Frequently Asked Questions about Epilepsy

Women and Epilepsy 

Frequently Asked Questions about Epilepsy

What is a seizure?

Seizures are caused by overexcitation of many nerve cells (neurons) in the brain. These neurons fire electrical signals over and over again. Normal brain function is interrupted. If a person is having a seizure, you might see them lose consciousness, stare, having jerking of the arms and/or legs, have trouble talking, make strange noises or have strange feelings.

How do I know if I have epilepsy?

Epilepsy is usually defined as having two or more seizures that do not have a specific cause. The doctor may order blood tests, an electroencephalogram (EEG), a magnet resonance image (MRI) or computerized tomography (CT). These tests plus your history and neurological exam will help to reach a diagnosis.

Is it possible to have more than one type of seizure?

Yes, some persons have several different types of seizures. Often these seizures are described as a syndrome. Examples include West syndrome and Lennox-Gestaut syndrome. These seizures are more difficult to manage.

Can I grow out of epilepsy?

It is possible for some children to stop having seizures as they age. After two or three years of not having seizures, you may decide with your doctor to stop taking seizure medications. There is about a 60 percent chance of having another seizure once you stop taking medication.

Your antiepileptic drug may not work as well if you have to restart it. If the medication is removed and a seizure happens, you will most likely need to take medication for the rest of your life.

Is there a cure for epilepsy?

There is no cure for epilepsy; however, a small number of patients may be able to have a part of their brain removed. This procedure may stop or significantly decrease seizures. If the seizures stop, patients may still require anti-seizure medication or surgery. Taking medications and avoiding situations that increase your risk of having a seizure can help control it. Another option includes placement of a vagal nerve stimulator. Even with treatment, some people will continue to have seizures.

What is a vagal nerve stimulator?

The vagal nerve stimulator (VNS) is a treatment option for patients who are not candidates for surgery. VNS placement requires a simple outpatient procedure under anesthesia. A small programmable battery is inserted in the chest wall (similar to a pacemaker). It has a flexible wire that wraps around the vagus nerve, which is a nerve that starts in the lower part of the brain and extends down into your torso.

The VNS is programmed to send a small electrical current intermittently to the vagus nerve. This interrupts the electrical activity in the brain. The most common side effects of the VNS are hoarseness, pain and cough. The VNS settings are gradually increased over time. In the event of a seizure, a magnet can be swiped over the battery site. This will often stop or shorten a seizure. VNS therapy is used along with medications. It may allow you to take less medication and have fewer side effects, or it may make your medication more effective.
 
recent analysis of VNS patients at Providence Epilepsy Services showed: 
  • 82 percent of patients experienced 50 percent fewer seizures after VNS placement 
  • 23 percent of patients became seizure-free after VNS placement
Is epilepsy contagious?

No, epilepsy is not contagious.

When do I need to get drug blood levels measured?

For most patients, routine blood levels are not necessary with every visit. Most antiepileptic drugs have recognized blood level values – meaning, guidelines for how much of the drug should be present in your blood in order for it to be effective. Not all patients do best when their blood level falls in the recommended range. For example, some patients continue to have seizures even though their blood levels show they have the prescribed amount. The right drug dose for you should be balanced between how often you have seizures and how well you handle side effects.

Blood levels do provide helpful safety information if you are pregnant or if you taking another medication that might interact with your antiepileptic drug. It also tells your doctor if you are taking your medication. Certain medications make it important for us to frequently monitor your blood count, electrolytes and liver enzymes.
 
Who should I tell about my condition?

People who don't understand epilepsy are afraid of it. You should consider who you would like to know about your condition.

Where are you most likely to have a seizure?

There are laws in place, such as the American Disability Act, that prevent discrimination in the workplace. It can be less scary to others if you describe what your seizures look like and how they can help you. You can also choose to wear a medical alert bracelet. Some people carry a card in their wallet stating they have epilepsy and who to contact if they have a seizure.

If I have a seizure, does that mean I won’t be able to drive again?

No. The DMV does require mandatory reporting of drivers who lose consciousness. They take the information provided by your healthcare provider and then review your case. If you have been controlled on medications for three to six months, you may reapply for your license.

More information can be found at www.oregon.gov/ODOT/DMV

If I have a seizure, should I take an extra dose of my medication?

No. You should not take additional medication unless your doctor tells you to. In most cases, the extra medication will not stop the seizure.

Some rescue medications, such as Diastat (rectal valium) and Ativan, may be given at the time of a generalized tonic clonic seizure to stop the seizure. Your doctor will give you specific directions on when to take this medication.

What happens if I miss a dose of my medication?

You should take a dose as soon as you remember or at the next interval that you would otherwise be scheduled to take it. If you miss a dose, you are more likely to have a seizure. If you take two doses close together, you may notice more side effects.

What types of side effects should I report to my doctor?

All drugs have side effects. Different antiepileptic drugs work differently and have different side effects. There are different types of side effects, including: 
 
  • Drug initiation: When you start a drug it takes two to three weeks for your body to get used to the drug.
  • Dose-dependent: Some side effects occur only at a certain dose. Other side effects are related to the drug itself and include: allergic reaction, liver failure, and changes in your blood count. If the side effects are bad enough that you stop taking the drug, talk to your healthcare provider.
Don’t wait to report the following side effects: 
  • A painful rash that is all over your body (not just one side)
  • Bleeding that doesn’t stop 
  • Abdominal pain and yellowing of the eyes or skin 
  • Fever or unusual infections that do not go away
Besides taking medications, is there anything I can do to prevent a seizure?

Certain factors may trigger a seizure. Not getting enough sleep, stress, flashing lights, rapid breathing, menses, taking drugs or alcohol, and drinking too much caffeine are among the most common factors.

It is important for people with epilepsy to try and keep a healthy lifestyle, including getting plenty of sleep, exercising regularly, and using stress-management techniques.

How do I help someone who is having a seizure?

If the person is having a tonic-clonic (grand mal) seizure: Help the person down to the ground if they are falling. Move any dangerous objects out of the way. Place something soft under the person’s head if available. Help the person onto their side when the seizure stops. Do not move the person if you think that they might have a neck or back injury from the fall.

Do not place anything in the person’s mouth—the person will not swallow his or her tongue. When the person regains awareness, he or she may be confused and tired. Someone should stay with the person until they are back to their normal. Tell the person that he or she just had a seizure.

If the person is having a non-convulsive seizure: The person may have trouble with word finding, blank staring, wandering, or behavioral changes after a seizure. The most helpful thing to do is to stay with the person and talk to him or her during the seizure. For someone who is wandering, try to verbally steer him or her away from danger. The person can usually hear you.

Can I have a baby if I have epilepsy?

Yes. Most women with epilepsy are able to get pregnant and have a normal healthy baby. This requires advance planning and close observation from your doctors. You may need to get frequent blood draws. After the baby is born, you can follow safety guidelines to keep your baby safe if you have a seizure.

Can I give epilepsy to my baby?

Genes do play a small role in epilepsy. Some epilepsy syndromes are more likely to be passed on genetically than others. Mothers with epilepsy are more likely to pass on epilepsy than fathers. This may be more related to fetal seizure exposure than genetics.
 
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