Epilepsy and Seizures Can Occur at Any Age

by Food and Drug Administration (FDA)

Few events compare to the drama of an epileptic seizure. Ancient people once thought that those with epilepsy were being attacked by evil spirits that had to be driven from the body with magic or prayer. If that didn't work, those affected were isolated to prevent the "spread" of fits to others. It wasn't until the Greek physician Hippocrates recognized epileptic seizures as a dysfunction of the brain that the stigma attached to such superstitions began to fade.

Today, nearly 3 million people in the United States have been diagnosed with epilepsy in one of its many forms, according to the National Institute of Neurological Disorders and Stroke (NINDS). Fortunately, scientific discoveries about how the brain works have enabled about 80 percent of those diagnosed with epilepsy to benefit from modern medicines and an implantable device regulated by the Food and Drug Administration, and to live productive lives. The most recent anti-epileptic treatment approved by the FDA was Lyrica (pregabalin), in June 2005.

What Is Epilepsy?

Epilepsy is a neurological condition that can produce brief disturbances, called seizures, in the brain's electrical function. According to the NINDS, clusters of nerve cells, or neurons, in the brain normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed briefly when the nerves in the brain "fire" spontaneously, causing strange sensations, emotions, and behaviors, and oftentimes seizures with muscle spasms and loss of consciousness.

Brain neurons may fire as many as 500 times a second during a seizure — much faster than the normal rate of about 80 times a second. This happens occasionally in some people, according to the NINDS, but may happen up to hundreds of times a day in others.

Doctors have identified hundreds of different epilepsy syndromes — disorders characterized by a specific set of symptoms that include seizures. According to the Epilepsy Foundation, classifying epilepsy by seizure type alone leaves out other important information about the patient and the episodes themselves. Classifying epilepsy into syndromes takes a number of characteristics into account, such as the type of seizure, behavior during the seizure, and genetics.

Most seizures do not seem to have a detrimental effect on the brain. Any changes that do occur are usually subtle, and it is often unclear whether these changes are caused by the seizures themselves or by the underlying problem that caused the seizures. Epilepsy can develop at any time in life, but develops most commonly in early childhood and old age. While it might not be curable, seizures for some can eventually go away.

Epilepsy is not contagious, nor is it a mental illness. People with mental retardation may experience seizures, but according to the NINDS, seizures do not mean that the person has or will develop mental impairment. While any seizure is cause for concern, the NINDS says that having one seizure does not by itself mean that a person has epilepsy.

In Sue Mielenhausen's case, her now 12-year-old son Mike experienced his first seizure when he was 4.

"We armed ourselves with as much information as we could, but held off with medications," she says. It wasn't until Mike had a second seizure a year later that he was diagnosed with epilepsy. Mielenhausen says that her son's seizures became sporadic and impossible to predict. He could go many months without one, but she also remembers onc e that "he had a stretch where he had more than one a week."

The NINDS says that a person is considered to have epilepsy only if he or she has two or more seizures. First seizures, fever-caused (febrile) seizures, those not caused by electrical disruptions in the brain (nonepileptic events), and seizures during pregnancy (eclampsia) all are examples of seizures that may not be associated with epilepsy.

Causes of Epilepsy

Epileptic syndromes can be of unknown cause (idiopathic) or can result from underlying brain damage or disease. Anything that disturbs the normal pattern of neuron activity — illness, brain damage, or abnormal brain development — can lead to seizures. According to the NINDS, research has shown that the cell membrane surrounding each neuron plays an important role in epilepsy. Cell membranes are crucial for a neuron to generate electrical impulses. For this reason, researchers are studying details of the membrane structure, how molecules move in and out of membranes, and how the cell nourishes and repairs the membrane. A disruption in any of these processes may lead to epilepsy.

In some cases, the brain's attempts to repair itself after a head injury, stroke, or other problem may generate abnormal nerve connections that lead to epilepsy. Although Mike was born with a birth defect that resolved without surgery, and also was diagnosed a few years ago with a learning disability, his mother says, "The neurologists we've worked with have been reluctant to say definitely that the birth defect caused Mike's seizures and his learning disability." But, she adds, "logic certainly suggests there must be a connection."

Paul Scribner, although not entirely certain, attributes his 20-year bout with epilepsy to three or four minor concussions he had as a child.

"If I had to guess, and knowing what I know today," he says, "it's the only thing it could be." The onset of his seizures, however, didn't begin until age 18, when he participated in a dance marathon "that involved 72 hours of perpetual motion."

According to the NINDS, about half of all seizures have no known cause. In other cases, however, seizures are clearly linked to infection, trauma, or other identifiable causes. Sometimes epilepsy is inherited.

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