Seizures have been described as irregular activity of the nerves in your brain, and sometimes these irregularities can become recurrent or chronic. When seizures become a consistent problem, this condition is called epilepsy.
You may have a seizure without having epilepsy, but you can’t have epilepsy without seizures — even if they don’t cause obvious effects.
Find out what distinguishes these seizures from epilepsy and what you can do to manage these conditions.
What’s the difference between epilepsy and seizures?
Seizures are individual occurrences of abnormal electrical activity in the brain. There are many causes of seizures, including singular events like a medication reaction. Epilepsy, on the other hand, is a chronic neurologic disorder that causes repeated seizure activity.
It’s important to treat the underlying cause of individual seizures and to know when to differentiate between a standalone seizure and epilepsy.
What’s a seizure?
Your brain works by sending electrical signals through nerve cells. If these signals are altered or interrupted, it can cause a seizure.
Seizures come in many forms and are triggered by a number of events and conditions. One seizure alone doesn’t mean you have epilepsy, but if you have two or more seizures, you may be diagnosed with epilepsy.
Seizures are the primary symptom of epilepsy, but they can also be caused by a number of other events.
Nonepileptic seizures are seizures brought on by situations that aren’t related to epilepsy. Some of the causes of nonepileptic seizures include:
- head injuries
- infections like meningitis
- alcohol withdrawal
- drug withdrawal
- very high blood pressure
- metabolic problems like kidney or liver failure
- low blood sugar levels
- a brain tumor
Seizures don’t always appear as violent shaking. There are several types of seizures, and they’re split into two categories: generalized and focal.
- Absence seizures. Also called petit mal, these may cause you may to lose focus, blink rapidly, or stare out into space for a few seconds.
- Tonic-clonic seizures. Also called grand mal, these may cause you to cry out, fall to the ground, or experience strong muscle jerking or contractions.
- Simple focal seizures. These affect just a small part of the brain and can have minimal symptoms, like a small twitch or a strange taste in your mouth.
- Complex focal seizures. These involve multiple areas of the brain and can cause confusion. You may become disoriented or unable to respond from a few seconds to a few minutes.
- Secondary generalized seizures. These seizures begin as a focal seizure in one part of the brain and progress to a generalized seizure.
Seizures can take on many forms. Here are a few of the most common ways to
- Tonic. Muscles stiffen.
- Atonic. Muscles go limp.
- Myoclonic. There are quick, jerking movements.
- Clonic. There are repeated periods of shaking or jerking movements.
What is epilepsy?
Epilepsy is the medical name given to the condition in which you experience recurrent seizures. When these seizures are tied to another event — like drug or alcohol withdrawal — the underlying cause is treated, and it’s usually diagnosed as a nonepileptic seizure.
However, when there’s no known underlying cause, it’s considered an unprovoked seizure and may be the result of abnormal or unexplained electrical impulses in your brain.
There are several kinds of epilepsy:
- Progressive myoclonic epilepsy. This includes several rare, generally hereditary conditions that stem from metabolic disorders. This disorder usually begins late in childhood or in the teen years and appears with seizure activity, myoclonus, and weakness that become progressively worse over time.
- Refractory epilepsy. Your epilepsy may be called refractory if the seizures continue despite medication.
- Reflex epilepsy. These types of epilepsy involve seizures are triggered by external or internal stimuli like emotions, temperature changes, or lights.
- Photosensitive epilepsy. This is the most common type of reflex epilepsy and is triggered by flashing or strobing lights. This type of epilepsy usually begins during childhood and may lessen or disappear in the adult years.
There are also a few types of epilepsy that are specific to childhood, including:
- Myoclonic astatic epilepsy of childhood (Doose syndrome). These seizures are characterized by a sudden loss of muscle control with no known cause.
- Benign rolandic epilepsy (BRE). These seizures involve twitching, numbness, or tingling of the face or tongue and can cause speech problems or drooling. This condition usually ends in adolescence.
- Rasmussen syndrome. This rare autoimmune syndrome is characterized by focal seizures which are usually the first symptom. Surgery is typically the best treatment for this condition, as seizures can be difficult to manage with medications.
- Lennox-Gastaut syndrome. This rare condition involves multiple types of seizures and is often seen in children with developmental delays. The cause for this condition is unknown.
- Electrical status epilepticus of sleep (ESES). This disorder is characterized by seizures during sleep and abnormal EEG findings during sleep. It usually occurs in school-aged children, mainly while they sleep. It can involve learning or language delays as well.
- Sturge-Weber syndrome. Children with this condition usually have nevus flammeus — also called a port-wine stain — on their scalp, forehead, or around the eye. They can have seizures, weakness, developmental delays, and vision difficulties. Surgery is sometimes required when medications can’t manage the condition.
- Juvenile myoclonic epilepsy. This condition starts around puberty and mostly appears as small, rapid jerking movements called myoclonic seizures. Absence seizures may also occur. This condition can usually be managed with medication.
How is epilepsy diagnosed?
Epilepsy is diagnosed in a number of steps, but first, your doctor will want to be sure you don’t have any other conditions that might be causing seizures. Possible conditions include diabetes, immune disorders, medications, stroke, or brain tumor.
Your doctor will likely perform the following checks to look for underlying conditions or to try to uncover another reason for your seizures:
- a complete medical history, examining medications you take and any existing conditions
- a neurological exam to test your cranial nerves, balance, and reflexes
- blood testing to check your electrolytes and look for other abnormal values that could trigger seizure activity
- imaging studies like a computed tomography exam or MRI to look for abnormal masses or accumulations of fluid that could be increasing pressure in your brain
- activity testing like an electroencephalogram (EEG) to show the patterns of electrical impulses in your brain
Why do people get epilepsy?
Epilepsy can arise as a result of a number of medical conditions, injuries, or hereditary disorders. Some examples include:
- head trauma
- congenital brain damage
- brain damage from lack of oxygen (hypoxic brain damage)
- brain tumors
- drug and alcohol use or withdrawal
- infections that affect the neurologic system
In some cases, your doctor may not be able to pinpoint a cause of your epilepsy. These conditions are usually called idiopathic, or of unknown origin.
Can you prevent epilepsy?
- preventing head injuries
- improving prenatal care to reduce birth injuries
- making appropriate medications and methods available to reduce childhood fevers and prevent febrile seizures
- reducing cardiovascular risks like smoking, alcohol use, and obesity
- treating infections and eliminating parasites that can cause epilepsy from central nervous system infections
What are common risk factors for developing epilepsy?
Stroke is one of the major causes of epilepsy that begins later in life, but many epileptic conditions begin in childhood. Genetics play a role in epilepsy as well.
Other factors that may increase your risk for seizures if you have epilepsy include:
- sleep deprivation
- poor diet
- drug or alcohol use
What are the symptoms of epilepsy?
Epilepsy can have a wide range of symptoms, from staring off into space to jerking uncontrollably. Some people who have epilepsy may experience multiple types of seizures.
Some people with seizures have noticed an aura or unusual sensation that serves as a warning signal before a seizure begins. This can come in the form of a visual disturbance, sound, or feeling of anxiety. Auras are sometimes a type of focal, or petit mal, seizure, and can be followed by a grand mal seizure. These are usually called secondary generalized seizures.
Depending on the type of seizure you have, you may experience any of the following symptoms:
- mood changes
- vision changes
- muscle jerking
- loss of balance
- teeth clenching
- biting your tongue
- rapid blinking or eye movements
- unusual noises
- loss of bladder or bowel control
- loss of consciousness
What to do if someone is having a seizure
If you think you see someone having a seizure, you can provide essential, emergency first aid that will help keep them safe:
- If the person is experiencing jerking movements or a loss of physical control, gently ease them to the floor. Place a blanket or something soft under the person’s head for a cushion.
- Turn them to their side to allow drool or vomit to drain and to help them breathe. Don’t try to hold someone still or stop their movements.
- Make sure that the area around the person is safe, with no sharp objects that could cause injury.
- Don’t put anything in the mouth of a person having a seizure. Don’t offer any food or drink until the person is fully alert.
- Remove glasses and any clothing items that could cause injury or strangulation.
- Don’t try to perform CPR or offer rescue breaths during an active seizure. Call 911 if the seizure lasts for more than 5 minutes.
How is epilepsy treated?
There are a lot of medications used to control seizure activity and epilepsy, and there’s no one best treatment for everyone. Your doctor will need to do specific tests and maybe even try a few different medications to find the right one to manage your specific type of seizure.
Most seizure medications are anti-epileptic medications, like:
- levetiracetam (Keppra)
- carbamazepine (Carbatrol, Tegretol)
- phenytoin (Dilantin, Phenytek)
- oxcarbazepine (Trileptal)
- lamotrigine (Lamictal)
- lorazepam (Ativan)
Seizures may also be prevented with surgery, such as vagus nerve stimulation, particularly if there’s a mass or accumulation of fluid in your brain that is causing the seizures to occur. To treat seizures with surgery, your doctor has to know the exact location in the brain where your seizures are beginning.
Don’t change your seizure treatment without consulting your doctor. With the advice of your doctor, you may want to consider other options as well. Diet changes, like using a ketogenic diet, can be effective for people who have certain types of refractory epilepsy.
Some people report success in reducing the number of seizures caused by triggers by adding complementary, alternative, or natural treatments to their medical seizure treatments, including:
- herbal treatments
- vitamin supplements
- chiropractic care
What’s the outlook for people with epilepsy?
Being born with epilepsy doesn’t necessarily mean you’ll have the condition forever. Some childhood seizure disorders fade in adulthood, while others don’t start until the teen years.
New onset of epilepsy is most common in childhood or after age 60. For older adults, stroke, traumatic injury, and drug and alcohol use are primary factors.
The good news is that there are many options for medications that manage seizures. If one doesn’t work for you, don’t worry. Your doctor may need to try several medications or a combination of therapies to find the right solution. You may also need to change medications every so often.
Surgery may be helpful if your seizures don’t respond to medication, but for many people, epilepsy is a lifelong condition.
Lifestyle changes may be required to help control the condition, and you may be prevented from doing certain activities, like drinking alcohol or driving a car. Unmanaged epilepsy can lead to brain damage and other problems.
The bottom line
Seizures can occur suddenly and for no apparent reason. People who have repeated seizures — either because of another condition or for no obvious reason at all — are diagnosed with a condition called epilepsy.
Epileptic seizures are caused by abnormal electric signals in the brain that cause you to lose focus, muscle control, or even consciousness. Your doctor may have to run a lot of tests to uncover the cause of your seizures, and it may take several medications to find the right fix.
Safety is a big concern when people have seizures, and it’s important that those around you know what to do when a seizure happens.