Neurology

Epilepsy: Frequently Asked Questions

Mark Granner, M.D., Associate Clinical Professor of Neurology
University of Iowa Hospitals and Clinics

First Published: May 2001
Last Revised: May 2001
Peer Review Status: Internally Peer Reviewed

I start taking Zonegran over 2 weeks ago, and my hands and feet are freezing cold. Is this a normal side effect from Zonegran?

It is not a usual effect of Zonegran, but is, as the case with many new medicines. If you are concerned, you should discuss it with your doctor.

How common is epilepsy?

Approximately 2 to 2.5 million Americans have epilepsy.

How does gamma knife surgery treat epilepsy? Is it still in research stages?

As I understand it the gamma knife is primarily used to treat vascular malformations and tumors, and if the seizures are being caused by those things then the gamma knife may help treat the seizures also. At the present time, resection surgery (removing the area where seizures come from) it still the most common surgical treatment of epilepsy.

How long can epilepsy last?

Epilepsy can last a few months, years, or life-long. It varies among individuals.

What kinds of tests are necessary to determine if an epileptic patient requires surgery?

The tests are done to see where the seizures are coming from and if that area can be safely removed. Most centers perform an EEG recording of seizures and MRI scan and a test of brain function known as neuropsychological testing. Other centers use PET and SPECT scans. These are tests that measure the brain's function.

At what age does epilepsy usually surface in most patients?

Epilepsy can occur or begin at any age. It most commonly begins in children and in older adults.

What are common treatments of epilepsy other than surgery?

Most commonly we use medicine to treat epilepsy. These medicines include standard things like Dilantin, Tegretol, and Depakote and a handful of newer medicines.

What are infantile spasms and can they be prevented?

Infantile spasms are a type of seizure that occur in young children (6-12 months old). These are known as salaam seizures. Most often they are treated with a medicine called ACTH, but they are often difficult to control.

If absence seizures go undiagnosed what could happen?

The possibilities include 1) affecting school performance such as learning, 2) a patient with absence seizures can also sometimes have a larger convulsion seizure and 3) absence seizures can go away on their own.

Is there a link between febrile convulsions as a child and adult epileptic seizures?

About 2% of children with febrile seizures will eventually develop epileptic seizures. The odds are slightly higher if the child has a long febrile seizure, the seizure primarily affects one side of the body or multiple seizures occur with a single febrile illness.

Is it true that diet can play a role in epilepsy?

There really aren't any dietary factors that are known to cause epilepsy. There is a diet known as the ketogenic diet that can treat certain children with a certain type of epilepsy. In general, I advise my patients to eat a healthy diet and not skip meals.

If a person has inherited epilepsy, could a sibling also have it but show no outward signs? Would the same patterns show up on an EEG?

If the sibling has not yet had a seizure then by definition they do not have epilepsy. I usually do not recommend doing an EEG on a family member that does not have seizures.

What is the chance of an infant outgrowing their seizures?

That is a tough one to answer because it depends on the type of seizures and what has caused them.

What should a bystander do if they see someone having a seizure?

First aid should include: 1) Helping the person to lie down and taking them away from any dangerous objects like stoves; 2) Rolling them onto their side so that they do not choke if they vomit; 3) Loosening any tight clothing such as neck ties; 4) Reassuring them as they are coming out of the seizure as they may be confused; and 5) Calling an ambulance if it is the person's first seizure or if it is significantly longer than the person's usual seizure.

Are nighttime seizures different than other types of seizures? What are the characteristics of nighttime seizures?

In some patients, it is the nature of their type of epilepsy to have nighttime seizures. In most cases we treat nighttime seizures the same as we treat daytime seizures.

What types of epileptic patients often opt for surgery in preventing future seizures?

Epilepsy surgery is indicated when: 1) the seizures are significantly impairing the person's quality of life, 2) the location of the seizures can be identified, 3) that area can be safely removed by the surgeon. In general there are no age limits to epilepsy surgery, although the person should be in generally good health.

My friend had a seizure at age 24. She had never had one before, is this common?

Only about 40 percent of these people go on to have more seizures.

Can antidepressants cause a seizure?

One particular antidepressant, Bupropion (Wellbutrin) is associated with a higher risk of seizures and should not be used in people with epilepsy. The risk of seizures is less certain with other antidepressants. A physician prescribing antidepressants should be made aware that the person has epilepsy.

Does meningitis cause epilepsy?

Meningitis can cause epilepsy if it injures the brain but does not always cause epilepsy.

What are the symptoms of epilepsy?

The main symptom of epilepsy is seizures. However, seizures can be of many different types in different people with epilepsy.

Are there different kinds of seizures?

Yes, there are many different types of seizures. The two main types include 1) generalized seizures that affect the entire brain, and 2) partial seizures, that come from a part or region of the brain. There are many sub-types of generalized and partial seizures.

How is it diagnosed?

The most important factor in diagnosis is a description of the seizures, not only from the person, but also from a witness to the seizures. A neurological examination is performed to look for any signs of brain dysfunction. Then we often use tests like the EEG or MRI to help us with the diagnosis.

What drugs can help prevent seizures? Can any currently cure it?

There are about 12 medicines that are now used to treat seizures. None of them however have been shown to cure epilepsy, they primarily just control the seizures.

What can be done to help prevent epilepsy?

Risk factors for epilepsy include: brain infections like meningitis and encephalitis, head trauma, stroke, and brain tumors. Some of these, such as head trauma and stroke, are potentially preventable.

How does Oxcarbazepine work?

Oxcarbazepine works similarly to Carbamazepine (Tegretol), but probably with fewer side effects.

What about Myoclonic epilepsy-age 13?

That would be a very long answer, but I can refer you to the Epilepsy Foundation of America who may have more information. Their web page is www.EFA.org. I would recommend this site for any one who has epilepsy-related questions. I would like to thank everyone for participating and I hope the information that we talked about has been helpful. Neurologists and epilepsy specialists have a number of effective treatments for epilepsy. Please consult with your doctor or with your nearest specialized epilepsy center.

See related Patient Topics Brain and Nervous System or Epilepsy.

See related Provider Topics or Brain and Nervous System.

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