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The battle against epilepsy can be challenging. Often, people jump from medication to medication, with little hope that their seizures will decrease, let alone stop completely. Yet, it’s not commonly known that people who have failed just two epilepsy medications can be referred to a comprehensive epilepsy center, like the one at UPMC, for a surgical evaluation.
In this week’s Medical Mondays video, you’ll learn about:
- Complications associated with epilepsy
- When it’s appropriate to consider epilepsy surgery
- How UPMC surgeons determine what area of the brain are causing seizures
- How epilepsy surgery can result in patients becoming seizure free
Interested in a more personal view on living with epilepsy? Visit Katrina’s blog, featured in this week’s Medical Mondays, where she documents her journey with epilepsy and shares important awareness and advocacy information.
For more information on epilepsy treatment at UPMC, visit our department website or call 1-877-986-9862 to schedule an appointment.
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string(3348) "Epilepsy is a condition in which bursts of electricity in the brain disrupt its normal functioning and cause seizures. It is commonly diagnosed in children or in elderly people, but it can develop at any time.
What Is Brain Mapping?
To help pinpoint the source of these electrical bursts in the brain, doctors use a process called brain mapping. By viewing and stimulating different areas of the brain, the doctor can map out what areas of the brain control what functions of the body.
This process identifies abnormalities, tumors, lesions, or injuries in the brain, as well as any unusual activity.
What Types of Brain Scans Are Used?
Magnetoencephelography (MEG)
Magnetoencephelography (MEG) is a noninvasive brain mapping technique, meaning it is done outside the body. MEG maps brain activity by using the magnetic fields created by the brain. There are no injections or radioactivity involved, so it's safe for kids as well as adults.
Electroencephalogram (EEG)
A MEG scan is usually combined with an electroencephalogram (EEG) to get an accurate idea of the inner workings of the brain. Add a magnetic resonance imaging (MRI) scan, which shows the brain structure, and your physician can see a detailed picture of what's going on and where.
What Happens During MEG?
The MEG scan is performed in a room that is shielded from magnetic or electrical activity. You will need to remove all metal jewelry or clothing. A technician will attach coils to your head with tape. Then the MEG machine fits over your head like a helmet.
You may sit in a chair or lie down and can sleep during the scan, but you must be as still as possible throughout. It takes 30 minutes to over an hour to complete. The machine is quiet and records brain activity while you wait. Sometimes, the technician performing the scan may stimulate areas of the brain to get a more accurate map.
Why Is Brain Mapping Important?
In addition to helping determine the cause of epileptic seizures, brain mapping serves as a guide for surgery. The surgeon can use the images from MEG, EEG, and MRI to pinpoint the tumor or lesion. The map also helps the surgeon avoid the well functioning areas of the brain and focus on those that are causing trouble.
To learn more about brain mapping for epilepsy management and treatment, visit the UPMC Department of Neurosurgery.
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string(467) "To help pinpoint the source of these electrical bursts in the brain, doctors use a process called brain mapping. By viewing and stimulating different areas of the brain, the doctor can map out what areas of the brain control what functions of the body. This process identifies abnormalities, tumors, lesions, or injuries in the brain, as well as any unusual activity. Read more to discover the types of brain scans used in brain mapping and why they are so important."
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To help pinpoint the source of these electrical bursts in the brain, doctors use a process called brain mapping. By viewing and stimulating different areas of the brain, the doctor can map out what areas of the brain control what functions of the body. This process identifies abnormalities, tumors, lesions, or injuries in the brain, as well as any unusual activity. Read more to discover the types of brain scans used in brain mapping and why they are so important.Read More
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string(4222) "What Causes Seizures? Epileptic vs. Non-Epileptic Seizures
Epilepsy is commonly thought of as the primary cause of seizures. However, there are different types of seizures, or episodes that look like seizures, that are not caused by faulty electrical signals in the brain.
We commonly think of someone falling down and shaking violently or having stiff, jerky movements when having a seizure. But a seizure doesn't always cause a person to lose consciousness. Sometimes, the person may:
- Stare into space
- Have muscle spasms
- Make involuntary movements
- Have disruptions to his or her speech, movement, vision, or senses
Understanding the Different Types of Seizures
Focal Epilepsy and Partial Seizures
Epileptic seizures occur when there are abnormal bursts of electricity in the brain. These bursts disrupt the brain's normal function and lead to some loss of consciousness or impaired senses.
Types of Epileptic Seizures
People with epilepsy may experience one of two main types of seizures: generalized or partial.
Generalized seizures occur across the entire surface of the brain rather than a specific location. These are less common and tend to be because of genetic factors.
Most adults with epilepsy experience partial seizures, which begin in a specific region of the brain. These seizures can result from:
- Brain injury
- Stroke
- Brain tumor
- Diseases that affect the brain
Partial seizures can last from 30 seconds to a few minutes.
Epilepsy is diagnosed by a brain scan such as an electroencephalogram (EEG). These scans will show the abnormal electrical activity and whether a tumor or injury is causing the trouble. With a diagnosis of epilepsy, medications are usually the first choice to lessen the frequency of seizures. Surgery may also be necessary if there is a brain tumor or lesion present.
Non-epileptic Seizures
Non-epileptic seizures appear the same as those from epilepsy:
- Impaired or jerky movements
- Tunnel vision
- A tingling sensation in the skin
- Temporary blindness
Other symptoms may also occur. However, with these seizures the central nervous system is not involved.
Causes of Non-Epileptic Seizures
Non-epileptic seizures have a range of causes including:
- Fever
- Infection
- Electrolyte imbalance
- Withdrawal from drugs or alcohol
- Extremely low blood sugar
- Brain damage from stroke, brain surgery, or head injury
Although some causes are the same between epileptic and non-epileptic seizures, the difference your doctor will look for is whether the brain's electrical activity is being disrupted. Results from an EEG will look differently if epilepsy is not the cause.
Your doctor may also perform a blood test to look for infection, check electrolyte levels, and monitor kidney and liver function.
Mental illness,
stress, or emotional trauma can also trigger seizures. In this case, working on the emotional and mental health of the individual is the
best course of treatment.
It's important to know the difference in the types of seizures before moving forward with
medication or other treatment plan for your seizures. Treating non-epileptic seizures with epilepsy medications can have serious side effects.
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string(342) "Not all seizures are caused by faulty electrical signals in the brain, which causes epilepsy. Epileptic and non-epileptic seizures may have similar symptoms, but their causes can be very different. The best way to determine the cause is to visit your doctor. Read more to discover the differences between epileptic and non-epileptic seizures."
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Not all seizures are caused by faulty electrical signals in the brain, which causes epilepsy. Epileptic and non-epileptic seizures may have similar symptoms, but their causes can be very different. The best way to determine the cause is to visit your doctor. Read more to discover the differences between epileptic and non-epileptic seizures.Read More
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string(4465) "Epilepsy is a disorder caused by abnormal bursts of electricity in the brain. These bursts create disruptions in normal brain function and lead to seizures.
Living With Epilepsy
Epilepsy is different for everyone, but it's common for people living with it to feel nervous, embarrassed, or even angry. Facing the possibility of having seizures is stressful and interferes with your daily life.
Understanding what triggers your seizures may help you avoid them. Getting consistent sleep and avoiding stress are also ways to reduce the frequency or intensity of seizures.
To return to a normal life, it's important to find appropriate treatment to reduce or eliminate seizures.
Anti-seizure Medication and Antiepileptic Drugs
This is usually the first choice to control seizure activity. Your doctor may try a few different types of medications depending on the kind of seizures you have.
The most common side effects of these medications are:
- Sleepiness
- Dizziness
- Appetite changes
Mood and behavior changes, such as nervousness, anxiety, irritability, and depression, are also common with anti-seizure medications.
About a third of people with epilepsy find that antiepileptic medication doesn't work for them.
Epilepsy Surgery
For adults who have tried at least two different seizure medications,
your doctor may recommend epilepsy surgery. Before surgery, your doctor will do an imaging technique called brain mapping to determine the exact location where the seizures are originating.
Brain mapping shows the affected areas of the brain and the areas that function normally. A
neurosurgeon will remove the area of the brain that is causing the seizures. This is the most common type of surgery and has a high success rate.
If the area of the brain causing trouble can't be safely removed, the surgeon can perform a procedure that involves making small incisions in the brain to interrupt seizure activity.
Implanted Stimulation Devices
Another treatment option is to implant a vagus nerve stimulator. Vagus nerve stimulation may be a good choice for people who didn't find relief with medication or can't undergo surgery.
The stimulator is implanted beneath the skin, near the collarbone, and a wire connects to the vagus nerve in your neck. The vagus nerve is one of the primary avenues for your body to carry messages to and from the brain.
The device produces mild electrical signals that travel along the vagus nerve at regular intervals. It helps to reduce the frequency and duration of seizures.
People with a stimulator also have the option of turning it off if it causes side effects or turning it on when they feel a seizure is coming.
The stimulator may not prevent all seizures, and you may still need to take medication along with the implant.
Epilepsy treatment can be tricky and involve some trial and error. Your physician will work closely with you to reduce or eliminate seizures with the best options that fit your life. Be open with your doctor about any side effects you experience or any mood changes, such as depression or anxiety, so that these can be addressed at the same time.
Learn more about
epilepsy treatment at the UPMC Department of Neurosurgery.
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string(443) "Epilepsy is different for everyone, but it’s common for people living with it to feel nervous, embarrassed, or even angry. Facing the possibility of having seizures is stressful and interferes with your daily activities. To return to a normal life, it’s important to understand the causes of your seizures and to find an appropriate treatment to reduce or eliminate them. Read more to discover the treatment options available for epilepsy."
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Epilepsy is different for everyone, but it’s common for people living with it to feel nervous, embarrassed, or even angry. Facing the possibility of having seizures is stressful and interferes with your daily activities. To return to a normal life, it’s important to understand the causes of your seizures and to find an appropriate treatment to reduce or eliminate them. Read more to discover the treatment options available for epilepsy.Watch Now
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string(4571) "Epilepsy is defined as an interruption in the electrical activity in your brain that disrupts its normal function. This disruption causes seizures. A person is considered to have epilepsy if they have at least two unprovoked seizures occurring greater than 24 hours apart.
Most people don't know why they have epilepsy, but understanding the causes and triggers of seizures can help you lessen the frequency and feel more in control.
Seizure Causes
Certain conditions can upset the electrical activity in the brain leading to and causing epileptic seizures. Common causes of seizures include:
Your doctor will perform tests and brain scans to help determine
possible epilepsy causes and work with you to develop a
treatment plan to manage your epilepsy.
Seizure Triggers
In some cases you may not be able to uncover the exact cause of seizures, or your anti-seizure or anti-epileptic medication may not prevent every seizure. It's also important to
find out what triggers your seizures as well as warning signs that you're about to have one.
Common triggers for epilepsy include:
Sometimes seizures are more likely to happen at a certain time of day, like at night while sleeping. Keeping a journal of your seizures is the best way to figure out your triggers. Note the time of day, what you were doing, how you felt, your sleep habits, and whether any common triggers were present.
You may also want to include notes on what you have eaten to see if any foods trigger seizures. Some people have found that a ketogenic diet, which is low in carbohydrates and high in fat, helps to control seizure activity.
Seizure Warning Signs
Many people also experience what's called an aura before having a seizure. This is basically your body's warning signal that one is coming.
Some common warning signs of seizures include:
- Sensitivity to smells, sounds, or sights
- Anxiety
- Nausea
- Dizziness
- Visual changes, such as tunnel vision
Learning your triggers and warning signs can help you gain more control over your seizure activity. For more information on
epilepsy and seizure management and treatment, visit the UPMC Department of Neurosurgery.
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Most people don’t know why they have epilepsy, but understanding the causes and triggers of seizures can help you lessen the frequency and feel more in control. Your doctor will perform tests and brain scans to help determine possible epilepsy causes and work with you to develop a treatment plan to manage your epilepsy. Read more to discover common seizure triggers and warning signs.Read More
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string(3980) "People with epilepsy have higher rates of being autistic or having attention deficit hyperactivity disorder (ADHD) symptoms, or depression than adults without epilepsy. At the same time, autistic people or people with ADHD or depression also seem to have a higher risk of epileptic seizures.
Although the reasons aren't clearly understood, epilepsy seems to be linked with many mental health issues.
The reasons behind why these conditions are closely linked aren't fully understood yet. It seems there are similar changes in brain functioning among these conditions. It's also possible that the electrical disruptions from epilepsy can affect certain areas of the brain and cause behaviors common to ADHD, depression, and autism.
Epilepsy and Depression
Living with seizures is tough. It's common to experience sadness, frustration, anger, and even embarrassment. People with epilepsy tend to have a higher risk of developing depression; likewise, people with depression have a higher chance of developing epilepsy.
Seizure and anti-epileptic medications may also play a role in developing depression because they can affect the mood centers of the brain. Brain injury that affects these mood centers may also lead to depression.
Treatment for both conditions gets tricky. People with depression tend to be more resistant to seizure medications, and many antidepressants cannot safely be combined with these medications. Cognitive behavioral therapy (CBT) or counseling may be a first step in treating depression.
Epilepsy and ADHD
Adults with epilepsy are more likely to have ADHD symptoms than adults without. In one large survey, about 18 percent of respondents with epilepsy had ADHD symptoms, compared with just over 4 percent of adults without.
People with epilepsy and ADHD tend to have higher rates of depression and anxiety as well. Given that these are common triggers for seizures, it's possible this could increase the frequency of seizures. Researchers are trying to make more connections between the two and find ways to manage ADHD.
Epilepsy and Autism
About one-third of autistic people also have epilepsy. It's unclear whether epilepsy leads to common behaviors associated with Autism Spectrum Disorder (ASD) or whether the atypical brain activity present in autism makes a person more likely to have seizures. Either way, research is showing that the two conditions are closely linked.
One reason is thought to be because the electrical bursts that cause seizures disrupt the brain's normal functioning that controls socialization. The brain's misfirings lead to behaviors similar to what commonly characterizes autistic people, such as less eye contact or less social interaction.
If you have epilepsy and any signs of depression or ADHD, it's important to talk to your physician. Together, you can find a treatment plan to help you manage seizures as well as your mental and emotional health. For more information on epilepsy treatment options, visit the UPMC Department of Neurosurgery."
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Although the reasons aren’t clearly understood, epilepsy seems to be linked with many mental health issues. People with epilepsy have higher rates of autism, attention deficit hyperactivity disorder (ADHD) symptoms, or depression than adults without epilepsy. At the same time, people with ADHD, autism, or depression also seem to have a higher risk for epileptic seizures. Read more to discover how epilepsy and mental health intersect.Read More
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string(2734) "Epilepsy is often misunderstood. Mostly, because people know so little about it. For example, did you know that it can be more than just shaking violently on the ground, as it's often depicted in movies? Sometimes, a seizure can just involve brief episodes of staring or daydreaming.
It also affects more people than you would think. In the U.S., Epilepsy affects around three million people of all ages – more than Multiple Sclerosis, Cerebral Palsy, Muscular Dystrophy, and Parkinson's Disease combined.
Want to learn more about epilepsy, such as causes, triggers, and risk factors? Check out the infographic below.
Educate Yourself About Epilepsy
Epilepsy is a neurological disorder that causes nerve cell activity (neurons) in the brain to become disrupted, resulting in seizures, unusual behavior, or loss of consciousness.
Did You Know?
Epilepsy affects 65 million people in the world, 2.2-3 million in the U.S. alone. Approximately 1 in 26 people will develop epilepsy at some point in a lifetime. Someone is said to have epilepsy if they've had two or more unprovoked seizures occur that can't be explained by a medical condition. For about 1 in 3 people with epilepsy, there is no treatment that works. The cause is unknown for 60 percent of people suffering from epilepsy.
Epilepsy Risk Factors
Risk factors of epilepsy include:
- Injuries in the brain
- Having a seizure in the first month of life
- Brain abnormalities
- Developmental disabilities
- Family history of seizures
More than 50 percent of people who develop epilepsy don't have any risk factors. Epilepsy is more common in Hispanic people.
Epilepsy Causes
The primary causes of epilepsy include:
- Genetics
- Autism
- Infections
- Stroke, for people 65+
Seizure Triggers
Common triggers of seizures include:
- Missing a dose of seizure medication
- Poor sleep
- Illness
- Hormonal changes
- Stress
- Missing meals
- Drugs or alcohol
- Dehydration
- Flashing lights or patterns
Epilepsy Diagnosis
To diagnose epilepsy, your doctor will:
- Ask for a detailed medical history
- Perform blood tests
- Order EEG tests, and CT and MRI scans
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Epilepsy affects 65 million people worldwide, but the cause is unknown in 60 percent of cases. The neurological disorder is caused by a disruption in electrical signals in the brain, which often results in seizures, unusual behavior or loss of consciousness. Read more to discover the risk factors, common triggers and causes of epilepsy.View Infographic
