Epilepsy is not a disease. It is a relatively common neurological disorder, a physical condition that periodically produces brief disturbances in the normal electrical activity of the brain. The condition is characterized by sudden, brief seizures that may temporarily interfere with muscle control, movement, speech, vision, or awareness.

For someone experiencing a seizure, this sudden change in the brain's electrical activity may alter the way everything looks, or may make the person's body move involuntarily. Sometimes it may even cause a convulsion, a more severe series of uncontrolled stiffening or shaking. Seizures usually last from a few seconds to a few minutes, then gradually subside as brain cell activity returns to normal.

Causes

Anyone can develop epilepsy; it occurs in all ages, races and social classes. In many cases, doctors can't pinpoint exactly what causes epilepsy in a particular person, but they do know some of the things that can make a person more likely to develop epilepsy. These include:

• Injury to the brain before, during or after birth
• Malformation of the brain
• Infections that damage the brain, such as meningitis and encephalitis
• Toxic substances that affect the brain, such as lead or alcohol poisoning
• Injury and lack of oxygen to the brain
• Disturbances in blood circulation to the brain (stroke and other vascular problems)
• Brain tumors

Unlike some other medical conditions, epilepsy has no identifiable or consistent "triggers" which can bring on a seizure. However, some environmental and internal factors that may make seizures more likely to occur in a susceptible person include:

• Alcohol
• Strong emotion
• Intense exercise
• Flashing lights or loud music
• Illness or fever
• Lack of sleep
• Emotional stress
• Menstrual period
• Hormonal changes
• Drug use, including some prescription medications
• Missed medication
• Poor nutrition
• Extreme fatigue
• Low blood sugar

Symptoms

Seizures are the only visible symptom of epilepsy. There are different kinds of seizures, and symptoms of each type can affect people differently. A medical exam is advised if one or more of the following symptoms occur:

• A convulsion with or without a fever
• Short periods of blackout or confused memory
• Occasional "fainting spells" in which bladder or bowel control is lost, followed by extreme fatigue
• Episodes of blank staring
• Brief periods of unresponsiveness to questions or instructions
• Sudden stiffening or falls for no apparent reason
• Episodes of blinking or chewing at inappropriate times
• Dazed behavior; being unable to talk or communicate for a short time
• Repeated movements that look out of place or unnatural
• Sudden fear, anger, or panic for no apparent reason
• Muscle jerks of arms, legs or body
• Odd changes in the way things look, sound, smell or feel

Diagnosis

Diagnosing epilepsy can be difficult. Your doctor will first try to determine whether you experienced a seizure and, if so, whether the seizure was due to a condition other than epilepsy.

A physical examination and detailed medical history often provide the best clues as to whether you have epilepsy and what type of epilepsy and seizures you have. Discussing what happens to you just before, during, and right after a seizure can help the doctor make a diagnosis.

The most useful test in support of a diagnosis of epilepsy is electroencephalography (EEG), which measures the electrical activity of the brain. Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be used to evaluate the cause and location of a possible source of epilepsy within the brain.

Treatment

Medication can effectively control seizures in many people with epilepsy. Other treatments that help control seizures include surgery; a special diet, especially helpful in children (ketogenic diet); or a device that stimulates nerves (vagus nerve stimulator). A combination of these treatments may be tried when medication alone does not control seizures.  For those whose seizures do not respond to medication, surgery can be considered if the source of the seizures can be identified and if that area of the brain can be safely operated upon.