What causes epilepsy?

Epilepsy is a disorder of the brain where nerve cells do not signal properly, which causes seizures. It is a neurological disorder, affecting around 600,000 people in the UK according to Epilepsy Action. What causes epilepsy? Researchers still aren’t sure, but there are many different risk factors that could play a role. In this post we’ll take a look at some of the possible causes of epilepsy and more.

What is epilepsy?

Epilepsy is a neurological condition that affects the nervous system. When someone has epilepsy, it means that they have a condition that causes their brain to produce electrical signals that are abnormal. This can happen in different ways, depending on the person. For some people, electrical signals may be produced that are too strong. For others, electrical signals may be produced that are too weak. Epilepsy can also cause electrical signals to be produced at a very high speed. All of these things can cause problems with how the brain works.

Seizures are one of the most well-known symptoms of epilepsy. Seizures happen when there is a sudden surge of electrical activity in the brain that causes a person to lose consciousness and/or have muscle spasms. The type of epilepsy someone has depends on the seizure type. There are many different types of seizures, and they can vary in severity from person to person. Some people with epilepsy only have seizures occasionally, while others may have them frequently.

There is no cure for epilepsy, but there are treatments that can help to manage it. Medications and changes in lifestyle are two of the most common treatments for epilepsy.

What are the different types of seizures?

There are two main types of epileptic seizures: generalised and focal.

Generalised seizures

Generalised seizures are the most common type of seizure experienced by people with epilepsy. They involve the whole brain and often result in a loss of consciousness.

Generalised seizures can be further divided into six subtypes: tonic, clonic, myoclonic, absence, atonic and tonic-clonic

• Tonic seizures cause muscles to stiffen and can make a person fall to the ground
• Clonic seizures cause muscle jerking and twitching
• Myoclonic seizures are brief, shock-like jerks of a muscle or a group of muscles. There can be just one, but sometimes many will occur within a short time
• Absence seizures cause a person to stare blankly and lose consciousness for a short period of time
• Atonic seizures cause muscles to suddenly relax, which can make a person fall down
• Tonic-clonic seizures (formerly known as grand mal seizures) are the most severe type of seizure and involve both muscle stiffness and jerking

Focal seizures

Focal seizures begin in one area of the brain, they were previously known as partial seizures. During a focal seizure, you may remain aware of your surroundings or you may not. If you don’t lose consciousness, you may have muscle jerking on one side of your body or your body may stiffen. You also may have changes in your senses, seeing, hearing, smelling or tasting things that aren’t really there. You may feel dizzy, nauseated, anxious or frightened. Some people say their focal seizures feel like déjà vu or jamais vu. Déjà vu is the feeling that you’ve experienced something before even though you haven’t. Jamais vu is when familiar things seem strange or new. Focal seizures can last a few seconds to a few minutes. They can occur infrequently or multiple times per day.

Focal seizures can also be divided into six subtypes: simple partial, complex partial, secondarily generalized, aura, motor and sensory

• Simple partial seizures do not cause a loss of consciousness but can cause changes in emotions or sensations
• Complex partial seizures involve a loss of consciousness and can cause repetitive movements like chewing or hand-rubbing
• Secondarily generalised seizures begin as focal seizures but then spread to the entire brain 
• Aura seizure is the term used to describe the warning signs or changes in brain activity that occur before a seizure
• Motor seizures cause body parts to jerk or twitch involuntarily
• Sensory seizures affect how a person experiences touch, taste, smell, sight or sound

Unknown seizures

When the beginning of a seizure is not known, now called an unknown onset seizure. A seizure could also be called an unknown onset if it’s not witnessed or seen by anyone, for example when seizures happen at night or in a person who lives alone.

• As more information is learned, an unknown onset seizure may later be diagnosed as a focal or generalised seizure

What causes epilepsy in the first place?

It is often difficult to determine what causes the condition in the first place. It is thought that some cases of epilepsy may be inherited, while other cases may be the result of head injuries or infections. In some people, epilepsy may also be caused by problems with the brain itself, such as tumours or strokes. Let’s take a look at this next. There is no single cause of epilepsy, the condition can often be very difficult to treat.

Brain injury

Head injuries can cause a wide range of problems, from concussions to more serious conditions like skull fractures and traumatic brain injuries. In some cases, head injuries can also lead to epilepsy. Epilepsy is a disorder that causes recurrent seizures or fits. Seizures can vary from mild to severe and can be caused by a variety of factors. However, head injuries are one of the most common causes of epilepsy, causing brain damage in a variety of ways, causing inflammation and scarring. This damage can disrupt the normal electrical activity in the brain, leading to seizures. If you have suffered a head injury, it is important to see a doctor as soon as possible.

Mesial temporal sclerosis

Mesial temporal sclerosis (MTS) is a brain disorder that causes problems with memory and learning. This condition is caused by the buildup of scar tissue in the hippocampus, which is the part of the brain that helps us remember things. MTS can lead to epilepsy and cause seizures. It can also cause changes in mood and behaviour. MTS is not curable, but treatments can help manage the symptoms. There is no one cause of MTS, but it is thought to be caused by a combination of factors, including genetics, infections and head injuries.

Brain infection

Brain infection is an infection that happens when bacteria, viruses or other organisms enter the brain. This can happen through a break in the skin, through the nose or mouth or through a wound in the head. Infections of the brain, such as meningitis or encephalitis can damage the brain and lead to seizures and epilepsy. Brain infections are very serious and can be life-threatening. They can cause inflammation (swelling) and damage to the brain tissue. Brain infections are often treated with antibiotics or antiviral medications. In some cases surgery may be necessary to remove the infected tissue.

Dementia

Dementia is a general term for a decline in mental ability due to disease or injury. Alzheimer’s disease is the most common form of dementia, but there are many other types as well. Epilepsy is one of the most common neurological disorders, it can cause changes in behaviour, cognition and mood, that may mimic dementia. In some cases, epilepsy and Alzheimer’s disease may co-occur. Many people with epilepsy are at an increased risk of developing Alzheimer’s disease and vice versa. Early diagnosis and treatment of epilepsy may help to delay or prevent the onset of dementia. While there is no cure for dementia, treatments are available that can help to improve quality of life.

Brain tumour

Brain tumours that are located in certain areas of the brain are more likely to cause seizures than those located in other areas. Tumours that press on the temporal lobe or frontal lobe of the brain, for example, are more likely to cause seizures than tumours located in other parts of the brain.

Family history

There is some evidence that epilepsy may have a genetic component. For example, family members of people with epilepsy are more likely to develop the condition themselves. Additionally, specific genes have been associated with an increased risk of developing epilepsy. Researchers first identified genes linked to epilepsy in the late 1990s, according to the Epilepsy Foundation. However, it is important to note that not everyone with a family history of epilepsy or specific genetic markers will go on to develop the condition. Epilepsy is thought to be caused by a combination of genetic and environmental factors.

Other medical conditions

Metabolic disorders and immune disorders can also lead to epilepsy. These conditions can interfere with the way the nervous system functions, which can trigger seizures.

What are some triggers of epilepsy?

There are two main types of triggers that can cause an epileptic seizure: external triggers and internal triggers. External triggers are things like flashing lights or loud noises, which can cause a seizure in people with photosensitive epilepsy. Internal triggers are things like hunger, stress or a lack of sleep, which can cause a seizure in people with any epilepsy. Although it may not be possible to avoid all triggers, it is important to try to identify your triggers and try to avoid them as much as possible. If you have photosensitive epilepsy, you may want to avoid watching television or going to concerts. If you have any epilepsy, you may want to try to manage stress by exercising or doing relaxation techniques. You should also make sure to get enough sleep and eat regular meals. By identifying your triggers and taking steps to avoid them, you can help reduce your risk of having a seizure.

How is epilepsy diagnosed?

There is no single test to diagnose epilepsy. Instead, doctors will often ask about your medical history and symptoms and may also order one or more of the following tests:

• Neurological exam. This exam assesses your nervous system functioning, including muscle strength and reflexes, sensation, coordination and balance
• Blood tests. These tests check for electrolyte imbalances, genetic conditions and other factors that can trigger seizures
• Imaging studies. These studies create pictures of the inside of your body and can be used to look for brain tumours or other abnormalities that can cause seizures. Common imaging studies include computed tomography (CT) scans and magnetic resonance imaging (MRI) scans
• Electroencephalography (EEG). This test records the electrical activity of your brain and can help to determine if you have epilepsy
• Sleep study. This study monitors your brain waves while you sleep, it can help to diagnose sleep-related problems that can cause seizures
• Neuropsychological testing. This testing assesses your thinking, memory and mood, it can help to identify any cognitive problems caused by epilepsy

If you have any questions about how epilepsy is diagnosed, don’t hesitate to ask your doctor. They will be able to discuss the process with you in more detail and answer any questions you may have.

What is the treatment for epilepsy?

There are many different types of epilepsy, the treatment depends on the type of seizures that a person experiences. Anti-epileptic drugs are the most common treatment for epilepsy. These drugs help to control seizures by stabilising electrical activity in the brain. More than 20 antiseizure medications are available today, with different benefits and side effects.

Surgery is another treatment option for some people with epilepsy. Surgery aims to remove the area of the brain that is causing seizures. Epilepsy surgery is mostly used when the seizure focus is located in the brain’s temporal lobe. In some cases, Vagus Nerve Stimulation (VNS) is a treatment option for people who have intractable seizures that cannot be controlled with medication. It involves surgically implanting a device that sends electrical impulses to the vagus nerve, which is located in the neck. The vagus nerve is part of the autonomic nervous system, which controls involuntary functions such as heart rate and digestion. VNS has been shown to be effective in reducing the frequency and severity of seizures in some people with epilepsy.

Diet and lifestyle changes can also help to control seizures in some people with epilepsy. For example, avoiding triggers such as alcohol or sleep deprivation can help to prevent seizures from happening. There is promising evidence that a ketogenic diet (high-fat, low-carbohydrate, adequate protein) decreases the number of seizures and eliminates seizures in some. Epilepsy is a serious condition that requires lifelong treatment. However, with proper medical care, many people with epilepsy are able to live normal healthy lives.

If you think you or a loved one may be experiencing epilepsy, it’s important to seek professional help. See your primary healthcare provider if you think you might have had a seizure for the first time. Your doctor may refer you to a neurologist or epilepsy specialist. An accurate diagnosis is essential for developing the best possible treatment plan. There are many options available and a specialist can help find the right combination of medications, therapies, and lifestyle changes for you.

Sources

• Epilepsy Foundation
• Epilepsy – NHS