Understanding epilepsy: Insights from a child neurologist

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week’s column is by Zahra Haghighat, M.D., a child neurologist specializing in epilepsy care at UK HealthCare’s Level IV Epilepsy Center.

LEXINGTON, Ky. (Nov. 11, 2024) –  Epilepsy is a common but complex neurological disorder that impacts millions of people worldwide. It occurs when groups of neurons in the brain send abnormal signals, leading to seizures. These seizures, which come in various forms, can affect memory, learning and even cause damage to brain cells. 

What is epilepsy and how does it affect the brain?

Epilepsy is a brain disorder that disrupts normal communication between neurons. Seizures are the hallmark of epilepsy, and their effects on the brain can vary significantly depending on the type and severity. Some seizures may cause brief pauses in behavior, while others lead to convulsions and more severe disruptions. Over time, recurrent seizures can interfere with memory, learning and overall brain function, especially if not properly managed.

Symptoms and causes of epilepsy

Epilepsy presents differently in each person. The symptoms can range from subtle behavioral changes to full-body convulsions, depending on the type of seizure a person experiences. Common causes of epilepsy include:

• Genetic factors
• Brain hemorrhages
• Infections
• Strokes

  In some cases, the exact cause of epilepsy cannot be identified.

Triggers and diagnosis

Certain triggers are known to provoke seizures in people with epilepsy. These can include:

• Missing doses of medication
• Sleep deprivation
• Exposure to flashing lights
• Alcohol
• Illness

Typically, diagnosis of epilepsy begins with a clinical evaluation, supported by diagnostic tests such as electroencephalograms (EEG) and brain MRIs. These tests help pinpoint abnormal brain activity and possible structural causes of seizures.

Treatment options for epilepsy

Managing epilepsy involves a range of treatment options, both medical and nonmedical. Anti-seizure medications are often the first line of defense, but they are not always effective for everyone. When medications are insufficient, other treatments such as vagus nerve stimulation (VNS), responsive neurostimulation (RNS), deep brain stimulation (DBS), and even epilepsy surgery may be recommended. These advanced treatments can significantly reduce the frequency and severity of seizures for some patients.

The impact of epilepsy on daily life

Living with epilepsy can profoundly impact daily activities. Seizures may cause physical injuries, interfere with work or school, and make it difficult to focus or concentrate. Epilepsy can also lead to emotional challenges such as anxiety and depression. Patients often need to make lifestyle adjustments to cope with their condition, such as ensuring they never miss a dose of medication and maintaining healthy sleep habits.

Supporting patients with epilepsy

Caregivers and family members play an essential role in the lives of people with epilepsy. In addition to providing emotional support, they may assist with practical needs like transportation and ensuring medication schedules are followed. For some, epilepsy affects their ability to drive or live independently, making family support critical during periods of active seizure management.

Latest advancements in epilepsy treatment

Advances in epilepsy research are opening new doors for treatment. New anti-seizure medications are currently in trial phases, offering hope for improved management. Devices like RNS and DBS have also shown promise in reducing seizures in patients with treatment-resistant epilepsy. Moreover, advances in surgical techniques are providing more options for those whose seizures cannot be controlled by medication alone.