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Epilepsy

Understanding the diverse range of epilepsy types is of utmost importance as it helps in accurately diagnosing and treating this brain disorder characterized by recurring seizures. While the cause can be identified in some cases, it remains unknown in others. With an estimated 1 in 26 people developing epilepsy, it is a common condition that affects individuals of all genders, races, ethnic backgrounds, and ages, as highlighted by the Epilepsy Foundation.
In order to effectively manage epilepsy, it is crucial to recognize that each type of epilepsy presents with its own unique set of characteristics and challenges. For instance, some types of epilepsy are focal, meaning seizures originate in a specific area of the brain, while others are generalized, involving both sides of the brain from the start. 
Additionally, specific triggers, symptoms, and response to treatments can vary significantly between different epilepsy types. By understanding the different types of epilepsy, healthcare professionals can tailor treatment plans to address the specific needs of each individual. This personalized approach can lead to better seizure control, improved quality of life, and reduced side effects from medications. 
Furthermore, accurate diagnosis allows for effective communication and education for patients, their families, and the broader community, promoting awareness, empathy, and support for those living with epilepsy. Overall, gaining knowledge about the various types of epilepsy not only enhances medical management but also contributes to the overall well-being and inclusivity of individuals affected by this condition.

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Types of Epilepsy

Understanding the different types of epilepsy is crucial for accurate diagnosis, appropriate treatment, and improved quality of life for individuals living with this condition.

Generalized Epilepsy

Seizures start on both sides of the brain (or quickly affect neurons on both sides)

Focal Epilepsy

Seizures develop in a particular area on one side of the brain

Generalized and focal epilepsy

An individual with this type of epilepsy can develop both generalized and focal seizures

Unknown if generalized or focal epilepsy

A clear understanding of where the seizures are coming from is unknown 

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Seizures

Seizures are the main characteristic of epilepsy and are caused by abnormal electrical activity in the brain. They can manifest in various ways, depending on the type of seizure and the area of the brain affected. During a seizure, individuals may experience changes in their behavior, consciousness, movement, sensations, or emotions. These changes can range from subtle and barely noticeable to intense and dramatic. 
Seizures can be classified into two main categories: focal seizures and generalized seizures. Focal seizures, also known as partial seizures, occur when abnormal electrical activity is limited to a specific area of the brain. Depending on the part of the brain affected, focal seizures can cause symptoms such as muscle twitching, numbness or tingling, changes in vision, altered senses, or uncontrolled movements. Focal seizures can be further classified as focal aware seizures, where the person remains conscious during the seizure, or focal impaired awareness seizures, where there is a loss of consciousness or altered awareness. 
On the other hand, generalized seizures involve abnormal electrical activity that spreads throughout both sides of the brain from the beginning. These seizures often result in loss of consciousness and can cause convulsions, muscle stiffness, jerking movements, staring spells, or brief periods of unconsciousness. Generalized seizures can be categorized into different types, including tonic-clonic seizures (formerly known as grand mal seizures), absence seizures, atonic seizures, myoclonic seizures, and tonic seizures. 
Seizures can vary in frequency, duration, and intensity. They can last from a few seconds to several minutes and may occur as isolated events or in clusters. After a seizure, individuals may experience a period of confusion, fatigue, or other physical or cognitive changes. Proper diagnosis and understanding of the different types of seizures are essential for effective treatment and management of epilepsy.

Seizures vs Epilepsy

The term "seizure" refers to a sudden, abnormal surge of electrical activity in the brain that leads to various symptoms and behaviors. Seizures can be caused by different factors, such as brain injury, infection, genetic conditions, or other medical conditions. They can also occur in individuals who do not have epilepsy. 
On the other hand, "epilepsy" is a neurological disorder characterized by recurrent and unprovoked seizures. In order to be diagnosed with epilepsy, a person must experience at least two unprovoked seizures that occur more than 24 hours apart or have a high likelihood of having additional seizures. 
Epilepsy is a chronic condition that can affect people of all ages and can have various causes, including genetic factors, brain injuries, developmental disorders, or unknown origins. In summary, a seizure is an event characterized by abnormal electrical activity in the brain, while epilepsy is a neurological disorder characterized by the presence of recurrent and unprovoked seizures.

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Types of Seizures

Seizures are classified based on how and where the brain activity causing the seizure began.

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Generalized Seizures

Affects both sides of the brain

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Focal Seizures

Affects one area of the brain

Generalized Seizures

Impaired awareness is common during this seizure type.

Absence seizures:● Rapid blinking, short period of blanking out  ● Typical: staring off into space and eyelids may flutter (<10 seconds) ● Atypical: slower onset and offset with more symptoms (20 or more seconds)
Tonic seizures: ● sudden stiffness in the limbs or body ● cry out, lose consciousness, fall to the ground, muscle jerks or spasms  
Atonic seizures: ● muscles suddenly become limp (e.g. drop attacks)  
Clonic seizures: ● rhythmical jerking movements of limbs and sometimes both sides of the body  
Myoclonic seizures: ● brief muscle twitching  
Tonic-clonic seizures: ● stiffening of muscles and rhythmical jerking  
Epileptic spasms: ● repeated extension of the body

Focal Seizures

Aware and impaired awareness can occur during this seizure type.

● Changes in emotions and thoughts● Intense emotions, strange feelings● Racing heart, goosebumps, head or cold waves● Behavior arrest: no movement occurs 
● Change in consciousness, which can produce a dreamlike experience; strange, repetitious behaviors such as blinks, twitches, mouth movements, and clapping (also known as automatisms)
● Simple Partial Focal Seizures affect a small part of the brain. Twitching or change in sensation, such as a strange taste or smell
● Complex Partial Focal Seizures can make a person with epilepsy confused or dazed. Unable to respond to questions or directions for up to a few minutes
● Secondary Generalized Seizures begin in one part of the brain but then spreads to both sides of the brain. The person begins with a focal seizure which can turn into a generalized seizure. 

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Seizure Triggers

● Sleep deprivation ● Illness ● Flashing lights ● Stress Alcohol and drug use ● Menstrual Cycle, or other hormones changes ● Dehydration, starvation, vitamin deficiencies ● Excess caffeine ● Missed Medication - this is the most dangerous trigger for people with seizure 

Seizure First Aid

Knowing what to do when a seizure occurs is vital. Familiarize yourself with these simple yet effective first-aid steps and learn how to create a safe environment for someone with epilepsy.  

● Stay Calm: Keep calm and reassure people around you. ● Prevent Injury: Remove any nearby objects that could cause injury. ● Make the Person Comfortable: Gently guide them to lie down on their side on a soft surface if possible. This will keep their airway clear. ● Time of the Seizure: Check the time when the seizure starts. Seizures usually last between a few seconds to a few minutes. ● Do Not Restrain: Never try to hold the person down or stop their movements. ● Do Not Put Anything in the Person's Mouth: This could injure their teeth or jaw. Contrary to popular belief, a person having a seizure is incapable of swallowing their tongue. ● After the Seizure: Once the seizure ends, make sure they're breathing normally. Keep them on their side and stay with them until they recover. ● Call for Medical Help: If a seizure lasts more than 5 minutes, if the person is not breathing normally if they get injured during the seizure, or if they have another seizure immediately after the first one, call for immediate medical assistance. 

Side Effects

Short-term

● Temporary confusion ● Fatigue ● Headaches ● Mood changes ● Muscle weakness ● After a seizure Injuries from falling, biting the tongue, or losing bladder or bowel control

Long-term

● Mental and emotional health ● Anxiety ● Depression ● Suicidal thoughts ● Cognitive and memory problems ● Sudden unexpected death in epilepsy (SUDEP) resulting from frequent tonic-clonic seizures or ineffective medication ● Status epilepticus; permanent brain damage and death

Treatments

Tips about going to a doctor’s visit:
Before:Prepare a list of concerns and questions for each visit.Communicate openly with your doctor and family about your understanding and needs regarding epilepsy.Don't hesitate to ask for clarification on medical terms you don't understand.
After:Take notes on the discussed topics and your next steps during the visit.If treatment changes, understand and document the new instructions.Research any recommended seizure medicine and adhere to the prescribed regimen.
Other options to manage Epilepsy: ● Seizure Medicines (AEDs) ● Surgery ● Ketogenic diet ● Seizure Devices ● Epilepsy Centers ● Therapies (Vagus nerve stimulation, Deep brain stimulation, Responsive neurostimulation)

Resources

Angels of Epilepsy Support group meeting: AOE’s support group meetings have survivors, caregivers, or advocates share their life journeys, presentations from medical-research companies, as well as an open floor discussion with attendees to discuss major topics, address concerns, and/or questions. Link to our event page to sign up: angelsofepilepsy.org/events
Visit Angels of Epilepsy Charity & Advocacy: angelsofepilepsy.org
For Seizure First-Aid Training and certification, visit First Aid for Seizures | Stay, Safe, Side | Epilepsy Foundation
Visit Epilepsy Alliance of America: Epilepsy Alliance America