Epilepsy

Epilepsy is a condition that affects the brain and means that someone has a tendency to have repeated seizures. Epilepsy can start at any age and there are many different types. It is often a life-long condition but for some, epilepsy lasts for a limited time and they stop having seizures.

Epileptic seizures are caused by a disturbance in electrical activity in the brain and the causes and effects vary. During a seizure, some people will remain alert and aware of what’s going on around them, others may lose awareness. Some people may go stiff, fall to the floor if they are standing, and jerk quickly.

The content on this page is provided solely for information purposes and provides an overview of the subject matter covered. It is not a substitute for professional medical advice, diagnosis or treatment. If you think you have epilepsy, please seek further information. The information on this page is subject to change without notice.

 

 

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Epilepsy is an invisible disability

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What is a seizure?

The brain has billions of nerve cells which control the way we think, move and feel. Nerve cells do this by passing electrical signals to each other. If these signals are disrupted, or too many signals are sent at once, this causes a seizure. 
The brain has many different functions. Mood, memory, movement, consciousness and our senses are all controlled by the brain, and any of these can be affected if someone has a seizure. 
The brain has two sides called hemispheres. Each hemisphere has four parts called lobes. Each lobe is responsible for different things such as vision, speech and emotions. The area of the brain affected by the seizure determines the symptoms people experience.

Different types of epilepsy

There are around 21 different types of epileptic seizures.  Below are the more common ones.

Absence seizures are more common in children than adults and can happen very frequently. During an absence seizure, a person stops what they are doing and appears to ‘switch off’ for a few seconds. They may look blank and stare and their eyelids might flutter. They will not respond to what is happening around them.

Focal preserved consciousness (FPC) seizures were previously called simple partial seizures or focal aware seizures. The person is conscious (aware and alert) and will usually know that something is happening and will remember the seizure afterwards. However, the seizures can be very different for different people. It depends on where the seizure happens in the brain. People may make repeated movements or have difficulty speaking, or they may have changes in emotion or experience unusual sensations. Most focal preserved consciousness seizures are brief, lasting between a few seconds and 3 minutes

Focal impaired consciousness (FIC) seizures were previously called complex partial seizures or focal impaired awareness seizures.  During this type of seizure, people can’t remember all, or part, of the seizure and may not be able to react how they normally would. Focal impaired consciousness seizures usually last between a few seconds and 4 ½ minutes. 

Myoclonic seizures are sudden and brief muscle jerks.  Myoclonic seizures are brief but can happen in clusters (many happening close together in time) and often happen shortly after waking.  Muscle jerks are not always due to epilepsy (for example, some people have them as they fall asleep).

Tonic seizure are where a person’s muscles tighten and their body goes stiff. Tonic seizures usually last between three seconds and two minutes.
If a tonic seizure starts in both sides of the brain, all the muscles go still they may fall to the floor. Their neck will extend, and their will eyes open wide and roll upwards. Their arms may raise upwards and their legs stretch or contract. They may cry out and stop breathing during the seizure.
If a tonic seizure starts in one side of the brain, your muscles tighten in just one area of the body.

Atonic seizure (or 'drop attack') the person’s muscles suddenly relax and they become floppy. If they are standing, they often fall, usually forwards, and may injure the front of their head or face. Like tonic seizures, atonic seizures tend to be brief and happen without warning. Atonic seizures are very short, usually lasting less than two seconds.

Tonic-clonic seizures are the seizures that most people think of as epilepsy. The person becomes unconscious their body goes stiff and if they are standing up, they usually fall backwards. They then jerk and shake as their muscles relax and tighten rhythmically.

Do seizures have triggers?

Yes, there are some triggers which may make seizures more likely for some people with epilepsy. However, not everyone with epilepsy will have triggers and they can be different for everyone. Some reported triggers are:

• Not taking epilepsy medicine as prescribed
• Feeling tired and not sleeping well
• Stress
• Alcohol and recreational drugs
• Flashing or flickering lights
• Monthly periods
• Missing meals
• Having an illness which causes a high temperature

 

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Effects on daily life and challenges faced 

There is a general lack of awareness, training and understanding in society about epilepsy, including the different types of epilepsy and what to do in the event of a seizure. This can mean that people with epilepsy :

• often feel vulnerable when out and about, particularly if they have seizures
• lack self-confidence as a result of bullying and being treated differently from or less favourably than others
• are often not fully using their skills and abilities in work and their career does not progress
• are prevented from carrying out duties or using equipment when there is no valid reason to do so

Challenges include:

• Many people experience memory issues as a side effect of their epilepsy medicine
• Being unemployed, often due to losing or leaving a job because of unsuitable conditions
• "Not doing well" at home, school, work, or with friends
• Cognitive or learning problems that require special help or accommodations
• Symptoms of depression, anxiety, or other changes in mood or behaviour
• Problems sleeping
• Unexplained injuries, falls, or other illnesses
• Thinning of the bones or osteoporosis
• Reproductive problems
• SUDEP (sudden unexpected death in epilepsy) is when someone with epilepsy dies and there is no clear reason why. Although it is rare, for example, in the UK, it affects around 1 in every 1,000 adults with epilepsy each year. A person’s risk depends on the type of seizure they have and how well-controlled their seizures are.

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Assistance and support you can offer

• Dont’ judge – be understanding and kind
• With some seizures it can appear that the person isn’t listening or has zoned out - don't assume that they know what is going on. It may help to explain what they have missed when the seizure ends

How can I help someone having a seizure?

Epilepsy Action’s first aid for seizures information shows how to support someone having a seizure but. all you have to do is CARE. 

COMFORT -  Cushion their head with something soft to protect them from injury.
ACTION – Begin to time the seizure, and clear the area of anything potentially harmful. You could also check if the person has any medical ID or bracelet with more information on how to help.
REASSURE – When the seizure has stopped, place them in the recovery position, stay with them and reassure them as they come around.
EMERGENCY – Call 999 if:

• The seizure lasts for more than 5 minutes
• The person goes into another seizure without regaining consciousness
• The person has trouble breathing after the seizure
• The person has never had a seizure before
• The person is injured. 

Here are some things to avoid doing:

• Do not put anything in their mouth
• Do not restrain them
• Do not try to bring them round
• Do not assume they know what is going on
• Do not make abrupt movements or shout at them

Words to avoid

• Illness: epilepsy is not an illness, it is a condition
• An epileptic: use “a person with epilepsy”
• Fit:  the term ‘seizure’ or ‘epileptic seizure’ is preferred by many people but some people with epilepsy do still choose to use the word ‘fit

Words that are okay to use

• Brainstorming: It depends on how the word is used, it should not be used to describe what happens in the brain during a seizure.

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Sources:

NHS: https://www.nhs.uk/conditions/epilepsy/
Epilepsy Action: https://www.epilepsy.org.uk/ 
TUC:  https://www.tuc.org.uk/sites/default/files/EpilepsyInTheWorkplace

 

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