Nearly 60,000 people in Connecticut live with epilepsy. There are many different types of epilepsy and seizures — and they can come out of nowhere. Hartford HealthCare epileptologist Dr. Erica Schuyler explains.
Q. What is epilepsy?
A: Epilepsy is recurrent, unprovoked seizures – caused by abnormal electrical activity in the brain. Epilepsy is different from person to person. Seizures typically last from a few seconds to a few minutes and consist of convulsions or shaking. Other times, a patient will simply become unresponsive and stare into space. There’s no one-size-fits-all seizure; in fact, some patients with epilepsy experience more than one type of seizure.
Q: What is going on in the body when a person has epilepsy?
A: When somebody has epilepsy, their brain is prone to having unprovoked seizures. Which means that at any time — and unpredictably — the neurons in the brain can fire abnormally. Those abnormal discharges in the brain are what lead to the clinical symptoms. Either losing consciousness, experiencing some abnormal neurological symptoms, or collapsing.
Q: How long do associated seizures last?
A: Typically, a seizure will last between 1 and 2 minutes. If a convulsive seizure lasts more than 5 minutes, that’s really a serious medical emergency. But most of them, fortunately, do end after about 60-90 seconds or so.
Q: Are you more at risk for this if you have a family history?
A: There are a lot of different risk factors for developing epilepsy. Some types of epilepsy have genetic components. In that case, a family history would be relevant. In other cases, somebody can develop epilepsy due to an injury to their brain such as a head injury, a stroke, a brain tumor, or anything else that really could damage the brain.
Q: What can people expect once they’re diagnosed?
A: After we make the diagnosis of epilepsy using imaging and EEG, we use medications as our first -ine treatment. At this point, there are many medications available. About 2 out of 3 patients with epilepsy respond well to the medications. It’s just a matter of finding the one that works and the one that doesn’t cause side effects. However, about 1 in 3 patients, the medications really are not effective in completely controlling the seizures. In some cases, we can actually cure epilepsy altogether with a surgery. So if it’s the type of epilepsy where there’s a tiny spot that’s really acting up, in some cases that spot can be surgically removed. In other cases, if there’s not that spot in the brain that can be safely removed, there are other devices. For example, the vagus nerve stimulator, which is sort of like a pacemaker. It’s a same-day procedure. It’s not a brain surgery, but implantation of that device can help reduce the frequency and severity of seizures.