What is epilepsy?

Epilepsy is a chronic (long-term) brain condition where a person has repeated seizures. It is thought to affect about 3 in every 100 Australians.

Having just one seizure does not mean that you have epilepsy — about 1 in every 2 people who have a single seizure never have another seizure.

Epilepsy is not a single condition. There are a few different conditions that can cause seizures.

What are the symptoms of epilepsy?

The key symptom of epilepsy is seizures. Seizures are episodes of changed electrical activity in the brain and can vary a lot depending on the part of the brain involved.

Seizures can cause symptoms such as loss of consciousness (passing out), unusual jerking movements (convulsions) as well as other unusual feelings, sensations and behaviours.

There are many different types of seizures. Generalised seizures involve the whole brain and so the whole body is affected. Focal seizures involve only part of the brain.

Seizures usually last 1 to 3 minutes.

To learn what to do if someone is having a seizure, look at Epilepsy Action Australia's seizure first aid resources.

Generalised tonic-clonic seizures

Previously known as 'grand mal seizures', these types of seizures are the most well recognised. The seizure starts with a sudden loss of consciousness. The person’s body then becomes stiff, followed by jerking of the muscles.

The person may also:

• turn red or blue
• bite their tongue
• lose control of their bladder

After regaining consciousness, the person may:

• be confused, drowsy or agitated
• not remember what happened
• have a headache

Absence seizures

Absence seizures were previously known as 'petit mal seizures'. These types of seizures usually start in childhood, but can happen in adults. These seizures are brief and involve staring, loss of expression, unresponsiveness and stopping activity. Sometimes eye blinking or upward eye movements are seen. The person usually recovers straight away and continues their previous activity, without remembering the seizure.

Focal seizures

Previously known as 'partial seizures', these start in one area of the brain and affect the parts of the body controlled by that area of the brain. The seizure may involve unusual movements, feelings, sensations, or behaviours. People can have different levels of consciousness during focal seizures.

Febrile convulsions

Febrile convulsions are seizures are associated with an illness causing a fever, such as a viral infection. They are generally harmless and do not require special or long-term treatment. Febrile convulsions are common, happening in about 3 in 100 healthy children up to 6 years old.

If they don’t have any additional risk factors for epilepsy, children who have febrile convulsions have a similar risk of developing epilepsy to the rest of the population.

What causes epilepsy?

The cause of epilepsy is unknown in half of all cases. Genetics (family history) is known to play an important role.

Seizures or epilepsy can also be caused by anything that damages the brain, including:

• head injury or trauma
• stroke or brain haemorrhage (bleed)
• brain infection or inflammation, such as meningitis, encephalitis or a brain abscess
• brain malformations or tumours
• brain diseases, such as Alzheimer’s disease
• alcohol or drug use
• high or low blood sugar and other biochemical imbalances

It may take years after an injury for seizures to develop.

When should I see my doctor?

Always see a doctor if:

• this is your first seizure
• you have repeated seizures
• you have seizures more often than is normal for you
• you are not sure if you’ve had a seizure
• you have a diagnosis of epilepsy, but feel like your medicine is not helping

You should seek medical attention after a seizure if you are injured, if you are pregnant or have diabetes.

How is epilepsy diagnosed?

A diagnosis of epilepsy is based on your history of seizures. Your doctor will ask you what you can remember and any symptoms you had before the seizures happened, such as feeling strange or any other warning signs.

It may be useful to talk with anyone who saw your seizure and ask them what they saw, especially if you can’t remember the seizure.

Your doctor may also do tests such as blood tests, an EEG (electroencephalogram) and scans of the brain (such as a CT scan or an MRI).

Any abnormal findings can help classify the type of epilepsy you have. You may still have epilepsy, even if you have normal results from your EEG and brain scans.

If your child or someone you know has a seizure, it can be helpful to record a video of it on your mobile phone. This can help your doctor make a more accurate diagnosis.

How is epilepsy treated?

Most people with epilepsy can control their condition with antiepileptic medicines and by avoiding triggers. Your doctor will recommend a treatment based on your age, what type of epilepsy you have and the underlying cause of your epilepsy (if known).

Many antiepileptic medicines need to be monitored with regular blood tests to make sure the amount of medicine in your blood is:

• not too low
• not too high
• doesn’t cause other medical problems

Some new treatments for epilepsy are being studied. These include:

• surgery on the area of the brain causing the seizures
• vagus nerve stimulation — nerves in the neck are stimulated by a device placed under the skin
• a strict medically supervised diet in some children with epilepsy, called a ketogenic diet
• medical cannabis, which has been shown in some studies to help people control seizures. You can read more about medicinal cannabis and epilepsy on the Epilepsy Action Australia website.

How do I manage epilepsy?

Keeping a seizure diary can help you track how well your epilepsy is being managed and help you identify any triggers. Your doctor can also help you develop an epilepsy management plan, which can be useful to your school, employer, and other health professionals.

It's important to work with your doctor to get the best control over your seizures, especially if you are planning a pregnancy.

Ask your doctor if it is safe for you to drive or do other high-risk activities such as operating heavy machinery or swimming. Depending on the type of epilepsy you have, most people are able to return to driving after being seizure-free for 6 months.

Can epilepsy be prevented?

You can help prevent seizures by taking your medicine as prescribed and avoiding triggers.

Diet and health related triggers include:

• caffeine
• missing meals
• having an infection
• vomiting, diarrhoea or constipation
• fever

Sleep, stress and medicine related triggers include:

• lack of sleep
• physical and emotional stress
• hormonal changes due to menstruation (periods)
• missing a dose or taking too much antiepileptic medicine

Environmental triggers include:

• allergens
• alcohol or drug use
• severe changes in temperature
• flashing lights

Complications of epilepsy

Having epilepsy puts you at higher risk of injury, so you will need to take extra precautions. During a seizure you might fall, knock yourself or breathe in food or saliva.

You should avoid jobs using heavy machinery, working at heights or under water. You may also need to stop driving, if your seizures are not controlled. Precautions may be needed around water, such as when swimming or bathing.

Children with epilepsy may find it harder to learn or to concentrate.

Epilepsy can affect your life and you will need to pay more attention to your health. You may feel anxious or depressed when you are first diagnosed. Stay healthy and avoid complications with information from Epilepsy Action Australia’s living with epilepsy.

If you get pregnant, talk to your doctor about adjusting your medicine.

Resources and support

Call the National Epilepsy Line 1300 37 45 37 to talk with a registered nurse with special training in epilepsy management. The nurse will help answer your questions and can refer you to other services for more help.

You can find more epilepsy information on these websites:

• Epilepsy Action Australia
• Epilepsy Australia

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.