About one in 100 people in the United States has experienced an unprovoked seizure at some point in life, but a solitary seizure doesn't mean you have epilepsy. Many people experience one seizure and then never have another one. But after you've had two seizures, the chance that you'll have additional seizures increases dramatically. At least two unprovoked seizures are required for a diagnosis of epilepsy. The onset of epilepsy is most common during childhood and after age 65, but the condition can occur at any age. Treatments may leave you free of seizures, or at least reduce their frequency and intensity. Many children with epilepsy even outgrow the condition with age.
Several types of epilepsy have been linked to defective genes that regulate how brain cells communicate with each other, but it appears that abnormalities in any of several hundred genes may play a role in the development of epilepsy. Genetic inheritance plays only a partial role in epilepsy, perhaps by making a person more susceptible to environmental factors that cause seizures.
In many cases the onset of epilepsy can be traced to an accident, disease or other medical trauma that injures your brain or deprives it of oxygen: head injuries are responsible for many cases of epilepsy. However, epilepsy has no identifiable cause in about half of all affected people.
Most people with epilepsy can become seizure-free by using a single anti-epileptic drug. Others can decrease the frequency and intensity of their seizures with medication. Finding the right medication and dosage can be complex: your doctor likely will first prescribe a single drug at a relatively low dosage, and may increase the dosage gradually until your seizures are well controlled. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest other treatment options such as surgery, vagus nerve stimulation or a ketogenic diet.
Seizures can be described by which part or parts of the brain the epileptic activity starts in. The three groups are partial (also called focal), secondary generalised, and generalised. Partial seizures involve epileptic activity in just a part of the brain. Partial seizures can be divided into simple partial and complex partial. In a simple partial seizure the person is fully conscious. They remain fully aware of their surroundings, despite seizure activity In a complex partial seizure a person partly loses consciousness and they are not aware of what they are doing. Because of this, they may not remember the seizure afterwards, or their memory of it will be unclear. Generalised seizures involve epileptic activity in both halves of the brain. The person loses consciousness during the seizure. Sometimes, the epileptic activity that starts as a partial seizure can spread to the rest of the brain. When this happens, the seizure is known as secondary generalised.
Photosensitive epilepsy usually begins in childhood and is often (but not always) outgrown before adulthood. It is more common in children with a parent who is also sensitive to flashing lights. Other reflex epilepsies may occur at any age. They affect only a small percentage of people with epilepsy. People who have reflex epilepsies generally are developmentally normal and have normal findings on a neurological examination. Recently, there has been great interest in the safety of video games for children or adults with epilepsy. Certain video games (as well as certain television shows and movies) can provoke seizures. Sleep deprivation and stress or excitement caused by playing the games for a long time should also be considered as potential provoking contributors. Seizures that are triggered by the flashing lights and changing patters of video games occur during the game. Seizures that occur later, after the person has finished playing, are not caused by the game.
While response may vary for different types of seizures, there are general guidelines on what to do. First aid steps can then be tailored to whether a person's awareness is affected during or after a seizure and other specific situations.
At times, ways to intervene and help stop or shorten seizures may be recommended by your doctor and other health care providers. If you are a person with seizures, make sure you tell loved ones or people close to you what your seizures are usually like and what to do during a seizure. Remember to tell them how long your seizures usually last and when to call for help. If you have a friend or loved one with seizures, or are frequently with a person who has seizures, talk to them. Ask them what to expect, what to do, and if there is anything special or different you should know ahead of time.
One of the problems of a seizure is that they sometimes just happen for no apparent reason. Seizures in adults and seniors can also be caused things like a head injury, a brain tumor, or from cerebral irritability resulting from infectious diseases e.g. meningitis, a stroke, high fevers or from toxic substances.
If you need to assist someone having a seizure, the following guidelines are recommended by healthcare professionals:
• Always stay with the person until the seizure is over. Most seizures last only a few moments.
• Make certain that the person is clear of dangerous objects or situations, and make them as comfortable as possible.
• DO NOT forcibly hold the person down, or place anything in their mouth: the story of people "swallowing their tongue" during an epileptic seizure is a myth, and because the jaw muscles may tighten uncontrollably any hard objects could break their teeth or cause choking. If the person is lying down, turn them on their side, with their mouth pointing to the ground. This prevents saliva from blocking their airway and helps the person breathe more easily.
During a convulsive or Tonic-clonic seizure it may appear that the person has stopped breathing; this happens when the chest muscles tighten during the tonic phase of a seizure. As this part of a seizure ends, the muscles will relax and breathing will resume normally. Rescue breathing or CPR is generally not needed during these seizure-induced changes in a person's breathing.
Most Epileptic seizures last 3 minutes or less and do not require emergency medical treatment. However, there are some situations in which medical help IS necessary and should be called immediately:
• If the person having a seizure stops breathing for longer than 30 seconds. After calling 911 or other emergency services, begin rescue breathing.
• If the seizure lasts longer than 3 minutes, the person experiences more than one seizure within 24 hours, or does not respond normally within 1 hour.
• If the person seizing is pregnant.
• If the person does not respond normally within one hour or experiences reduced awareness, nausea or vomiting, inability to walk or stand, fever or dizziness after the seizure.
• If the seizure occurs after a sudden, severe headache, head injury, or after ingesting or inhaling any substance which could be considered toxic or allergenic.
• If a seizure occurs with signs of a stroke, such as trouble speaking or understanding speech, loss of vision, and inability to move part or all of one side of the body.
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