What Causes Epilepsy?

One of the most common causes of repeat seizures is epilepsy. A diagnosis of this disorder usually comes after someone has experienced at least 2 seizures that were not caused by another medical condition, such as low blood pressure. While the seizures might have different symptoms, they are all caused by a temporary change in the brain’s electrical functioning. Epilepsy is more common than you might think, so this November, for Epilepsy Awareness Month, we’d like to highlight this disorder and look at its causes, its symptoms, and ways to treat and possibly prevent it. 

Common Causes Of Seizures

premature baby's little foot with cuff around it with red light inside.
Epilepsy is very common amongst kids within the first year of their life, especially in newborns.

Approximately 65 million people around the world live with epilepsy, and 1 in 26 Americans will develop epilepsy in their lifetime. It can develop in a person at any time and at any age, but most  new cases occur in children during their first year of life. In about 50% of cases the causes of epilepsy are unknown, but, in general, the most common include:

  • Genetics and family history
  • Metabolism changes
  • Trauma during birth, such as oxygen deprivation
  • Premature birth or low birth weight
  • Brain malformations
  • Congenital conditions such as Down’s syndrome, Angelman’s syndrome, tuberous sclerosis, and neurofibromatosis
  • Infectious disease such as meningitis
  • Head trauma
  • Alzheimer’s disease
  • Stroke
  • Alcohol or drug abuse
  • Immune system abnormalities

The Different Types of Seizures

Generally, the different types of epileptic seizures can be grouped into 2 broad categories:

  1. Primary generalized seizures– begin with a widespread electrical discharge that involves both sides of the brain at once, and can result in a loss of consciousness, falls, or muscle contractions. A predisposition to this type of seizure is generally hereditary,  Absence, Atonic, Tonic, Clonic, Myoclonic, Tonic-clonic seizures fall into this category.illustration of a silhouette of a head with an orange electric lightning running downwards.
  2. Partial (or Focal) seizures– begin with an electrical discharge in one area of the brain. Some of these seizures are related to head injury, infection of the brain, stroke, or tumor, but most of the time the cause is unknown. This kind of seizure affects about 60% of people with epilepsy and can turn into generalized seizures. Motor focal, Sensory focal, Autonomic focal, and Psychological focal seizures fall into this category.

Factors That Increase Risk

medication bottles with 2 different kinds of pills in each, one yellow and one orange.
Failing to take prescribed medications increases your risk factor of epilepsy.

While it is not always clear why someone begins having seizures, there are some known risk factors that increase the chances of predisposed people having one, including:

  • Stress
  • Sleep deprivation
  • Failure to take prescribed medications
  • Insufficient food intake

Epilepsy is also more common in men than it is in women, and children are more likely to have epilepsy of a genetic origin than to experience seizures for another reason. 

In addition, having one seizure also increases the likelihood of having more. Half of all people who have an unexplained seizure will most likely have another one within 6 months of the first one. If someone has had a seizure due a head injury, then that person becomes twice as likely to have another. If someone has 2 seizures, then the likelihood of them having another one is 80%. 

Diagnosis & Treatment

caucasian person sitting in an MRU machine with the red lasers cross pointed on their head.
An epilepsy diagnosis can be done with an MRI, or CT scan.

The good news is that epilepsy is treatable. Once a doctor makes a diagnosis based on symptoms, and tests such as electroencephalograms (EEG), CT scans, or MRIs, they can prescribe antiepileptic drugs, which reduce the brain cells’ tendency to send excessive electrical signals. 

Approximately 70% of both children and adults that take medication for the disorder can go 5 years without having a seizure and enter remission. Once they are in remission, an additional 75% can be weaned from the medication over time. For those looking for extra help, diet can have a positive effect on some patients with specific forms of epilepsy. The keto diet and modified Atkins diet have been shown to reduce seizures in half of patients, mainly children. 

Epilepsy is a chronic condition that affects people of all different ages in different ways, but most people with epilepsy can live active lives. As long as those diagnosed with epilepsy take their medications, keep a positive attitude, and maintain a healthy diet, they can control the disorder.

Epilepsy Or Dementia? How to Differentiate The Two

When people think of an epileptic seizure, they imagine a person convulsing on the ground. This is normally what occurs, but for older adults, that is not the case. Older adults experience seizures subtly and in different ways. About 25% of newly diagnosed epileptics are adults 60 years or older, and the percentage is expected to rise to 50% by

Silhouette of a person's head drawn around a bolt of yellow lightning.
Many seniors get misdiagnosed as having dementia when in reality they have epilepsy. The symptoms are similar, which is why it is important to know the difference.

2020. An epileptic seizure will cause faster cognitive decline if it is left untreated. Many seniors get misdiagnosed as having dementia when in reality they have epilepsy. Knowing the signs is important to get diagnosed and treated properly.

Epilepsy Symptoms

Often times, epilepsy is misdiagnosed as dementia in older adults because of the similarity in symptoms. Focal epilepsy impacts a small portion of the brain which causes:

 

  • Confusion
  • Hearing or seeing things
  • Sporadic Memory Loss
  • Suspended awareness

 

Other signs that a senior might be having a seizure are:

  • Repetitive lip-smacking, hand movements, or jerking. It will last less than a minute and will mimic a tic. If they happen regularly, over a few months, then it is possible they are seizures.
  • Irregular behavior– This is when a person is usually happy and talkative, and then out of nowhere, they seem different or “off.” 
  • Unexplained falls– If a senior falls due to a heart condition, weakness, or accidents, then epilepsy is not the cause. However, if they are falling and blacking out, then it is a warning sign. 
A black silhouette if a person with puzzle pieces missing from the head in white, show noutside of the head in black.
Memory loss and confusion are similar symptoms between epilepsy and dementia. Symptoms can last almost 2 weeks after a seizure.

Epileptic seizures will have longer-lasting effects on older adults than in those of younger adults.  For example, their confusion can last up to two weeks after a seizure. This is often the reason why seniors are misdiagnosed with dementia. 

Risk Factors

An older adult is more likely to experience a seizure if they:

  • Had a prior stroke
  • Have a history of traumatic brain injury or concussions
  • Have a family history of seizures, or brain tumors
  • Take more than the recommended dose of medications such as antibiotics, painkillers, sleep medications, smoking-cessation drugs, and mental health medications. Be sure to consult with your doctor if you experience any of the mentioned symptoms while on these medications. 

If the first seizure is left untreated, about 90% of seniors will have a second occurrence. This leads to a faster decline in their cognitive health, and leads to other health issues including stroke. The risk of falls and broken bones increase as well. While treatment in seniors is tough, it is not impossible. It can be fully controlled with the appropriate medication so seniors can enjoy an improved quality of life. Epilepsy resembles dementia because of the confusion and memory loss that follows up to two weeks after a seizure. Learning the difference between epilepsy and dementia symptoms can make a huge difference in getting the appropriate help, and controlling epilepsy.

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