Identify the various signs of seizure disorders. Learn about the symptoms, risk factors, and underlying causes including genetics and head trauma.
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Symptoms and Risk Factors
The symptoms of epilepsy are diverse because they depend on which part of the brain is affected by the abnormal electrical activity. While most people associate epilepsy with convulsions, many seizures are subtle. Recognizing these symptoms is the first step toward diagnosis and safety. The symptoms can range from a brief lapse of attention to severe muscle spasms.
Common symptoms include:
Seizures are the main symptom of epilepsy, but the way a seizure presents can vary dramatically. Doctors classify seizures based on how they begin in the brain. In generalized onset seizures, the electrical discharge involves the entire brain from the start. In focal onset seizures, it begins in one spot.
For generalized seizures, symptoms often include:
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a tendency to have recurrent seizures, you have epilepsy. Seizures can last from 30 seconds to two minutes. A seizure that lasts longer than five minutes is a medical emergency.
Seizures are often preceded by a warning sign known as an aura. This is actually the start of the seizure in a small part of the brain. The aura might be a strange smell, a rising sensation in the stomach, or a feeling of fear. Recognizing what a seizure is allows patients and families to take safety precautions immediately.
Focal epilepsy is the most common type of epilepsy in adults. In this form, the seizures originate in a specific area of the brain. The symptoms of focal epilepsy are directly related to the function of that brain area. For example, if the seizure starts in the part of the brain that controls the hand, the hand may start twitching.
Focal seizures are divided into two types:
Temporal lobe epilepsy is the most common form of focal epilepsy. The temporal lobes are located on the sides of the brain, behind the ears. They are responsible for processing emotions, short term memory, and hearing. Seizures in this area often present with distinct symptoms that can be mistaken for psychiatric issues.
Symptoms often include:
For about half of the people with epilepsy, the cause is unknown. However, for the other half, the condition can be traced to various factors that damage the brain or disrupt its development. Understanding the cause is important because it can influence the choice of treatment and the long term outlook.
The primary causes include:
Genetics play a significant role in many cases of epilepsy. Some types of epilepsy run in families, suggesting an inherited factor. Researchers have linked specific types of epilepsy to specific genes. However, for most people, genes are only part of the cause. A person may inherit a susceptibility to seizures, but an environmental trigger is needed to start the epilepsy.
There are hundreds of genes that can affect the brain’s electrical channels. If these genes have mutations, the channels may stay open too long or close too fast, leading to the hyperexcitability that causes seizures. Genetic testing is becoming an increasingly important tool in identifying the cause of epilepsy, especially in children.
Head trauma is a common cause of epilepsy, particularly in young adults and active individuals. A severe blow to the head can cause scarring in the brain tissue. This scar tissue interferes with the normal electrical signals of neurons, creating a focus for seizures. The seizures may start immediately after the injury or develop years later.
Preventing head injuries is a key way to prevent epilepsy. Wearing seatbelts in cars and helmets while biking or skiing can significantly reduce the risk. While mild concussions rarely lead to epilepsy, severe traumatic brain injuries with bleeding or skull fractures have a much higher risk.
Stroke is a leading cause of epilepsy in adults over the age of 35. When a stroke occurs, blood flow to a part of the brain is cut off, causing brain cells to die. This damage creates a scar that can generate seizures. Both ischemic strokes caused by clots and hemorrhagic strokes caused by bleeding can lead to epilepsy.
Vascular diseases that restrict blood flow to the brain can also contribute to seizure risk. Controlling risk factors for stroke, such as high blood pressure, high cholesterol, smoking, and diabetes, is essential for reducing the risk of developing epilepsy later in life.
Infections of the central nervous system are major causes of epilepsy, especially in developing countries. Meningitis, encephalitis, and neurocysticercosis (a parasitic infection) cause inflammation in the brain that can lead to permanent seizure disorders.
Developmental disorders are also linked to epilepsy. Autism and neurofibromatosis are examples of conditions that have a higher rate of epilepsy co occurring. In these cases, the brain development is altered in a way that predisposes the neural networks to misfire.
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The most common symptoms are recurrent seizures, which may involve altered awareness, involuntary movements, or sensory changes.
No, many seizures occur with preserved awareness, especially focal seizures.
Yes, some seizures are brief and easily missed, such as absence seizures or focal seizures with minimal movement.
Risk factors include genetic predisposition, brain injury, developmental abnormalities, and certain neurological conditions.
No, triggers provoke seizures in people with epilepsy but do not cause the condition itself.
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