Epilepsy is a neurological disorder characterized by a tendency to have recurrent, unprovoked seizures. Although epilepsy can develop at any age, adults may develop seizures due to various underlying conditions, including brain injuries, strokes, infections, tumors, or genetic factors.
Recognizing the signs of epilepsy and seeking timely medical evaluation can help reduce complications and improve quality of life.
What Is Epilepsy?
Epilepsy occurs when abnormal electrical activity in the brain causes recurrent seizures. A seizure can affect awareness, movement, sensations, emotions, or behavior, depending on which part of the brain is involved.
Having one seizure does not necessarily mean a person has epilepsy. A neurologist evaluates the person’s symptoms, medical history, examination findings, and test results before making a diagnosis.
Signs and Symptoms of Epilepsy in Adults
Seizure symptoms can vary considerably. Some people experience obvious convulsions, while others may have subtle changes in awareness or behavior.
Common signs include:
- Temporary loss of awareness
- Sudden staring spells
- Uncontrolled shaking or jerking movements
- Muscle stiffness
- Sudden falls or loss of muscle control
- Repetitive movements such as lip-smacking or hand movements
- Temporary confusion after an episode
- Unusual smells, tastes, sounds, or sensations
- Sudden fear or unusual emotions
- Temporary difficulty speaking
- Loss of consciousness
- Tongue biting or loss of bladder control during some generalized seizures
Some seizures may last only a few seconds, while others can last longer.
Common Causes of Epilepsy in Adults
Epilepsy can have many possible causes. In some people, no specific cause is identified.
Potential causes include:
1. Previous Brain Injury
A traumatic brain injury caused by an accident, fall, or other event can sometimes lead to seizures.
2. Stroke
Stroke can damage brain tissue and is an important cause of epilepsy, particularly in older adults.
3. Brain Tumors
Certain brain tumors or other structural abnormalities can interfere with normal electrical activity and cause seizures.
4. Brain Infections
Infections involving the brain, such as encephalitis or meningitis, can sometimes result in seizures.
5. Genetic Factors
Some forms of epilepsy have a genetic component and may run in families.
6. Developmental or Structural Brain Abnormalities
Changes in the structure or development of the brain can increase the risk of epilepsy.
7. Unknown Causes
Despite appropriate investigations, the exact cause may remain unknown in some individuals.
How Is Epilepsy Diagnosed?
A detailed medical history is an important part of epilepsy diagnosis. Your neurologist may ask about what happened before, during, and after the episode.
Depending on the situation, investigations may include:
- Electroencephalogram (EEG): Records electrical activity in the brain and can help identify abnormal patterns.
- MRI or CT scan: May be used to look for structural abnormalities in the brain.
- Blood tests: Can help identify metabolic or other conditions that may contribute to seizures.
- Other neurological tests: May be recommended depending on the patient’s symptoms and medical history.
If possible, a description or video of the episode from someone who witnessed it can be extremely helpful to the doctor.
Epilepsy Treatment in Adults
Treatment depends on the type of seizure, cause of epilepsy, age, overall health, and other individual factors.
Anti-Seizure Medications
Anti-seizure medicines are commonly used to control seizures. The neurologist selects the medication based on the individual’s seizure type and other medical considerations.
Taking medication exactly as prescribed is important. Do not stop anti-seizure medication suddenly without medical guidance, as this can increase the risk of seizures.
Lifestyle Management
Medication is often supported by healthy lifestyle habits, including:
- Getting adequate and consistent sleep
- Taking prescribed medication regularly
- Avoiding known seizure triggers
- Limiting or avoiding excessive alcohol
- Managing stress
- Maintaining regular meals
- Following medical advice about driving and safety
A comprehensive evaluation at an epilepsy center may be recommended for drug-resistant epilepsy.
What Should You Do During a Seizure?
If someone is having a convulsive seizure:
- Stay calm and remain with the person.
- Move nearby dangerous objects away.
- Protect their head with something soft if possible.
- Turn them gently onto their side when practical, especially after the convulsions stop.
- Loosen tight clothing around the neck.
- Note how long the seizure lasts.
- Do not restrain their movements.
- Do not put anything in their mouth.
- Do not give food, drink, or medication until they are fully alert.
When Should You Consult a Neurologist?
You should seek neurological evaluation if you experience a first-time seizure, repeated unexplained episodes of loss of awareness, unexplained falls, unusual repetitive movements, or other symptoms that could indicate seizures.
A neurologist can determine whether the episodes are related to epilepsy or another condition and recommend appropriate investigations and treatment.
