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What is it about ?
The epileptic crisis is a transient disorder of brain function caused by abnormal electrical activity in the brain. The epileptic seizure can be caused by triggers such as stress, suddenly stopping alcohol or a severe lack of sleep. The epileptic seizure presents as local seizures (focal seizures) or generalized seizures. The cause, however, is far from always obvious.
The focal seizures indicate a problem in a limited area of the brain and reflect dysfunction in that area. There may be a loss of consciousness, but this is not always the case. In focal seizures with retained consciousness, there may be both motor symptoms (eg, limb twitching or fixed gaze), sensory changes (eg, change in taste), palpitations of the heart and psychological symptoms (eg, anxiety, hallucinations). The type and extent of symptoms depend on where in the brain the seizure activity is located. Focal seizures with decreased level of consciousness can go hand in hand, in addition to the symptoms mentioned above, with unconscious automatic movements (eg lip smacking).
Generalized convulsions indicate a problem in both hemispheres of the brain. The seizure begins with a loss of consciousness, and from the start the convulsions are symmetrical on both sides.
A diagnosis is usually only made if the person tends to have multiple seizures, eg. at least two seizures in the past year. Having a one-time epileptic seizure does not therefore mean that you have epilepsy.
What is its frequency?
It is estimated that 5% of the population have at least one epileptic seizure in their lifetime and 1% develop epilepsy.
How to recognize it?
The precise symptoms depend on where in the brain the seizure activity is located.
Often the victim does not remember anything about the epileptic seizure. The people who were present can of course describe it.
How is the diagnosis made?
The story of the victim and those present at the time of the epileptic seizure is very important. The doctor tries to find out how long the attack lasted, whether it was preceded by certain symptoms, whether the victim was unconscious, whether there was a loss of urine, etc. He checks for any triggers, such as stress or an underlying infection. The description of the post-seizure period is also helpful: Did the person recover quickly or remained a little dazed for a few minutes after the seizure?
An EEG (electroencephalogram) measures electrical activity in the brain and indicates whether epileptic activity is still present. If necessary, additional imaging tests are done, such as a CT scan or MRI (magnetic resonance imaging) of the brain.
What can you do ?
Many people who have had epileptic seizures are afraid that another seizure might unexpectedly occur. Inform those around the patient: at home, at school or at work. When people know what to do, it can avoid confusion and misunderstandings.
Those present should first try to ensure that the person having a seizure does not injure themselves (and do not bang themselves against sharp objects or doors, for example). During a first attack or in the event of a prolonged attack (more than 5 minutes), you should always call the emergency room (112).
What can the doctor do?
If seizures return without a triggering factor, the doctor may prescribe appropriate anti-epileptic drugs. Sometimes it takes a bit of research to find the medication that is effective and well tolerated. Talk to the doctor if you have any concerns about the medication, as it is very important to follow the treatment properly.
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