17636 Epilepsy

Overview

Epilepsy is a long-term condition that affects the brain and causes repeated seizures. A seizure is a sudden burst of electrical activity in the brain that briefly changes how the brain works. This can cause changes to movement, behavior, feelings, or awareness. It is not a mental illness and is not contagious.

Yes — epilepsy is one of the most common neurological conditions in the world. In the UK, around 1 in 100 people have epilepsy.

Epilepsy can begin at any age. It often starts in childhood or after age 60, but it can affect anyone, regardless of sex, background, or lifestyle.

Symptoms

Common symptoms

• Temporary confusion or being unable to understand what is happening
• Staring blankly into space for a few seconds
• Uncontrollable jerking or twitching of the arms, legs, or face
• Losing awareness or consciousness
• Muscle stiffening followed by relaxation
• A strange feeling, smell, or taste just before a seizure (called an aura)

Symptoms in children

• A brief pause in behaviour where the child stares and does not respond
• Turning the head or eyes to one side
• Making unusual sounds or becoming unresponsive
• Falling suddenly without a clear reason
• Rapid blinking or chewing movements

Symptoms in older adults

• A period of confusion that comes and goes
• Staring spells or brief unresponsiveness
• Sudden falls without loss of consciousness
• Memory gaps lasting a few minutes
• Feeling that things look or sound strange just before an episode

Causes

Main causes

• Head injury or trauma to the brain
• Stroke or other conditions that reduce blood flow to the brain
• Brain infection such as meningitis or encephalitis
• Brain tumour or abnormal growth
• Genetic changes inherited from family members
• Differences in the way the brain develops before birth
• In many cases, the exact cause is never found

Risk factors

• Family history of epilepsy
• Being under 5 years old or over 60 years old
• Previous head injury
• Stroke or heart disease
• Heavy alcohol use or recreational drug use
• Lack of sleep or chronic sleep deprivation

When to see a doctor

See a doctor urgently if:

• After a first-time seizure, even if it was brief
• If seizures become more frequent or more severe
• If you have a seizure that is different from your usual pattern
• If you are injured during a seizure

Book a routine appointment if:

• If you notice unusual spells that could be seizures
• If you have side effects from your epilepsy treatment
• If you have concerns about memory, mood, or thinking
• If you are planning a pregnancy and have epilepsy

Diagnosis

A doctor will ask about your symptoms, your personal and family history, and may refer you to a specialist (a neurologist) who cares for people with brain conditions. They may ask for a description from someone who has observed your episodes.

Tests that may be done

• Electroencephalogram (EEG) — a painless test that records the electrical activity of the brain
• Blood tests to check for other medical conditions
• MRI or CT brain scan to look for physical causes
• Sometimes videos of your episodes taken by family members can help the doctor understand what is happening

What to expect at your appointment

The process can take time. You may need to wait for a specialist appointment and some tests. The doctor will listen carefully and work with you to find the cause and create the right plan for your care.

Treatment

The main treatment is anti-seizure medicine (also called anticonvulsants or anti-epileptic drugs). These medications do not cure epilepsy, but they help prevent or reduce seizures. Many people take one medicine; some need more than one. Treatment is tailored to your type of epilepsy, your health, and your lifestyle.

Self-care at home

• Take your prescribed medicines exactly as directed, even if you feel well
• Get enough sleep and try to keep a regular sleep schedule
• Manage stress with relaxation techniques such as breathing exercises or gentle yoga
• Avoid known seizure triggers, such as alcohol or flashing lights, if they affect you
• Keep a seizure diary to track when and how seizures happen

Medical treatments

Besides anti-seizure medicines, other treatment approaches include a special diet called the ketogenic diet (high fat, low carbohydrate) which can help some people, especially children; surgery to remove the area of the brain that is causing the seizures; or a device implanted under the skin (such as a nerve stimulator) that can help reduce seizure activity. These options are considered when medicines do not work well enough. Always discuss all choices with your specialist.

When is surgery considered?

Surgery may be an option if tests show that your seizures come from a single area of the brain that can be safely removed. This decision is made by a specialist team after a careful assessment. It is not suitable for everyone, but it can offer real benefit for some people.

Living with this condition

Everyday life with epilepsy involves taking your medicines, having regular check-ups, and being aware of your seizure triggers. You can still work, study, drive (if you meet your local rules), and enjoy personal relationships. If seizures are not fully controlled, you may need extra safety measures, such as showering instead of bathing, or avoiding swimming alone.

Lifestyle tips

• Wear a medical ID bracelet or carry a card that says you have epilepsy
• Tell close friends, family, and co-workers what to do during a seizure
• Avoid drinking large amounts of alcohol and avoid recreational drugs
• Always tell a qualified instructor or buddy before swimming, cycling, or doing high-risk sports
• Make sure you have enough medication for trips and holidays

Diet and exercise

Aim for a balanced, regular diet and stay active. Exercise is generally safe and helpful for both body and mind. Some sports need extra supervision or safety equipment, so it is best to talk with your doctor about which activities are suitable for you. Avoid skipping meals and try to avoid extreme tiredness.

Mental health and emotional wellbeing

Living with epilepsy can be stressful. Anxiety, depression, and worry about the next seizure are common. It is important to acknowledge these feelings and talk to your doctor or a mental health professional if they affect your daily life. You are not alone, and support is available.

Prevention

Most cases of epilepsy cannot be prevented. However, you can reduce some known risks: wear a helmet for risky sports, take steps to prevent head injuries, manage high blood pressure, and avoid heavy alcohol use. Following your treatment plan helps prevent seizures.

Vaccines

There is no vaccine to prevent epilepsy itself. However, staying up to date with routine childhood vaccines can prevent some infections that could lead to brain injury and epilepsy.

Screening programmes

There is no routine screening test for epilepsy for everyone. If you have symptoms or have had a seizure, a doctor can arrange tests to find the cause and guide treatment.

Complications

If left untreated

• Injuries from falls or accidents during seizures
• Burns or scalds from baths, kettles, or cooking
• A rare but serious condition called status epilepticus, where a seizure does not stop or happens over and over again
• Difficulties with learning, work, or relationships due to repeated seizures

Long-term outlook

With the right treatment and care, most people with epilepsy are able to control their seizures and live a full, independent life. Some children outgrow epilepsy, and some adults can reduce or stop their medicine with specialist advice. There is always reason to hope, and getting the right support can make a real difference.

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