10 Facts You Should Know About Epilepsy

While the signs of some chronic illnesses are vague or invisible, epilepsy symptoms can be hard to miss. The neurological disorder is characterized by recurrent epileptic seizures, or periods of excessive or overlapping activities in the brain. It also comes with a stigma: Patients who exhibit epileptic seizures have been accused of being violent, mad, and even possessed. Those misconceptions are sometimes more harmful than the epilepsy symptoms themselves. With proper treatment, people with the condition often lead safe, happy lives. Here are some more facts.

1. Epilepsy has fueled superstitions for centuries.

Before modern medicine, cultures around the world mistook epileptic seizures for spiritual possession. There’s even a passage in the New Testament of the Bible where Jesus performs an exorcism on a boy having an apparent epileptic fit. The ancient Greeks [PDF] believed seizures were a punishment sent from the gods, and therefore considered them sacred. We now know that seizures originate in the brain, but the superstitions that surround them persist.

2. Epileptic seizures are caused by a neurological imbalance.

The brain is controlled by neurons: cells that carry electrical impulses that allow us to process our environment. Some neurons stimulate other brain cells, while others tell them to calm down. This balance is what allows us to function normally. In people with epilepsy, too many stimulating or calming neurons fire at the same time, causing epileptic seizures.

3. There are different types of epileptic seizures.

When most picture someone having a seizure “seizing up,” losing consciousness, and convulsing uncontrollably. These are the characteristics of grand mal or tonic-clonic seizures, but it’s not the only form they take.

Generalized seizures are caused by activity in both hemispheres of the brain, and they include tonic-clonic seizures, as well as absence seizures (brief loss of consciousness), myoclonic seizures (random muscle jerks), and more. Focal seizures occur in only one region of the brain and can be simple—limited to twitching and odd feelings, tastes, or smells—or complex, where sufferers experience a temporary loss of awareness.

4. Not all seizures are signs of epilepsy.

Spontaneous, non-epileptic seizures happen for a number of reasons, ranging in seriousness from brain tumor or stroke to low blood sodium or lack of sleep. A patient is usually diagnosed as epileptic after they’ve experienced two or more seizures, or if they have a positive result on a diagnostic neurological test. The most common test, an electroencephalogram (EEG), monitors electrical activity in the brain.

5. Epilepsy causes vary from person to person.

A person can develop epilepsy for a variety of reasons. In some cases, mutations in the genes related to regulating neurons can make some people more vulnerable to the environmental factors that cause the disorder. Other causes include brain damage, infectious diseases like AIDS, and developmental disorders like autism. But in roughly half of all cases, the condition is cryptogenic, which means doctors can’t pinpoint a specific cause.

6. Outside stimuli can trigger epileptic seizures.

Things that affect brain function, like drinking alcohol, taking drugs, and not getting enough sleep, can make someone more vulnerable to having epileptic fit. Other triggers are much harder to avoid: People with reflex epilepsy get seizures as a reaction to stimuli, such as flashing lights or even music.

7. Auras can signal an impending seizure.

Warning signs known as auras can take the form of a strange smell or taste, a sudden wave of fear or joy, a feeling of déjà vu, or random muscle twitches. Auras are technically focal seizures, which are seizures the sufferer is aware of, and though they often precede bigger seizures that trigger a loss of consciousness, they can also happen on their own.

8. Temporary paralysis sometimes follows an epileptic seizure.

After their seizure has stopped, patients may experience full or partial paralysis, usually on one side of their body. The loss of motor function can last anywhere from 30 minutes to 36 hours, but most of the time it doesn’t exceed 15 hours. This phenomenon is named Todd’s paralysis after Victorian physician Robert Bentley Todd, who first described it.

9. Few epileptic seizures are fatal.

The biggest threat during an epileptic fit is injury from falling down and convulsing in an unconscious state, but the majority of seizures don’t cause serious harm on their own. The exception is tonic-clonic status epilepticus, which is the name for a seizure that lasts five minutes or longer. These are considered emergency seizures and can result in brain damage or death [PDF].

10. Epilepsy can be treated with vagus nerve stimulation.

Epilepsy is highly treatable with a number of methods, from drugs to brain implants. Many patients take anti-seizure medications that balance neural signals and prevent seizures from happening. Surgery to remove the area of the brain where seizures typically begin is another form of treatment. Other options include a high-fat, low-carb diet, which can stabilize neuron function, and vagus nerve stimulation, which uses implants to send electric pulses up the vagus nerve in the neck to regulate brain activity.