Just over 1 percent of the U.S. population, adults and children, have epilepsy.
Hartford HealthCare’s Jocelyn Maminta recently spoke with neurologist Dr. David Tkeshelashvili, director of ambulatory epilepsy services with the Ayer Neuroscience Institute, about how to detect epilepsy and when to undergo testing.
Epilepsy is a central nervous system disorder characterized by abnormal brain activity that causes seizures. Epilepsy does not present the same way in each person diagnosed with the disorder.
“It can be quite dangerous because, No. 1, it can be associated with severe head trauma that could cause bleeding,” Dr. Tkeshelashvili said. “Patients may have a seizure while driving. There are types of seizures where people have twitching or shaking of certain parts of the body, depending on where the seizures are coming from. There’s a tremendous variety in terms of disease.”
Because epilepsy is not a uniform disorder, the warning signs are often different for each person, ranging from flashing lights to unpleasant smells and even psychic phenomena.
“There can be a plethora of different symptoms depending on where it starts in the brain,” he said. “A patient who sees flashing lights means that it is probably starting in the back of the head, the occipital area.”
Epilepsy can be diagnosed at any age. Most pediatric cases are linked to genetic syndromes and are typically outgrown by adulthood.
“In the adult population, it can be caused by stroke, cerebral vascular disease, head trauma, severe concussions with loss of consciousness,” Dr. Tkeshelashvili said. “Sometimes people fall and develop bleeding in the brain. This can act as an irritant for the brain and can be a focus for disease.”
One way to diagnose epilepsy is with an EEG test, or electroencephalography, which records electrical activity in the brain. An EEG test is used when there is a suspicion of epilepsy or the person is having recurrent seizures without a clear cause.
“EEG shows us particular areas in the brain that can be irritable and can be potential for seizures,” he said. “Sometimes we can record the seizure.”
Epilepsy is most commonly treated with medication to control seizures. For individuals who still have breakthrough seizures, other treatment options include brain stimulation and surgery.
