What is epilepsy?
Epilepsy is not a disease or a mental illness. Rather, it is
a neurological disorder characterized by recurrent seizures.
Brain cells communicate with each other by means of tiny
bursts of electrical activity. Sometimes a group of brain
cells has an unexpected, erratic electrical discharge. This
event produces a seizure. Someone who has multiple seizures
is said to have epilepsy, which is defined as a functional
disorder of the brain caused by sudden, brief malfunctions.
These malfunctions may cause uncontrollable shaking
(convulsions). They may also cause loss of awareness,
confusion or even disturbance of the senses (visual and
aural hallucinations, phantom odours, etc.).
Epilepsy: is NOT a disease; is NOT a psychological disorder;
is NOT contagious
Approximately one person in one hundred has epilepsy.
In Canada, there are 330,000 people with epilepsy.
What causes epilepsy?
In many cases (60 to 75 percent), the cause of epilepsy is
not known. In the remaining 25 to 40 percent, some of the causes
Birth injury (e.g. lack of oxygen to the babys brain at birth)
Developmental disorder (e.g. brain damage to the fetus during pregnancy)
Brain trauma (e.g. from car accidents, sports injuries)
Infection (e.g. meningitis, encephalitis, AIDS)
Cerebral degenerative disorder (e.g. those associated with Alzheimers disease)
Alcohol and drug abuse
Types of Seizures
There are many different kinds of seizures, which
fall under two main classifications: "partial" and
Partial Seizures: If the excessive electrical discharge in the brain is limited
to one area, the seizure is partial. The two most common types of partial seizures are
simple partial and complex partial.
In a simple partial seizure, the person remains aware, and can experience a
range of strange or unusual sensations, e.g. sudden jerky movements of one body part,
distortions in sight or smell, sudden sense of fear, stomach discomfort, or dizziness. If
these sensations act as a warning sign that a generalized seizure is about to occur, they
are known as an "aura".
In a complex partial seizure, the person loses awareness as the seizure
begins and appears dazed and confused. The person will exhibit meaningless
behaviours such as random walking, mumbling, head turning, or pulling at clothing.
These behaviours cannot be recalled by the patient after the seizure.
Generalized seizures affect the entire brain. The two most common forms are absence seizures and
tonic-clonic (convulsive) seizures.
During an absence seizure, the person appears to be staring into space and
their eyes may roll upwards. This kind of seizure is
characterized by 5 to 15 second lapses of consciousness and
when it has ended, the person will not recall this lapse of
consciousness. An individual may experience many absence seizures per day. Absence seizures most often occur in
childhood and disappear by adolescence. They are less
prevalent in adulthood.
In a tonic-clonic seizure, the person will usually emit a short cry, and
fall to the floor. Their muscles will stiffen and their body
extremities will jerk and twitch. With this type of seizure,
bladder or bowel control may be lost, and consciousness is regained
slowly. Tonic-clonic seizures typically last 1 to 3 minutes.
Postictal states: Postical states commonly follow both tonic-clonic and
complex partial seizures. As a person regains consciousness
after the seizure, they experience fatigue, confusion and
disorientation lasting from five minutes, up to hours or
even days and, rarely, as long as one to two weeks. The
person may fall asleep or gradually become less confused
until full consciousness is regained.
Are seizures painful or dangerous?
Seizures are not painful and are generally
not harmful, but prolonged or recurrent seizures can cause
damage to the brain.
A continuous seizure state known as status epilepticus is a life threatening condition.
If seizures are prolonged (last longer than 5 minutes) and/or occur one after another without full recovery between seizures, immediate medical care is necessary. The seizures may be convulsive or non-convulsive.
There is also an increased risk of injury in people with epilepsy. If seizures are
uncontrolled, then a person is at greater risk.
Sudden Unexplained Death in Epilepsy (SUDEP)*
Sudden Unexplained Death in Epilepsy (SUDEP) refers
to the unexpected death of a seemingly healthy person with epilepsy, where no
cause of death can be found. Rather than pertaining to a specific disease or
condition, it is used to denote a category to which these types of unexplained
deaths are assigned. Sudden unexplained death also occurs in the general
population but the risk is higher for people with epilepsy.
The cause of SUDEP is not well understood, and risk
factors are still being researched. However, the risk factors most
consistently identified in case studies to date include:
·Early onset of epilepsy
·Young adult age
·Frequent generalized tonic-clonic seizures
·Poor seizure medication compliance
Minimizing the risk of SUDEP
In the current absence of a proven SUDEP prevention method, the
recommended approach is to attempt to keep modifiable contributory factors to a
minimum. As research indicates that SUDEP is largely a seizure-related
phenomenon, optimizing seizure control is highly important. Recommendations to
achieve this include:
·Seeking regular medical consultation to re-evaluate epilepsy diagnosis,
review medication and the possibility of new treatments, discuss implications
of lifestyle changes etc;
·Maintaining good medication compliance; and
·Identifying possible triggers for seizures and determining an effective
strategy for keeping these to a minimum. For example, maintaining regular and
adequate sleep patterns or learning ways to better manage stress.
For more information about SUDEP, please visit
SUDEP Aware at: