It was 9:30 at night and Anna Young, 42, was sitting on her bed typing and strategizing on her laptop. She was opening her own business and going to law school and had just returned from working in Europe at her job as a banker—she had many balls in the air.

Read more of Anna Young's story here.



Share this

font size Down Arrow Up arrow

Frequently Asked Questions about Epilepsy

FAQ

What is Epilepsy?

Epilepsy (seizure disorder) is a chronic neurological condition characterized by recurrent seizures caused by abnormal electrical brain activity. The types of epilepsy are classified as either idiopathic or symptomatic. Idiopathic epilepsy has no known cause, and the patient has no other signs of neurological disease or mental deficiency. Symptomatic epilepsy results from a known condition such as stroke, head injury, tumors, congenital abnormality, etc.

How Common is Epilepsy?

Epilepsy is a common chronic disorder. About five percent of individuals in the general population will have a seizure during their lifetime. Approximately one and a half percent of the population will be diagnosed with epilepsy. This translates into more than two million people in the United States, and more than 30,000 people in Brooklyn.

What Causes Epilepsy?

Just as there are different types of epilepsy, there are many different causes of the disease. Some people are born with a gene that causes epilepsy, others may suffer from a head injury that leads to the disorder. Other causes include brain tumors, stroke, or infection. In most cases the cause of the disease is unknown, but this does not preclude diagnosis and treatment.

What are the Various Types of Seizures?

Seizures may vary in type and severity, but they are often frightening - for the patient, the family, and any onlookers. They may last anywhere from a few seconds to several minutes and may recur frequently (several times within a day) or infrequently (not for several weeks). Symptoms of seizures include confusion, behavior changes, an "aura" that provides a warning that a seizure is coming, convulsions, and a sudden loss of consciousness.

There are two main categories of seizures: partial and generalized seizures. A partial seizure can evolve into a generalized seizure. There are several subtypes of each.

Partial Seizures

The site of origin is a localized or discrete area in one hemisphere of the brain. The two most common subtypes are:

  • Simple partial seizures: These seizures originate from a localized focus in the brain. The nature of the symptoms depends on the function of the particular focus from which the seizure originates. There may be motor signs, sensory symptoms, autonomic signs and symptoms (involuntary activity controlled by the autonomic nervous system), and psychic symptoms (fear, sadness, joy). Consciousness remains intact in simple partial seizures.
  • Complex partial seizures: Impairment of consciousness, characteristic of complex partial seizures, results in the inability to respond to or carry out simple commands or to execute willed movement. There is a lack of awareness of one's surroundings. Automatisms may occur. An automatism is a more or less coordinated, involuntary motor activity such as lip smacking or blinking.

Generalized Seizures

At the onset, seizure activity occurs simultaneously in large areas of the brain, often in both hemispheres. These seizures involve the whole body, and can be convulsive or nonconvulsive.

How is Epilepsy Diagnosed?

Patients should be evaluated thoroughly after their first seizure. A physician at our Center will obtain a complete patient history including details of birth, childhood, family history and a thorough medical history, including illnesses of the nervous system and medication regimen. A detailed description of the seizures is important to distinguish seizure types. Eyewitness accounts are very helpful.

There are two main categories of seizures: partial and generalized seizures. A partial seizure can evolve into a generalized seizure. There are several subtypes of each.

What is Electroencephalogram (EEG)?

EEG monitoring is the foundation of an epilepsy diagnosis. The EEG measures electrical activity on the surface of the brain through small electrodes that are placed on the scalp. An EEG recording can identify abnormal electrical activity in the brain, provide information about the type of seizure disorder, and locate the area of seizure focus.

Some of the findings from an EEG are specific to particular disorders and subtypes of epilepsy. Activity during a seizure can be identified by a pattern on the recording. Correlating this type of data with clinical symptoms of seizures often helps make an accurate diagnosis. Additionally, the EEG recording between seizures is often abnormal in patients with epilepsy.

  • A Routine-EEG can record between 30 minutes and a few hours of EEG on an inpatient or outpatient basis in the Center.
  • An Ambulatory-EEG is used to record a patient's EEG over one to three days in their home environment. As is the case with the cardiac "Holter" monitor, patients have a box strapped to their waist. EEG electrodes are placed on the head. Recordings saved in the box are later evaluated in our Center.
  • A Video-EEG consists of simultaneous continuous EEG and video recording. When the patient experiences a seizure, the clinician can compare the clinical manifestation recorded by video with the brain's electrical activity recording. This process assists in characterizing and treating the seizure disorder. The patient can be admitted for few days of monitoring or undergo a shorter recording for few hours on an outpatient basis.

The results of these monitoring tests are supplemented by other diagnostic procedures, including magnetic resonance imaging (MRI), single photon emission computerized tomography (SPECT), neuropsychological tests, the Wada test, and positron emission tomography (PET). In addition to these services, our Center provides EEG monitoring in a variety of settings, for example, in the operating room or while undergoing procedures like interventional radiology.

How is Epilepsy Treated?

Medication

Antiepileptic drugs (AEDs) can prevent seizure activity by altering neurotransmitter activity in nerve cells, but cannot correct the underlying condition. Approximately seventy percent of patients successfully control seizures with AEDS. Fifty percent of these require two drugs to be seizure free.

Surgery

If medical treatment fails to control seizures, the patient may benefit from epilepsy surgery. In some patients, after extremely careful evaluation, it might be concluded that a small area of the brain can be resected without compromising any functions. This selective surgery can have an extremely successful outcome.

Certain patients may benefit from insertion of a device called a vagal nerve stimulator JVNS). The VNS is a small device that is surgically inserted under the skin in the chest area. It can act as a generator of a small electrical current that can abort seizure activity.