What You Should Know About Epilepsy and Seizures

Epilepsy and seizures affect more than three million Americans, with about 200,000 new cases diagnosed each year. Properly diagnosed and treated, most people with epilepsy can expect to get their seizures under control. Patients who have persistent, recurrent seizures or those with an unconfirmed seizure diagnosis may benefit from the advanced services of a comprehensive epilepsy center.

What is the difference between a seizure and epilepsy?

Seizures happen when your nerve cells fire more rapidly and with less control than usual, affecting how a person feels or acts. These range from “absence seizures,” involving a brief lapse of conscious activity to “complex, partial seizures,” where one is unaware and unresponsive, to seizures where there is a full loss of consciousness with the potential for falling, shaking and difficulty breathing. Epilepsy refers to a brain disorder resulting in multiple seizures.

Does having a seizure mean you have epilepsy?

Seizures are not always related to epilepsy. They can be a symptom of a disruption of brain function, such as from a high fever, a head injury or lack of oxygen. Ten percent of Americans will experience a seizure at least once in their lifetime, with the highest incidence occurring under the age of two and over the age of 65.

What causes epilepsy?

Epilepsy may be related to genetic factors, structural abnormalities of the brain or brain metabolism, and can begin in infancy and childhood. It can also be acquired (become symptomatic) during the course of one’s life due to infection of the brain, trauma, tumors or stroke. When no cause is found, the term “idiopathic” is used, which may mean one has to look harder for a proper diagnosis.

How is epilepsy diagnosed?

Epilepsy is diagnosed through a detailed medical history and electroencephalogram (EEG) or video EEG monitoring to record brain wave patterns during and between seizures. Imaging scans (i.e., MRI) of the brain and blood tests are performed to help rule out other potential causes of seizures, such as a brain tumor or other disease.

How is epilepsy treated?

For a majority of patients, antiepilepsy drugs are helpful, with the goal of controlling the seizures while minimizing medication side effects. There are three new antiepileptic drugs avalable with different mechnaisms of action: PotigaTM (ezogabine), FycompaTM (perampanel) and AptiomTM (eslicarbazepine). For some patients, surgery may be an option. In particular, epilepsy surgery may benefit patients whose seizures are associated with structural brain abnormalities, such as brain tumors, malformations of blood vessels and damage related to strokes. Vagus nerve stimulation, designed to send mild electrical pulses to the brain by a device that is like a pacemaker, is a surgical option for some patients.

Diet can also be a treatment for some, specifically the ketogenic diet or a modified Atkins diet. The diets are prescribed by a physician and carefully monitored by a dietitian.

What is the success rate for controlling epilepsy?

Properly diagnosed and treated, most people with epilepsy do very well. Nationally, two out of three people with epilepsy can be expected to enter remission; that is, five or more years free of seizures while using medication. About 75 percent of people who are seizure-free while on medication for two to five years can be successfully withdrawn from medication.

What distinguishes Stony Brook’s approach?

A multidisciplinary team of specialists makes a difference. Seizures and epilepsy can involve and affect multiple body systems, so having a staff with broad-based expertise readily available helps achieve a more effective treatment plan. In addition to a multidisciplinary team that includes renowned epileptologists, pediatric neurologists and neurosurgeons, our Comprehensive Epilepsy Center offers distinct capabilities:

  • A six-bed dedicated video-EEG epilepsy monitoring unit (EMU) with 24/7 observation staff on Neurology and Pediatric units
  • Portable video-EEG epilepsy monitoring capability that can be set up anywhere in the hospital where there is a patient experiencing possible seizures
  • Multiple treatment options, including advanced surgical techniques
  • Access to research, including clinical trials of new drugs
  • Support and education services for patients and families, including a nurse practitioner and Epilepsy Foundation of Long Island-associated social worker and support group

For more information about Stony Brook’s Comprehensive Epilepsy Center, call (631) 444-4000 or visit neuro.stonybrookmedicine.edu.

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All health and health-related information contained in this article is intended to be general and/or educational in nature and should not be used as a substitute for a visit with a healthcare professional for help, diagnosis, guidance, and treatment. The information is intended to offer only general information for individuals to discuss with their healthcare provider. It is not intended to constitute a medical diagnosis or treatment or endorsement of any particular test, treatment, procedure, service, etc. Reliance on information provided is at the user's risk. Your healthcare provider should be consulted regarding matters concerning the medical condition, treatment, and needs of you and your family. Stony Brook University/SUNY is an affirmative action, equal opportunity educator and employer.