Epilepsy : Common Questions   [ Epilepsy ] 
 

What is Causes Seizures?

Seizures occur when nerve cells discharge their electric current in an abnormal manner, much like a "short circuit". The patient may lose consciousness, and have shaking movements of all limbs, or smaller attacks may occur, with just staring spells, an unusual behavior, or movements of one arm or leg. When seizures occur again and again, the patient is said to have epilepsy.

Sometimes seizures occur as an acute warning that there is an underlying problem which needs attention.

We therefore carefully investigate each case of new-onset seizures, through neurological examination, brain scan, electroencephalogram (EEG) and blood tests. We then treat the underlying cause, as well as providing medical management of the seizures. Acute causes of seizures such as these include a dramatic change in blood sugar, stroke or brain tumor.

However, in most epilepsy cases, there is no specific acute cause. Instead, perhaps a minor brain injury in the period surrounding birth or an inherited tendency toward having seizures produces the episodes. Although persons with epilepsy may have seizures frequent enough to be disabling, most people are relatively well between episodes, and lead normal lives.

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How Can Epilepsy be Treated?

Treatment with medications usually reduces seizure frequency or eliminates seizures. In some cases, standard medications fail to provide control; these cases are called intractable. At the Comprehensive Epilepsy Center, we approach the care of these more difficult cases through the use of sophisticated techniques. These techniques include FDA- approved clinical trials of new experimental anti epileptic medications not otherwise available, and surgical approaches to control epilepsy.

Surgery For Epilepsy

Neurologists, neurophysiologists and neuroradiologists work together with other team members to evaluate the possibility of surgical treatment of carefully-selected intractable seizure disorders. Special monitoring techniques, such as video-EEG telemetry, a simultaneous recording of the patient's EEG with a video recording of his behavior, often allow us to localize the area of the brain "responsible" for the seizures.

Extensive "mapping" of the brain, by neurodiagnostic imaging, neuropsychological testing and other means, is done to ensure that the neurosurgical approach, if chosen, is a safe and desirable option. Our neurosurgical staff proficiently meets the needs of adults and children during all stages of surgical intervention for epilepsy.

A Further Note About Children

Many cases of childhood epilepsy are well-controlled and have a good outcome. Some children have a more difficult time, and the combination of seizures, medication effects and behavioral or learning problems requires a multidisciplinary effort where family needs are recognized as well.

Whether seen out-patient or in-patient, children receive expert medical attention with an emphasis on developmental needs. Children requiring hospitalization for monitoring, medication adjustment or surgical management are housed in a special room on constant video-camera surveillance; parents are encouraged to stay overnight.

Children with hard-to-manage seizures may be considered for epilepsy surgery when treatment with anti-epileptic medication fails. Neurosurgical intervention, even at an early age, can sometimes end frequent, uncontrollable seizures, allowing children to maximize their potential. Epilepsy surgery in children serves to remove the source of the seizures, or in some cases, to disrupt pathways which spread seizures. A nurse clinician with a background in education coordinates the efforts of neurologists, neurosurgeons, language therapists and pediatric rehabilitation staff in all cases requiring attention.

The Epilepsy Center of LHSC provides care of all patients with seizures, no matter how complex their needs. We have active research interests, including new approaches to the management of status epilepticus, and the effects of epilepsy on mood and memory. The Center offers clinical trials for several new anti-convulsants, as well as new techniques.

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Can I Live a Normal Life?

Sure why not?

Epilepsy can carry with it a host of social and pyschological problems. Friends and family's lack of understanding about seizure disorders are often due to ignorance and/or fear. This sometimes leads to over&enspprotectiveness or imposing unnecessary restrictions on the individual.

Individuals who are physically able to work are often unemployed or under-employed. Of those with jobs, many have to accept positions well below their levels of education and ability. For many, it is not the seizure disorder itself, but the negative public attitudes which create a greater disability. Public education and information are vitally important in eliminating social injustice.

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Can I drive a car?

The Ontario Ministry of Transportation and Communications with guidelines from the Highway Traffic Act, make all decisions about driver's licenses.

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