November is National Epilepsy Awareness Month, and there are a lot of questions that often surround this medical condition.

What is epilepsy?

Epilepsy is a medical condition that affects the brain, mainly the cortex. It produces recurrent seizures affecting a variety of mental and physical functions. It is also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy. A seizure happens when a brief, strong surge of electrical activity affects the brain. The official definition of epilepsy is “a disorder of the brain that causes seizures.” But epilepsy patients know that there’s so much more to living with this neurological condition, and that it can often be unpredictable and frightening. Not all seizures are epileptic. Some seizures are provoked by another medical condition like a drop in blood sugar or even caused by a medication/drug. Some seizure-like manifestations are part of a psychological disorder and not a brain disorder (psychogenic non-epileptic seizure).

Is epilepsy common?

More than 4 million adults in the United States have had a diagnosis of epilepsy or seizure disorder. According to the Centers for Disease Control, 470,000 children had epilepsy in 2015. Contrary to popular belief, epilepsy can start at any age. Most cases of epilepsy have no identifiable cause. Some risk factors include family history, head injury, brain surgery, stroke, meningitis and febrile seizures.

Symptoms of epilepsy

Seizures come in various shapes and sizes — some are quiet staring spells, while others can cause a person to collapse, shake and become unaware of what’s going on around them. Symptoms vary depending on the type of seizure and the part of the brain where the seizure originates. Some, but not all, patients have brief “warnings” or “auras” before having a seizure. Other symptoms may include uncontrollable jerking movements of arms and legs, loss of consciousness or awareness, fear, anxiety or déjà vu, smelling, hearing or seeing things that are not there, language problems (expression and comprehension) and tingling. In most cases, a person with epilepsy will have the same type of seizure each time. Some seizures come from a specific part of the brain (focal or partial epilepsy) and some come from the whole cortex (generalized).

How is epilepsy treated?

Epilepsy is treated by seizure medications (antiepileptic drugs). About two thirds of patients with epilepsy achieve seizure freedom with medications only. Persons with epilepsy should never ever stop taking their seizure medications even if they go decades with no seizures. Some epilepsy cases are resistant to medications and may require other treatments like brain surgery to help control the seizures.

What are seizure precautions?

Seizure precautions are measures intended to minimize the health consequences of breakthrough seizures, like avoiding driving. Seizure precautions are commonsense and are based upon asking, “What would happen if I had a seizure while doing this?”

Planning for pregnancy when you have epilepsy

Epilepsy should not prevent women from having children, but pregnancy must be planned and monitored carefully. Patients should not stop taking their medication when they realize they are pregnant; they should consult with their neurologist immediately. We recommend all women who can get pregnant take folic acid to reduce the risk of malformations.

If any of the following occurs, you should seek immediate medical attention:

• A seizure that lasts more than three minutes
• No breathing or consciousness after seizure ends
• Another seizure follows immediately after the first
• An injury during the seizure
• A high fever or heat exhaustion
• If the patient is pregnant

Ochsner’s Epilepsy Program

There are many ways to treat epilepsy. Ochsner’s Epilepsy Program aims to provide the most modern and innovative medical and surgical care for patients with epilepsy and seizure disorders. We also understand that for many patients, their seizure disorder is far from simple, which is why each patient undergoes a thorough evaluation in the clinic and a comprehensive diagnostic work up including outpatient and inpatient video-EEG monitoring, sophisticated brain imaging, cardiac and psychological testing. Our team collaborates with other medical disciplines to manage other medical conditions related to seizure disorder and medications.