Epilepsy and seizure disorder means the same - a disorder of the brain in which the electrical activity becomes abnormal causing sudden, unpredictable recurrent episodes of sensory disturbance, loss of consciousness or convulsions. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Approximately 65 million people around the world suffer epilepsy.

What happens in the brain during a seizure?

Complex chemical changes in nerve cells are responsible for the electrical activity at brain. There is usually a balance between exciting and inhibiting brain cells from sending messages. When a seizure occurs, there may be too much or too little activity, causing an imbalance.

Symptoms

• Temporary confusion
• A staring spell
• Uncontrollable jerking movements of the arms and legs
• Loss of consciousness or awareness
• Psychic symptoms such as fear, anxiety or Deja vu

Focal seizure means that the abnormal activity occurs only in one area of the brain.

without loss of consciousness

• alterations of emotions or change the way things look, smell, feel, taste or sound
• involuntary jerking of a body part, such as an arm or leg
• sensory symptoms such as tingling, dizziness and flashing lights

with impaired awareness

• staring into space and not respond normally to the environment
• performing repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.

Generalized seizure affect both sides of the brain at the same time like tonic-clonic seizure (abrupt loss of consciousness, body stiffening and shaking and sometimes loss of bladder control or biting on tongue), absence seizure (staring into space or subtle body movements such as eye blinking or lip smacking), atonic seizure (loss of muscle control, which may cause to collapse and fall down) and myoclonic seizure (sudden brief jerks or twitches of arms and legs).

Causes

50% has no identifiable cause, the other 50% may be traced to various factors including:

• Genetic factors
• Head trauma
• Brain diseases as tumours, strokes, meningitis
• Prenatal injury and developmental disorders

Trigger factors:

• Sleep deprivation – overtired, not sleeping well, not getting enough sleep
• Flashing bright lights or patterns
• Alcohol or drug use
• At times of fevers or other illnesses
• Stress
• Associated with menstrual cycle (women) or other hormonal changes
• Low blood sugar
• Use of certain medications

Diagnosis

Diagnosis starts by taking an extensive medical history addressing your symptoms, the trigger factors, the duration and the frequency, work environment, social habits, toxic exposure, risk of infectious diseases and family history of neurological disease. Check of vital signs such as blood pressure and pulse, followed by a proper physical examination should give a first differential diagnosis. Additional tests such as laboratory tests, Electroencephalography (EEG), imaging of brain are recommended investigations for confirmation.

Treatment

Seizure-freedom is achievable in most patients by taking one anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. If medications fail to provide adequate control over seizures, surgery may be an option. In addition, ketogenic diet (high in fats and low in carbohydrates) was found to improve seizures, not only in children.