Epilepsy is a chronic neurological condition marked by recurrent, unprovoked seizures.

The hallmark of epilepsy is epileptic seizures, and the condition is only diagnosed after a person has had more than one seizure.

Seizures start in the brain and can happen for many different reasons – for example, they can happen to people suffering from diabetes, a heart condition or even tuberculosis (TB). It is important to remember that not all seizures are due to epilepsy.

Epilepsy causes are complex, and the condition can be challenging to diagnose. Causes of epilepsy are put into three main groups:

  • Symptomatic: when it has a known cause such as a head injury, stroke or tumour
  • Idiopathic: which is due to a genetic tendency or change to a person’s genes when they are born
  • Cryptogenic epilepsy: when the cause is unknown

What are its symptoms?

Epilepsy signs and symptoms can vary from person to person and depend on what type of seizures you have. Seizures can occur when you are awake or asleep.

The main symptoms are repeated epilepsy fits or seizures. There are many different types of seizure, depending on the area of the brain affected.

Doctors classify seizures by how much of the brain is affected. There are:

  • Partial (or focal) seizures: only a small part of the brain is affected. There are two main types of partial seizures, that is, simple and complex.
  • Generalised seizures: most or all of the brain is affected. There are six types of generalised seizures.
  • Some seizures don’t fit into these categories and are known as unclassified seizures.

Your doctor will be able able to discuss these with you when diagnosing your condition.

How is it diagnosed?

A typical epilepsy diagnosis will begin with your doctor reviewing your symptoms and medical history. He/she will also make use of different tests to diagnose epilepsy and determine the cause of seizures. These include:

  • A neurological examination: testing your behaviour, motor abilities, mental functioning and other areas to determine your condition.
  • Blood tests: blood samples are taken to check for signs of infections, genetic conditions or other conditions related to seizures.
  • An electroencephalogram (EEG): a test that measures the electrical activity of the brain

There is a range of scans to detect brain abnormalities. Your doctor will explain the different purposes of these scans.

What are your treatment options?

The type of treatment prescribed will depend on a number of factors, including the frequency and severity of the seizures and a person’s age, overall health and medical history. An accurate diagnosis of the type of epilepsy is critical to choosing the best treatment.

The most common form of treatment is medication, particularly anti-epileptic drugs (AEDs). Drugs are designed to reduce the brain activity that leads to seizures, and about 70 percent of people are reportedly able to control their seizures with these AEDs.

Children who have epilepsy may be put on the special high-fat, low-carbohydrate ketogenic diet, which can help control the seizures. It is stricter than the modified Atkins diet, requiring careful measurements of kilojoules, fluids, and proteins. Read here for more on the ketogenic diet.

Not everyone with epilepsy needs treatment as it may be possible to control your condition by avoiding triggers such as alcohol abuse and sleep deprivation.

Can it be prevented?

As the exact cause of epilepsy is not known, the disorder itself can't be prevented but it can be successfully managed. Here’s how:

  • Know your triggers and avoid them
  • Keep a diary and document triggers and patterns
  • Take your medication as prescribed
  • Have regular check-ups with your GP and/or neurologist
  • Eat healthily, exercise regularly, and prevent illness and injury as far as possible.

For more info
Epilepsy South Africa

The accuracy of this information was checked and approved by physician Dr Thomas Blake in May 2015