Does having a seizure mean you have epilepsy?
Having a seizure does not necessarily mean that a person has epilepsy. It is only after a person has two or more seizures that he or she is considered for a diagnosis of epilepsy. This is determined through testing such as EEG, PET scan, or MRI.
What are the symptoms?
Symptoms can vary greatly from simple staring spells to violent shaking and are associated with different types of seizures. The types of seizures people experience are dependent on the part of the brain affected and the inciting cause of epilepsy. Typically, the type of seizure is similar to the previous seizure experienced. Some people report experiencing “auras” prior to each seizure and some may feel a tingling sensation, undergo emotional changes, or smell some absent odors.
There are different types of seizures?
Yes, there are more than 40 known types of seizures a person may experience. A few of them are discussed below.
Types of Seizures
For the most part, seizures can be classified based on where in the brain the epileptic activity starts.
Generalized seizures result from epileptic activity in both halves of the brain. Below are four major types of generalized seizures: tonic-clonic, absence, myoclonic, and atonic.
- Tonic-Clonic: This type is what is commonly recognized as a seizure. As the name implies, it is split into two phases: the tonic and the clonic. In the tonic phase, the person will lose conscious and may fall to the floor. The body goes stiff as the muscles contract, and the person may cry out. Due to a lack of oxygen, the blood tends to be less red than normal, so the skin may turn blue. After the tonic phase, the clonic phase will begin. The muscles begin to tighten and relax in a cycle that results in jerking limbs. The person may lose control of his or her bladder. After the seizure (post-ictal state), the person’s muscles will relax and the body goes limp. Consciousness will slowly return, but the person may appear confused and may not be able to remember the seizure. This can last anywhere from a few minutes to several days. Recovery varies from person to person, but generally involves sleeping for a certain period of time.
- Absence Seizures: When a person has an absence seizure, he or she loses consciousness for a few seconds. This can look like a person daydreaming, so these tend to be harder to spot. It is possible for a person with epilepsy who has this type of seizure to have upwards of one hundred absence seizures in the span of a day.
- Myoclonic Seizures: Myoclonic seizures cause the muscles in the body to jerk. This can include the whole body, but the jerking is usually isolated to the limbs or neck and shoulders, and generally occurs on both sides at the same time. The person is unconscious for a brief period of time, but may not notice it. Myoclonic seizures can be mild or can be associated with the more extreme forms of epilepsy such as Lennox-Gastaut syndrome.
- Atonic Seizures: Contrary to the muscle stiffness experienced during tonic seizures, atonic means “without tone”, so the person will lose all muscle function and fall to the floor. These are usually very brief and the person can generally stand up quickly without experiencing confusion. For more information on atonic seizures, see here.
Focal (Partial) Seizures
Unlike generalized seizures, focal seizures affect one area (generally one lobe) of the brain. During a focal seizure, a person may be able to remain alert, but can still be confused as to what is happening. Below are examples showing symptoms of seizures specific to the temporal and frontal lobes.
- Seizures in the Temporal Lobes: The temporal lobes contain functions such as hearing, speech, memory, and emotions, so symptoms of seizures in this area can vary greatly. Commonly, a person experiencing a focal seizure in the temporal lobe can be flushed or go very pale. He or she may see distorted objects or things that are not actually there. Additionally, smelling non-existent smells or tasting non-existent tastes can occur. The list of symptoms is very long, but these seizures can generally be identified by sensory experiences or emotions that seem out of place along with an inability to clearly process location or emotions.
- Seizures in the Frontal Lobes: The frontal lobes contain functions including movement, emotions, and language. Typically, frontal lobe seizures result in very outward displays including stiffness of the limbs, thrashing arms, and crying out. Furthermore, the person may have problems forming or understanding speech. Sometimes these seizures may be incorrectly diagnosed as a condition other than epilepsy due to their dramatic appearances. For more information on frontal lobes, click here.
Who do I approach for diagnosis?
When your doctor determines that a seizure has occurred, you may be referred to a neurologist. Neurologists are specialists with knowledge of the workings of the brain as a whole. However, if multiple seizures have occurred, an epileptologist is appropriate. Epileptologists are neurologists that specialize in epilepsy and are preferred, but not always locally available.
How do I find a good neurologist?
There are several steps to take to find a great neurologist (or epileptologist):
- Find out whether or not you need a referral from your primary care provider. If you do, keep this in mind while searching for your new doctor.
- Figure out what you want out of this new doctor. It can be helpful to make a list, physical or mental. Do you prefer if the person is a man or a woman? Would you like the head of a department or the lead researcher? Compiling the “must have” qualities is essential before moving on to the next step.
- Check out the Top Doctors in your area. This is a good starting place to learn who has a long track record of success in the area. You will want to dig deeper on anyone who has been on the list for a few years running.
- Location, location, location. The top doctor can be closest to your workplace, your home, or your child’s school, but you will need to be able to conveniently visit this doctor often.
- Make sure to determine which neurologist is in your health insurance network. If you don’t have health insurance, then speak to your to find out what options are available to you. If you do have health insurance, go to the insurance company’s website. Most will have a “Find a Doctor” section. Typing in the name of the doctor you want to see will quickly show you whether the doctor is in the network or not.
- Call and make an appointment!
- After you make the appointment you may have to go back to your primary care provider for a referral. Be sure to ask for a referral for multiple visits to save yourself the hassle of having to get a new referral each time.
How do I fire my doctor?
For future reference, there may (and probably will) be a time when you need to cut ties with your current doctor. This may seem as daunting as a task as finding the doctor, but don’t worry. To know if it is time to find a new doctor you need to:
- listen to your instincts.
- Make sure your doctor is meeting your needs — not his/her needs
When firing your doctor, don’t play games, simply tell them that you “will be looking for another doctor and that his staff can expect a call from requesting records.”
Getting to the Answer
When epilepsy symptoms emerge, frustration is natural. Dealing with this frustration requires patience, but ruling out other conditions is a necessary part of the diagnosis process. The testing you may undergo includes the following:
A complete neurological exam will usually be given to check brain and nerve functioning, as well as diagnose which part of the brain is being affected. Next, the functioning of senses, muscles, reflexes and coordination, as well as cognitive functions will be tested. These will provide a base level in the occasion that medicine is prescribed, to check that the dosage is appropriate.
An EEG is one of the most common ways to diagnose epilepsy. An EEG will measure abnormal electrical activity in the brain. This test will take about 90 minutes, with brain activity being measured for about a half hour. Since this is such a short period of time, the doctor may ask the patient to stay in the hospital facility for a longer period of time, up to a few days, to monitor brain activity over a longer period of time. In addition to monitoring brain activity, this test often includes monitoring physical movements and behavior with a video camera.
Positron Emission Tomography (PET)
A PET scan may be taken to help identify the area of the brain that is causing the seizures. This test begins with a small injection of a radioactive ‘tracer’, which sounds out positrons that enables an image to be formed and helps detect the problematic area.
Magnetic Resonance Imaging (MRI)
An MRI scan may be taken to assist the neurologist in providing treatment. This test lasts about a half hour, and makes a very loud and distinctive sound. You will also be asked to remain still in a fairly confined space. It helps to come prepared with earplugs and to wear comfortable clothing.