the first clinical manifestation (except for altered awareness), a few new generalized seizure types, ability to classify some seizures when onset is unknown, and renaming of certain terms to improve clarity of meaning. Seizure types are organized according to whether the source of the seizure within the brain is localized or distributed. Here is a list and description of some of the most common types.” >>>> READ MORE ABOUT THEM HERE >>>>

Abdominal (Autonomic) Epilepsy: Abdominal Epilepsy, sometimes referred to as autonomic seizures, is a very rare form of seizure which presents with the acute onset of symptoms seemingly related to the gastrointestinal (GI) system. Sudden abdominal pain and other symptoms can occur which are generally first thought to be related to abdominal disease such as irritable bowel syndrome or gastroenteritis.

However, in a small set of patients it has been shown that these symptoms can occur along with seizure activity in the brain, demonstrated by electroencephalogram (EEG), and may respond to treatment with anti epileptic medications. Panayiotopoulos syndrome is a benign age-related focal seizure disorder occurring in early and mid-childhood. It is characterized by seizures, often prolonged, with predominantly autonomic symptoms, and by an EEG (electroencephalogram) that shows shifting and/or multiple foci, often with occipital predominance.

Absence Seizures: Absence seizures are brief episodes of staring or daydreaming. During the seizure, awareness and responsiveness are impaired. People who have them usually don’t realize when they’ve had one. There is no warning before a seizure, and the person is completely alert immediately afterward. During this seizure the person may blink their eyes rapidly, pick at clothing, smack their lips, or swallow frequently. These seizures typically last anywhere from 3 to 20 seconds and can occur up to several hundred times a day. This type of seizure usually begins in childhood between the ages of 4 and 12.

Atonic Seizures: Muscle “tone” is the muscle’s normal tension. “Atonic” (a-TON-ik) means “without tone,” so in an atonic seizure, an epileptic seizure characterized by sudden loss of muscle tone; may cause the head to drop suddenly, objects to fall from the hands, or the legs to lose strength, with falling and potential injury; usually not associated with loss of consciousness. Close muscles suddenly lose strength. The eyelids may droop, the head may nod, and the person may drop things and often falls to the ground. These seizures are also called “drop attacks” or “drop seizures.” The person usually remains conscious. Another name for this type of seizure is “akinetic” (a-kin-ET-ik), which means “without movement.”

Atypical Absence Seizures: The person will stare (as they would in any absence seizure) but often is somewhat responsive. Eye blinking or slight jerking movements of the lips may occur.

Aura: A warning before a seizure; a simple partial seizure occurring within seconds before a complex partial or secondarily generalized tonic-clonic seizure, or it may occur alone; also a warning before a migraine headache.

Autonomic Seizures (Simple Partial): These common seizures may include strange or unpleasant sensations in the stomach, chest, or head.

Catamenial Epilepsy: Refers to seizure exacerbation in relation to the menstrual cycle. Traditionally, the term has been used to refer to seizure exacerbation at the time of menstruation.

Childhood Absence Epilepsy: The seizures of childhood absence epilepsy (CAE) are usually staring spells during which the child is not aware or responsive.

Clonic Seizures: Clonic seizures consist of rhythmic jerking movements of the arms and legs, sometimes on both sides of the body.

Complex Febrile: Age, neurological status before the illness, and fever are the same as for simple febrile seizure. This seizure is either focal or prolonged (i.e., >15 min), or multiple seizures occur in close succession.

Complex Partial: These seizures affect a larger portion of the brain than the simple partial seizures, but the seizure activity is still limited to part of the brain. Complex partials can occur in any part of the brain, but they mainly occur in temporal and frontal lobe epilepsies. A person having a complex partial will not be aware of what is going on during the seizure and will have a brief postictal phase following the seizure. During a complex partial seizure the person may wander around aimlessly as if in a trance, stare vacantly, pick at clothing, and/or make chewing motions. They may try to talk but speech will be garbled. These seizures typically last from 30 seconds to 1 or 2 minutes.

Eclampsia: Convulsions are the other most common feature of this syndrome. Convulsions are the most common neurologic manifestation in Eclampsia because the occurrence of convulsions confirms the diagnosis of Eclampsia. Convulsions are usually generalized tonic-clonic in nature. Usually a brief single seizure occurs. Multiple seizures can also occur; however, status Epilepticus is rare. Partial seizures or complex partial seizures can also occur. The seizures can occur prepartum, intrapartum, or postpartum. If the seizure occurs postpartum, it usually occurs within the first 24 hours after delivery; however, late postpartum eclamptic convulsions are by no means rare and have been reported as late as 23 days postpartum.

Emotional Seizures: A type of simple partial seizure which manifests as exaggerated emotions without cause, most commonly fear, though joy, rage, anger or sadness may also occur.

Febrile Seizures (3 months to 5 years old): A febrile seizure occurs when a child contracts an illness such as an ear infection, cold, or chickenpox accompanied by a high fever. Febrile seizures are the most common type of seizure seen in children. Two to five percent of children have a febrile seizure at some point during their childhood. Why some children have seizures with fevers is not known, but several risk factors have been identified.

Focal Seizures (Partial Seizures): Focal seizures (also called partial seizures) occur in a limited area of the brain. The seizures may sometimes turn into generalized seizures, which affect the entire brain. This is called secondary generalization.

Frontal Lobe Epilepsy: Frontal Lobe Epilepsy are seizures that originate in the front of the brain. The epilepsy symptoms can vary depending on what part of the brain is involved. Frontal lobe seizures may produce unusual symptoms that can appear to be related to a psychiatric problem or a sleep disorder. Frontal Lobe Seizures often occur during sleep and may feature bicycle pedaling motions and pelvic thrusting. Some people scream profanities or laugh during Frontal Lobe Seizures.

Gelastic Seizures: A Gelastic Seizure is a rare type of epilepsy which is also known as Gelastic Epilepsy. Gelastic seizure is defined as sudden occurrence of emotions in the form of a laugh or a cry. The name gelastic epilepsy comes from Greek word ‘gelos’ which means laughter. Time of seizure is generally 5 to 60 seconds. Percentage of occurrence is slightly higher in male than female. Previously it is considered that gelastic seizures are originated in the temporal lobes but further study described that it is associated with hypothalamic hamartomas. It is affected to any age group but mostly before three or four years of age. In most of the cases gelastic seizures is followed by tonic-clonic seizures and atonic seizures.

Generalized-Onset Seizures: Generalized-onset seizures have an onset recorded simultaneously in both cerebral hemispheres. Generalized-onset seizures are classified into 6 major categories: (1) absence seizures, (2) tonic seizures, (3) clonic seizures, (4) myoclonic seizures, (5) primary generalized tonic-clonic seizures, and (6) atonic seizures.

Infantile Spasms(West Syndrome): Infantile spasms may begin up to age 2, but most commonly begin between the 4 and 6 months, with about 90 percent beginning in the first year. The causes are widely variable and in some cases are unknown. However, the most common causes are tuberous sclerosis and perinatal asphyxia (lack of oxygen). Parents sometimes attribute the cause to pertussis vaccination, a connection that has yet to be proven. Since the peak in onset of spasms occurs at the same age range that the vaccination is given, it is likely that the concurrent timing is the only link.

Juvenile Absence Epilepsy: All children with juvenile absence epilepsy (JAE) have absence seizures but usually they are limited to a few episodes per day. Tonic-clonic (grand mal) seizures are usually the symptom that brings the patient to the doctor.

Juvenile Myoclonic Epilepsy: People with JME have myoclonic seizures (quick little jerks of the arms, shoulder, or occasionally the legs), usually in the early morning, soon after awakening. The myoclonic jerks sometimes are followed by a tonic-clonic seizure. Absence seizures also may occur.

Multifocal Seizures: Whilst most seizures can be neatly split into partial and generalized, there exists some that don’t fit. For example: the seizure may be generalized only within one hemisphere. Alternatively there may be many focal points (multifocal seizures) that are distributed in a symmetrical or asymmetrical pattern.

Myoclonic Seizures: Brief, shock-like jerks of a muscle or a group of muscles. “Myo” means muscle and “clonus” (KLOH-nus) means rapidly alternating contraction and relaxation “jerking or twitching” of a muscle.

Neonatal Onset Seizures (first two months of life): Neonatal Onset Seizures happen more frequently in the newly born than at any other stage in life. They occur in preterm neonates (babies born earlier than 40 weeks) somewhat more frequently than in full-term babies. Babies who have seizures in the first few days after delivery tend to have more severe outcomes than those whose seizures begin later in the neonatal period.

Nocturnal Seizures: Nocturnal seizures are usually tonic-clonic. They might occur just after a person has fallen asleep, just before waking, during daytime sleep, or while in a state of drowsiness. People who experience nocturnal seizures may find it difficult to wake up or to stay awake.

Occipital Lobe Seizure: Occipital Lobe Seizures arise from the occipital lobe of the brain, which sits at the back of the brain, just below the parietal lobe and just behind the temporal lobe. The occipital lobe is the main center of the visual system. Occipital lobe epilepsy accounts for about 5-10% of all epilepsy. This kind of epilepsy can be either idiopathic (of unknown, presumed genetic, cause) or symptomatic (associated with a known or suspected underlying lesion). Benign occipital epilepsies usually begin in childhood and are discussed elsewhere.

Partial Seizures: An electrical disturbance which limits itself to a certain part of the brain such as the temporal or frontal lobes.

Photosensitive Epilepsy: Seizures occur when an individual is exposed to visual stimuli, usually flashes of light of a particular frequency. In other reflex epilepsies, seizures may be provoked by auditory, olfactory, or vestibular stimuli.

Post Traumatic Epilepsy: Post traumatic epilepsy (PTE) refers to a recurrent seizure disorder, the cause of which is believed to be injury to the brain. This injury can be a result of head trauma or a sequel to an operation on the brain. The term PTE must be differentiated from the term post traumatic seizure (PTS), which signifies any seizure that occurs as a sequel to brain injury. The seizures are usually partial (focal) or generalized tonic-clonic. Often, both types coexist. Most early PTS are partial seizures, whereas most late PTS, especially when part of PTE, are generalized and either primary or secondary.

Post traumatic Seizure: Any seizure that occurs as a sequel to brain injury. If the seizures occur within 24 hours of the injury, they are called immediate PTS. A PTS that occurs within 1 week of injury are termed early PTS, and a seizure that occurs more than 1 week after injury is termed late PTS. About 20% of people who have 1 late PTS never have any more. The seizures are usually partial (focal) or generalized tonic-clonic. Often, both types coexist. Most early PTS are partial seizures, whereas most late PTS, especially when part of PTE (Post traumatic Epilepsy), are generalized and either primary or secondary.

Progressive Myoclonic Epilepsies: Progressive myoclonic epilepsies feature a combination of myoclonic and tonic-clonic seizures. Unsteadiness, muscle rigidity, and mental deterioration are often also present.

Pseudo seizures (Psychogenic Seizures): Events that look like seizures but are not due to epilepsy are called “non epileptic seizures.” A common type is described as psychogenic (si-ko-JEN-ik), which means beginning in the mind.

Reflex Epilepsies: Reflex Seizures (Epilepsy) are a group of seizures in which certain stimulus can bring upon a seizure. It can be as somethings simple within the environment or more complex as active brain functioning in reading, writing, arithmetic or even thinking about certain topics.

Secondarily Generalized Seizures: Seizures of this kind start as a partial seizure, that is, they start in one limited area of the brain. The forms they take vary as much as other partial seizures.

Simple Partial: These seizures can be further broken down into different classes depending on the symptoms. A person can have motor, sensory, autonomic, and/or psychic symptoms. Examples of motor symptoms could be (but are not limited to): abnormal jerking of fingers, hands, or arms. This can be unilateral (one side) or bilateral (both sides). Examples of sensory symptoms could be (but are not limited to): a strange sense of taste or smell, a feeling of numbness, and/or seeing flashing lights. Examples of autonomic symptoms could be (but are not limited to): strange sensation in the stomach, nausea, stomach pain, and/or vomiting. Examples of psychic symptoms could be (but are not limited to): a sense of deja vu, memory impairment, difficulty speaking, and/or feelings of intense emotions.

A person having a simple partial seizure will often remain aware of what is going on during the seizure but may not be able to respond. Simple partial seizures typically last from 30 seconds to 1 or 2 minutes. During this time the person may be walking around fumbling at clothing, smacking their lips, bobbing their head, or even laughing/crying.

Subtle Seizures: Examples include chewing, pedaling or ocular movements. These seizures may look like absence seizures, lasting for a few seconds. The brain activity may be even more subtle and very difficult for teachers, parents or health care staff to spot.

Temporal Lobe Epilepsy: The temporal lobes, one on each side of the head, just above the ears, are the sites of one of the most common forms of epilepsy. Complex partial seizures with automatisms (unconscious actions), such as lip smacking or rubbing the hands together, are the most common seizures in temporal lobe epilepsy. Seventy-five percent of patients also experience simple partial seizures (Auras) which may include such features as: a mixture of thoughts, emotions, and feelings that are hard to describe; sudden emergence of old memories or feelings of strangeness in familiar surroundings; hallucinations of voices, music, smells, or tastes, and feelings of unusual fear or joy.

While partial seizures dominate, approximately half the people with temporal lobe epilepsy have generalized tonic-clonic seizures as well. The seizures characteristic of temporal lobe epilepsy often begin in the deeper parts of the temporal lobe (part of the limbic system) which control emotions and memory. Memory problems may develop over time in people with this syndrome.

Tonic Seizures: Muscle “tone” is the muscle’s normal tension at rest. In a “tonic” seizure, the tone is greatly increased and the body, arms, or legs make sudden stiffening movements. Consciousness is usually preserved.

Tonic-clonic Seizures: This type is what most people think of when they hear the word “seizure.” An older term for them is “grand mal”. A person having this seizure will first stiffen (tonic phase) and then go into rhythmic jerking of all extremities (clonic phase.) Some people may only experience the tonic phase or the clonic phase.

A person having a tonic clonic seizure will appear to have slowed their breathing or even stopped breathing and their lips may even turn blue. Breathing should start again after the clonic phase. The person may even be incontinent of bladder and bowel. After the person comes around he/she may be very tired and confused and will not remember what happened.

Visual Reflex Seizures: Visual reflex seizures induced by complex stimuli may be triggered by patterned and flashing displays that are now ubiquitous. The seizures may be clinically generalized, but unilateral and bilateral myoclonic attacks also may be triggered.

Withdrawal Seizures: This type of seizure is seen when certain medications, such as barbiturates and benzodiazepines, are stopped abruptly. Withdrawal seizures are common when a person with alcoholism is trying to quit drinking.


What is Status Epilepticus and SUDEP?

What is Status Epilepticus

Status epilepticus is a potentially life-threatening condition in which a person either has an abnormally prolonged seizure or does not fully regain consciousness between seizures. Most people agree that any seizure lasting longer than 5 minutes or if a second seizure occurs before recovery, should, for practical purposes, be treated as though it was status epilepticus. Status epilepticus affects about 195,000 people each year in the United States and results in about 50,000 deaths.

It is important to treat a person with status epilepticus as soon as possible. Doctors in a hospital setting can treat status epilepticus with several different drugs and can undertake emergency life-saving measures, such as administering oxygen, if necessary. People in status epilepticus do not always have severe convulsive seizures. Instead, they may have repeated or prolonged non convulsive seizures. This type of status epilepticus may appear as a sustained episode of confusion or agitation in someone who does not ordinarily have that kind of mental impairment.

What is SUDEP

Sudden Unexpected Death in Epilepsy is a mysterious, rare condition, better known as SUDEP, in which typically young or middle-aged people with epilepsy die without a clearly defined cause. By definition, (1) death is sudden and unexpected, (2) a clear cause of death must be absent, and (3) victims must have had epilepsy. Victims are often found in bed with or without signs of having had a convulsive seizure, but were otherwise in a reasonable state of health at the time of death. Although seizures are suspected to have occurred prior to death, there should be no evidence of seizure as the direct cause of death.

What causes SUDEP

Although the cause of death is unknown, some researchers suggest that a seizure causes an irregularity in the heart rhythm. More recent studies have suggested that a combination of impaired breathing (apnea), increased fluid in the lungs (impairing the exchange of oxygen and carbon dioxide), and being face down on the bed all combine to cause death due to impaired respiration. In many cases, death probably occurs after a seizure has ended.

How common is SUDEP

Various report information gathered shows the number of people with epilepsy who die of sudden unexpected death in epilepsy (SUDEP) to be rare. The incidence of SUDEP in the general epilepsy population has been reported to be 0.09–1.2/1,000 person-years. This incidence is higher, 1.1–5.9/1,000 person-years, in patients with medically refractory epilepsy and even higher, 6.3–9.3/1,000 person-years, in patients who have failed respective epilepsy surgery ({A} Tomson T, Nashef L, Ryvlin P, Sudden unexpected death in epilepsy: current knowledge and future directions, Lancet Neurol, 2008; (11):1021–31. {B} Devinsky O, Sudden, unexpected death in epilepsy, N Engl J Med, 2011;365(19):1801–11.)

One most recent study out from the Institute of Medicine 2012, entitled; Epilepsy Across the Spectrum: Promoting Health and Understanding sites “SUDEP numbers vary from 1 in 10,000 newly diagnosed people with epilepsy to 9 of every 1,000 candidates for epilepsy surgery.” It is clear that much more research and data collection is needed in order to get more accurate numbers.

Although the risk is highest in people with severe, intractable epilepsy that have frequent seizures and take large doses of many anti-epileptic drugs. A recent 40 year follow-up of children once diagnosed with epilepsy suggests that SUDEP may account for approximately 30% of all deaths in people with epilepsy (Sillanpää & Shinnar 2010). However, with poor case identification and inconsistencies in the investigation and recording of the deaths, these numbers could very well be an underestimate.

The lowest risk is seen among people with newly diagnosed Epilepsy. The risk is highest in young male adults (ages 20-40), with frequent convulsive seizures, taking several anti-epileptic medications. Combination therapy (poly-therapy) with anti-epileptic drugs had a 3 times higher risk compared with those on a single anti epileptic drug (mono therapy) in a recent combined ILAE analysis. There is no conclusive evidence of greater risks associated with the use of individual specific anti-epileptic drugs. On the other hand, SUDEP is rare in patients with new onset epilepsy, in patients without convulsive seizures as a seizure type, and in patients with well controlled seizures.

What are the risk factors for SUDEP
Major risk factors for SUDEP appear to relate to the severity of the epilepsy, as SUDEP is more common in people with:

  • Seizures that can’t be controlled
  • Treatment with multiple anti-convulsant drugs
  • Having long standing chronic epilepsy
  • Generalized tonic-clonic seizures
  • Seizures that happen at night (called nocturnal seizures)
  • Not taking anti convulsant medicine as prescribed
  • Stopping the use of anti convulsant medicine abruptly
  • Developmental delays
  • Onset of epilepsy at a young age

A few safety precautions can minimize the chances of SUDEP

  • Patients should make sure to take the medications prescribed for them.
  • Patients should visit with their doctor regularly, especially if convulsive seizures are not completely controlled.
  • Adult patients with a high likelihood of tonic-clonic seizures in sleep should be supervised whenever possible. (SUDEP is extremely rare in children with epilepsy and in other patients who are well monitored. In fact, supervision has emerged as a protective factor for SUDEP, independent of seizure control.)
  • Basic first aid should be provided during a seizure, including rolling the person onto one side, checking respiration and avoiding putting any object in the patient’s mouth.
  • Family members and/or caregivers of patients with uncontrolled convulsive seizures should learn cardiopulmonary resuscitation.

IOM Summary: Data seem to suggest that the mechanism of SUDEP may be dependent upon individual susceptibility to one or a combination of factors. These may include: seizure-related central apnea and/or lung edema with respiratory death; seizure-related hypoxia plus acute pulmonary changes and systemic acidosis leading to a fatal arrhythmia; an inherited cardiac ion channelopathy combined with acute seizure-related cardiac autonomic disruption leading to a fatal arrhythmia. Added to the mix is the unknown of acute psychological stress. The mechanism(s) of SUDEP remain a mystery, but with a growing interest in investigating the mechanistic variables, there is reason to be optimistic that eventually it will be solved.

I’m work to raise SUDEP awareness in part by teaching seizure recognition and first aid. The ultimate goal of all SUDEP research is to prevent deaths caused by seizures. This requires a better understanding of it, by comparing people who die from SUDEP to people living with epilepsy, and people with epilepsy who die of other causes.


About Epilepsy

What IS epilepsy?

Seizures are a symptom of epilepsy. Epilepsy is the underlying tendency of the brain to release electrical energy that disrupts other brain functions. So the seizure is the symptom of this underlying condition. Having a single seizure does not necessarily mean a person has epilepsy. Epileptic seizures are usually convulsive, but not always. Seizures can last from a few seconds up to minutes or hours, depending on the intensity of neuronal excitability. Epilepsy treatment usually requires the regular intake of controlled anti-convulsive medications.

Epilepsy will affect every person (directly or indirectly) at some point during their lifetime. There are approximately 30,000 (about 1% of the population) people in Orange County, California affected by epilepsy and 380,000 people with epilepsy and seizure disorders throughout the state of California. Most people with epilepsy lead outwardly normal lives. Approximately 80 percent can be significantly helped by modern therapies, and some may go months or years between seizures. However, the disease can and does affect daily life for people with epilepsy, their family, and their friends. Approximately 1 in 10 people will experience a seizure at some point in their life; about 1 in 20 children have epilepsy; and nearly 1 in 26 people will develop epilepsy during their lifetime.

Epilepsy affects about 65 million people worldwide. An underestimated 3.4 million Americans are diagnosed with epilepsy, with approximately 150,000 new cases diagnosed in the United States each year. The onset of epilepsy is highest in children and older adults; depending on the diagnostic criteria and study method used. There are about 326,000 children in America with epilepsy under the age of 15. Epilepsy affects 1 in 20 children. It may be associated with another serious and difficult to treat syndrome, developmental disorder or genetically related condition. The social impact on children with epilepsy can be severe and they have almost a 45% higher risk of being bullied.

As many as 50,000 Americans die each year from seizures and related causes, including drowning and other accidents. It’s widely misunderstood condition that too often goes untreated and misdiagnosed. By some estimates, the mortality rate for people with epilepsy is two to three times higher—and the risk of sudden death SUDEP is 24 times greater than that of the general population.

Epilepsy ranks 7th on the global burden of mental health, neurological and substance use disorders worldwide after Alzheimer’s, schizophrenia, and depression and alcohol use; but ahead of migraine, panic disorder, insomnia, post-traumatic stress, Parkinson’s disease, and multiple sclerosis. Law enforcement personnel are becoming educated about the different intensities and types of epileptic seizures in order to prevent misinterpreting behavior, such as the appearance of intoxication, exhibited by persons experiencing a seizure or in or in the immediate recovery period.

What causes epilepsy?

In approximately 70% of people diagnosed with epilepsy, the cause is not known. The remaining 30% of patients are found to have common causes such as stroke heredity, lead poisoning, infection, brain tumor/head trauma, prenatal brain development problems and more. About 1% of the general population will develop epilepsy. Although the risk is higher in people with certain medical conditions such as Alzheimer’s disease, Autism, Cerebral palsy, Mental retardation and Stroke.

In some cases, head injury can lead to seizures or epilepsy. Simple safety measures can protect people from seizures, epilepsy and other problems that result from head injury.  Other types of epilepsy may be induced through occupational damage, due to repeated exposure to acoustic or visual stimuli, or as a result of an isolated high-intensity auditory or visual stimulus.

Whatever the case, the sensory stimulation induces chemical changes in the related brain areas, causing a kind of electrical short-circuit, with a group of neurons briefly firing in a synchronous rhythm. These stimuli-induced forms of seizures are known as acquired epilepsy. When the epilepsy results from an identified cerebral condition, it is classified as symptomatic. Non-symptomatic epilepsies are those occurring in people who do not present brain abnormalities or neurological disorders other than the seizures.

Epilepsy is associated with a variety of developmental and metabolic disorders. Epilepsy is just one of a set of symptoms commonly found in people with these disorders. Sometimes, epilepsy develops as a result of brain damage (simple safety measures can protect people from seizures that result from head injury) and from other disorders. For example, brain tumors, alcoholism, and Alzheimer’s disease frequently lead to epilepsy because they alter the normal workings of the brain. Strokes, heart attacks, and other conditions that deprive the brain of oxygen also can cause epilepsy in some cases. Meningitis, AIDS, viral encephalitis, and other infectious diseases can lead to epilepsy, as can hydrocephalus — a condition in which excess fluid builds up in the brain. Epilepsy also can result from intolerance to wheat gluten (also known as celiac disease), or from a parasitic infection of the brain called neurocysticercosis. Seizures may stop once these disorders are treated successfully.

Seizures can result from exposure to lead, carbon monoxide, and many other poisons. They also can result from exposure to street drugs and from overdoses of antidepressants and other medications. These seizure triggers do not cause epilepsy but can provoke first seizures or cause breakthrough seizures in people who otherwise experience good seizure control with their medication. Sleep deprivation in particular is a universal and powerful trigger of seizures. For this reason, people with epilepsy should make sure to get enough sleep and should try to stay on a regular sleep schedule as much as possible.

For some people, light flashing at a certain speed or the flicker of a computer monitor can trigger a seizure; this problem is called photosensitive epilepsy. Smoking cigarettes also can trigger seizures. The nicotine in cigarettes acts on receptors for the excitatory neurotransmitter acetylcholine in the brain, which increases neuronal firing. Seizures are not triggered by sexual activity except in very rare instances.

What are the benefits of keeping a seizure diary? Keeping a daily seizure diary (a good one is is one way to make living with epilepsy easier. By tracking your seizure activity and epilepsy medication routine, you can help provide valuable diagnosis information to your neurologist/epileptologist.

Medical ID bracelet/chain – absolutely!

A quick Google search will give you a lot of options for medical ID bracelets and chains. But which one do you get? Nowadays there are a lot of companies offering tons of different style ID’s. I think that Medic-Alert is a great choice. I know that wearing it has saved me more than once, by getting the paramedics the information they need.

Below I’ve attached a screenshot of my health record that the Medic-Alert agent relays to a first responder or someone that calls in and gives them the code on my bracelet. It has important information and instructions as well as who to contact.

Check out their website and see for yourself. Prices start at $49.99 per year, with a discount for a 3 year.