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Epilepsy

The brain maintains a balance between neuronal excitation and inhibition.1 With epilepsy—a chronic disorder in which neurons can signal abnormally, excessively, and at high speed—this balance can be disrupted, leading to seizures.1 There are many different types of seizures, many kinds of epilepsy, and many epilepsy syndromes.1 In the US, more than 3.4 million people have active epilepsy: 3 million adults and 470,000 children.2

At least 150,000 people are diagnosed every year in the US; one in 26 people will develop epilepsy.3 A diagnosis of epilepsy can make life challenging. Even when seizures are controlled by medication, people with epilepsy can still be at risk for breakthrough seizures.4 People who have occasional seizures have a risk for significant consequences, including:

  • Immediate suspension of driving privileges5
  • A high risk for seizure-related injuries and emergency room visits4,6
  • Status epilepticus, a dangerously prolonged seizure that can be life-threatening1
  • SUDEP, or Sudden Unexpected Death in Epilepsy. In neurology, SUDEP is second only to stroke as a cause of total years of potential life lost4,7,8

Despite these challenges, people with epilepsy have jobs in all walks of life, have made important achievements, and, with the right treatment, can thrive.

When beginning treatment for epilepsy, patients should be sure to communicate frequently with their treatment teams for the best results.

Icon of a stethoscope
Icon of a stethoscope

Symptoms

People with epilepsy have seizures that are not caused by a known event, such as a traumatic brain injury or a high fever.1 Seizures and symptoms vary widely, depending on the type of epilepsy.1

Seizures may:

  • Come with convulsions
  • Involve a lapse of awareness and staring
  • Involve loss of consciousness
  • Happen infrequently
  • Happen hundreds of times a day
  • Seem dreamlike to the person having them
  • Involve automatisms, such as blinking, twitching, moving one’s mouth, or walking in circles
  • Cause sudden loss of muscle tone, causing one to fall or drop one’s head
  • Some people with epilepsy experience an aura, a prodrome, or a warning that a seizure is coming, while others do not.1
Icon of a magnifying glass
Icon of a magnifying glass

Diagnosis

Epilepsy is diagnosed when a person has at least two unprovoked seizures (with no known cause), at least 24 hours apart.1

Beyond that, tests may be used to determine the type of seizures or to rule out other disorders, including1:

  • An electroencephalogram (EEG)
  • Video monitoring during EEG
  • A magnetoencephalogram (MEG)
  • Brain scans, such as:
    • Computed tomography (CT)
    • Magnetic resonance imaging (MRI)
    • Positron emission tomography (PET)
    • Single photon emission computed tomography (SPECT)
Icon of a medical treatment bag
Icon of a medical treatment bag

Treatment

It is important to get seizures under control as quickly as possible.1 Neurologists and epileptologists look for a treatment that delivers powerful efficacy with the fewest side effects.

Many different antiseizure medications (ASMs) are available, targeting many different channels and receptors in the brain, including both presynaptic and postsynaptic neurons.8 Other treatment options may include1:

  • Diet
  • Devices
  • Surgery

ASMs may be taken alone or in combination, depending on the type of epilepsy and how it responds to treatment.1 Some people whose seizures have been controlled for long periods of time without a breakthrough seizure may be able to taper off of their medications while under their doctor’s supervision.1

Learn about our epilepsy treatment for convulsive seizures and focal seizures.

References:

  1. National Institute of Neurological Disorders and Stroke. Health Information: Epilepsy and Seizures. Accessed April 11, 2023. https://www.ninds.nih.gov/health-information/disorders/epilepsy-and-seizures#.
  2. Centers for Disease Control and Prevention. Epilepsy: Epilepsy Data and Statistics. Accessed April 11, 2023. https://www.cdc.gov/epilepsy/data-research/facts-stats/?CDC_AAref_Val=https://www.cdc.gov/epilepsy/data/index.html
  3. Sirven, JI. Epilepsy: A Spectrum Disorder. Cold Spring Harb Perspect Med. 2015;5:a022848.
  4. Bonnett LJ, Powell GA, Tudur Smith C, Marson AG. Breakthrough seizures—further analysis of the standard versus new antiepileptic drugs (SANAD) study. PLoS One. 2017;12(12):1–16.
  5. Koubeissi, MZ, Azar NJ. Epilepsy Board Review: A Comprehensive Guide. Springer Nature; 2017.
  6. Manjunath R, Paradis PE, Parisé H, et al. Burden of uncontrolled epilepsy in patients requiring an emergency room visit or hospitalization. Neurology. 2012 Oct;79(18):1908-16. doi:10.1212/WNL.0b013e318271f77e
  7. Devinsky O, Hesdorffer DC, Thurman DJ, et al. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol. 2016;15(10):1075-1088.
  8. Devinsky O, Spruill T, Thurman D, et al. Recognizing and preventing epilepsy-related mortality: A call for action. Neurology. 2016;86(8):779-786.
  9. Hakami T. Neuropharmacology of Antiseizure Drugs. Neuropsychopharmacol Rep. 2021 Sep;41(3):336-351. doi:10.1002/npr2.12196.

All information contained on the Catalystpharma.com website is intended for informational and educational purposes. The information provided on this website is not intended to be a replacement or substitute for professional medical advice. Any information that you have received from Catalystpharma.com should be verified with your licensed healthcare provider. Individuals should never disregard or delay seeking medical advice due to the content of this site.

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