The Facts About Epilepsy

Maureen Robb's picture
By Maureen Robb on April 17, 2019

Did you know that more than two million children and adults in the United States—one to two percent of the population—have epilepsy?

Common as it is, this disruptive condition that can affect relationships and the ability to work and drive remains stigmatized in our society.

“Unfortunately there is still a stigma and some fear surrounding epilepsy,” said Mark R. Witcher, M.D., Ph.D., a neurosurgeon with the Carilion Clinic Institute for Orthopaedics and Neurosciences.

“Maybe for that reason, not everyone with epilepsy seeks medical care right away,” he said. “But because untreated seizures can get worse over time, we often see patients who have to contend with seizures for much longer than they would have had to otherwise.”

There are four types of epilepsy:

  • Generalized, which involves seizures in many regions of the brain
  • Temporal lobe, marked by repeated seizures in the temporal lobe under the temple that last for one to two minutes
  • Lesional, related to damage, trauma, tumors or infection in the brain
  • Non-lesional, which can't be identified by routine MRI testing

Stigma and fear surrounding epilepsy can prevent people from seeking medical care, forcing them to live with seizures much longer than they may need to.

Symptoms
The symptoms of epilepsy can include:

  • Staring blankly for several seconds
  • Uncontrollable twitching or jerking of your arms and legs
  • Temporary confusion or disorientation
  • Losing consciousness
  • Clenched muscles and body rigidity

“Get medical help immediately if you have a seizure for the first time, or if a seizure goes on for over five minutes,” said Dr. Witcher.

Many diagnostic tools today can detect brain abnormalities and help to diagnose epilepsy, including MRI testing, neuropsychological testing, intracranial monitoring and PET/CT scans.

a Carilion Clinic neurosurgeon looking at a 3D brain map from ROSA robot
Carilion Clinic neurosurgeon Mark Witcher, M.D., uses a stereotactic system called ROSA to diagnose and treat epilepsy with precision and minimal invasiveness.

Dr. Witcher also advises you to seek emergency care if you:

  • Get a second seizure immediately after the first
  • Are pregnant
  • Injured yourself
  • Have trouble breathing
  • Have diabetes

If you or someone you’re with suffers a seizure, follow these steps to guard against injury:

  • Don’t attempt to stop the body movements
  • Remove any hard or sharp objects nearby
  • Place the person on their side to keep the airway clear
  • Don’t place anything in the mouth
  • Time the seizure

Treatment
About two-thirds of those who have epilepsy take medications that control their seizures. For patients whose symptoms are not well-controlled by medications, there are also several surgical options. They include:

  • Intracranial laser ablation, in which a laser fiber is guided toward the source of the seizures to destroy abnormal brain tissue
  • Vagal nerve stimulation, which involves placing a tiny device on the vagus nerve that sends pulses of electrical energy to the brain
  • Surgical resection to remove the part of the brain causing seizures
  • NeuroPace RNS, in which a device similar to a pacemaker is implanted in the brain to prevent seizures
  • Deep brain stimulation, which involves placing a battery in the chest and electrodes in the brain; the battery sends electrical pulses to the brain to reduce seizures

Epilepsy has posed huge challenges to patients and caregivers over many centuries. But new treatments are giving relief to many for the first time.

“We also hope to see more public discussion and education about this chronic disorder,” said Dr. Witcher. “We certainly hope that patients don’t have to suffer with it as long as they have in the past.”
 
Contact your provider if you experience any of the symptoms listed above. If you don't have a primary care provider, call Carilion Clinic at 800-422-8482 for a recommendation.