The Johns Hopkins Epilepsy Center

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What Is the Difference between Seizures and Epilepsy?
Seizures are characterized by a sudden change in movement, behavior, sensation or consciousness produced by an abnormal electrical discharge in the brain. Epilepsy is a condition of spontaneously recurring seizures. About 1% of all Americans have uncontrolled epilepsy.

What Causes Epilepsy?
In about half of the cases, no one knows the cause. In the remainder, there has been evidence that a portion of the brain has been injured by infection, severe trauma, stroke, tumor, lack of oxygen, or some other cause. Epileptic seizures occur when large numbers of brain cells "fire" (send electrochemical messages) rhythmically and in unison. It is this simultaneous "firing" of large numbers of brain cells which disrupts normal behaviors and causes the shaking, confusion, and other signs and symptoms of seizures.

Can Epilepsy Be Controlled?
In some people, epilepsy is a chronic condition with seizures recurring at unpredictable times over many years. In others, epilepsy can be controlled completely. Some patients, especially children, can even outgrow epilepsy.

Is There More Than One Type of Seizure?
There are two major types of seizures. The first type, known as a generalized seizure, begins on both sides of the brain at about the same time. Full "grand mal" convulsions and brief staring episodes are examples of generalized seizures.

The second type, known as a partial seizure, originates in one region of the brain. In a simple partial seizure, the seizure related brain messages remain very localized so that one experiences a feeling, sensation, movement, or other symptom without any change in the level of awareness. However, people who experience the most common type of a partial seizure, called a complex partial seizure, may suddenly become confused, fumble, wander or repeat inappropriate words or phrases. This appears to be due to spread of the seizure to wider areas of the brain. There are also many other less common types of seizures.

Are there other conditions that can be confused with Epileptic Seizures?
There is more than one kind of epileptic seizure. Similarly, epilepsy can be divided into primary epilepsy and secondary epilepsy. Primary epilepsy can be "idiopathic" - that is of no currently known cause. However, more and more cases of primary epilepsy are found to have causes. For example, some cases of epilepsy are due to abnormalities of brain development, or are due to changes in the genetic code. Second, there are conditions that can produce epileptic seizures, such as strokes, infections, tumors, abnormalities of brain developments, and Alzheimer's disease. Finally, there are conditions that can produce changes in sensation, consciousness, or behavior that can resemble epileptic seizures, but that are not actually epileptic seizures. These conditions include migraine, heart and other cardiovascular conditions, psychological disorders, sleep disorders, substance abuse, and abnormalities of blood components including fluids, electrolytes and hormones.

What Can't People with Epilepsy Do?
First we would like to stress that people who have seizures can lead normal and active lives - with only a few restrictions.

Driving is prohibited in people with uncontrolled seizures. Each state's motor vehicle administration has regulations stating what minimal period of freedom from seizures is required before you are allowed to drive. You should contact your state's motor vehicle bureau to notify them of your epilepsy and find out the process (i.e., forms, interview) of determining whether you can drive.

You should avoid working from heights or around dangerous machinery and under water. Showering is recommended instead of tub bathing because of the risk of drowning during a seizure. If you are in a pool or lake, others around you should be aware of your seizures and be attentive to you while you are in the water. There should be someone present who can rescue you and perform first aid in the event of a seizure.

What Should I Know about My Anticonvulsants?
We've included some information about the most common anticonvulsant drugs. Keep in mind that these are just the highlights. Other information is available if you would like to know more.

What About Surgery for Epilepsy?
In some patients, surgery can be a very effective treatment for seizures.

Can I Drink Alcohol?
In some people, alcohol can increase the risk for seizures. In others, alcohol and anticonvulsants can combine to make them less alert. However, in many people, a small amount of alcohol (one beer, one glass of wine) will not cause a problem.

Can Women With Epilepsy Have Children?
Most women with epilepsy can become pregnant and have healthy children. Planning for the pregnancy is the best thing you can do to help insure that you have a healthy baby. Because of seizures and/or anticonvulsants, there is a slightly increased risk for birth defects. The amount and kinds of risk depend upon the medication(s) you are taking and you should ask your doctor about your own situation. The major risk of birth defects occur during the first three months of pregnancy. Therefore, your doctor may want to adjust or change your medication before you become pregnant. It is also highly recommended to begin taking at least 1mg of folic acid per day for several months before becoming pregnant; you should speak with your doctor about the dose to use in your case. Anticonvulsant medication does not seem to increase the risk of birth defects in the children of men with epilepsy.

How Can I Take Care of a Person Who Is Having a Seizure?
For a tonic-clonic seizure (grand mal, convulsion), help the person to a lying position and turn him or her onto one side. Place something soft under their head and loosen tight clothing. Do not restrain their arms or legs. Do not put anything into their mouth. Forcing something in to the mouth may cause more harm than good. The seizure itself should only last a few minutes. Afterwards, the individual may be very sleepy and confused and should be talked to in a calm and quiet manner. A trip to the hospital is usually not necessary unless there has been an injury, or if the seizure lasts for more than ten minutes (not counting the sleepy, confused period after the seizure), or if one seizure goes into another without recovery.

For a complex partial seizure, stay with the person, talk calmly, and protect him or her from self-injury. Do not restrain. The person may be able to respond to simple commands such as "sit down". After the seizure, explain where you are and what has happened if this is necessary.

Where can I get more information about epilepsy?
Try the website of the Epilepsy Foundation of America:
http://www.efa.org/