Epilepsy: Signs, Symptoms, Diagnosis & Treatment


Epilepsy is a condition that affects the brain, causing repeated seizures – these are bursts of electrical activity in the brain that affects how it functions temporarily. 

Having just one seizure doesn’t indicate epilepsy, as some people who have one seizure may never have another seizure again. Other conditions such as fever, diabetes, heart conditions and alcohol withdrawal can also cause seizures. 

Seizures usually last 1 to 3 minutes. If someone has a seizure that lasts for more than 5 minutes, call an ambulance immediately.

Epilepsy can start at any age but usually starts in childhood or in people over 60.

Symptoms of Epilepsy

Seizures can cause symptoms such as:

  • A loss of consciousness
  • Uncontrollable jerking movements (convulsions) 
  • Strange feelings, sensations and behaviours

There are many different types of seizures:

Tonic-clonic seizures

Tonic-clonic seizures are the most recognised. The seizure begins with a sudden loss of consciousness, the body becomes stiff and muscles jerk. It is also common for some people to turn blue, lose control of their bladder and bite their tongue.

After regaining consciousness, the person may feel drowsy and confused. It is also common to have some memory loss and a headache. Agitation can also occur while regaining consciousness.

Absence seizures

This type of seizure usually starts in childhood but can occur in adults. 

The seizures are brief and involve:

  • Staring
  • Loss of expression
  • Unresponsiveness 
  • Suddenly stopping activity

Sometimes eye blinking or upward eye movements can be noticed. After the seizure, the recovery is immediate and the person often resumes their previous activity with no memory of the seizure. 

Focal seizures

This seizure begins on one part of the brain and affects the part of the body that is controlled by that area of the brain. 

The seizure may involve:

  • Unusual movements
  • Unusual sensations or behaviours. 

People can also experience different levels of consciousness during focal seizures.

Febrile convulsions

Febrile convulsions are seizures that occur in children up to the age of 6 years. The seizures are generally harmless and associated with an illness causing fever, such as a viral infection.

During a febrile seizure, the child’s body usually becomes stiff, they lose consciousness and their arms and legs twitch. Some children may also lose control of their bladder.

What causes epilepsy?

Seizures or epilepsy can also be caused by anything that causes damage to the brain, including:

  • Trauma to the head or a head injury
  • A stroke or brain haemorrhage
  • Infection of inflammation of the brain 
  • Brain tumours
  • Diseases of the brain, such as Alzheimer’s disease
  • Chronic drug or alcohol use
  • Genetic factors
  • High or low blood sugar levels
  • Other biochemical imbalances

However, it is important to note that seizures may not develop for years after damage to the brain occurs. seizures may not develop for years after the damage to the brain occurs.

When should you see a doctor?

Having a seizure does not mean that you have epilepsy. A seizure can have different causes and you may only have a one-off seizure. However, it is still important to see a specialist neurologist to find the cause of the seizure.

It is important to see a doctor if:

  • This is the first seizure
  • If there are repeated seizures
  • Seizures occur more often than usual
  • Unsure whether it was a seizure
  • If you are pregnant or have diabetes
  • If you are injured

Diagnosis Epilepsy

A specialist may conduct a test to check the activity in your brain to detect any problems:

Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test used to assess brain activity or the functionality of the brain. Brain cells communicate through tiny electrical impulses and seizures are a result of abnormal electrical activity.

If a person is having seizures, they are referred to a specialist who will conduct an electroencephalogram (EEG). The test is painless and doesn’t involve any injections or needles. 

It’s important to note that people with epilepsy can have normal EEG in-between seizures. In these cases, an EEG is recorded while the patient is asleep to gather additional information on the brain’s activities.

Electrical currents do not pass from the machine into the patient’s brain during the test.

MRI scan

Brain scans can identify any problems in your brain that can cause epilepsy. This includes:

  • A brain tumour 
  • Damage to the brain – damage caused by a stroke
  • Scarring in the brain

The scan used for this is known as a magnetic resonance imaging (MRI) scan. This uses strong magnetic fields and radio waves to produce detailed images of the brain.

Epilepsy treatment

Epileptic seizures can be controlled by antiepileptic medicines as well as avoiding triggers. Antiepileptic therapy depends on different factors, such as your age and the type of seizures that a person has. Before antiepileptic medicine is prescribed, a person will be required to take blood tests to ensure that the levels in their blood are not too high or too low, as well as being able to identify any other medical problems. 

We recommend keeping a diary of all seizures to help monitor how well epilepsy is being managed. A diary will also be useful in identifying the triggers that cause seizures. Often, specialists will help to develop an epilepsy management plan which can be useful for schools, employers and other health professionals. 

Working very closely with a specialist will help to gain control over seizures. It is important to ask if it is safe to drive or to do other high-risk activities like operating heavy machinery. 

How to prevent seizures

Seizures can be prevented by taking medication and avoiding triggers. 

Some triggers include: 

  • Missing or taking too much antiepileptic medication
  • Lack of good quality sleep
  • Physical and emotional stress
  • Fever
  • Alcohol or drug use
  • Flashing lights
  • Hormonal fluctuations
  • Caffeine
  • Skipping meals
  • Infection
  • Allergies
  • Menstruation
  • Severe changes in temperature

Epilepsy puts you at greater risk of injury as, during a seizure, you may fall, knock yourself, breathe in saliva or food. 

Avoid using heavy machinery or working from great heights and underwater – precautions may be required around water, such as bathing or swimming. 

Although epilepsy can affect your life as you will need to pay more attention to your health, you can still lead an active and fulfilling life. If you are feeling anxious or depressed, speak to a specialist to help you manage your mental wellbeing.