Monday Medical: Destigmatizing seizures — they can be managed with proper medication
For Steamboat Pilot & Today
Experiencing a seizure, or watching a family member or friend suffer one, can be a frightening experience. The person may stiffen and shake, while in other cases they might display odd behavior such as having an altered awareness, repeatedly trying to complete a task or locking their gaze on an object.
Neurologists want to take the fear and mystery away from seizures, and they urge patients and family members to educate themselves and seek the proper treatment, as living with seizures can be manageable with the correct medication.
“It’s a tough diagnosis, but it’s important to know that for many patients with seizures or epilepsy, it’s typically a treatable condition,” said Dr. Tracy Vargas, a neurologist at UCHealth Neurology Clinic in Steamboat Springs. “If it’s well controlled, you can lead a normal life.”
What causes seizures?
Seizures occur when there is a sudden change caused by altered electrical activity within the brain. They affect 8-10% of the population and account for up to 2% of all visits to the emergency department, with one quarter of those being first-time seizure episodes. First-time seizures can occur at any age.
“If it’s a first-time seizure, don’t just watch and wait,” said Vargas. “You need to be evaluated by a neurologist. This is definitely a reason for an emergency visit.”
The medical diagnosis of epilepsy is given to a person if they have two or more unprovoked seizures over any given time period, with the mid-20s being the average age for the condition to appear.
Finding the correct treatment
A person experiencing a seizure must be evaluated by a medical professional to determine its underlying cause, and whether it was “provoked,” meaning it was caused by external factors that could include sleep deprivation, alcohol, certain medications, an illness such as meningitis or as the result of an accident or head injury.
- Call 911.
- Make sure they are in a safe space, roll them on their side and wait for help.
- Do not administer CPR.
- Afterward, the patient may be confused, tired and achy.
If there are no provoking factors explaining a seizure, Vargas said neurologists will conduct a brain MRI and EEG where they will examine images of the brain and search for abnormal electrical activity. If all tests are normal, a “wait-and-see approach” is appropriate in most circumstance; however, there is a more than 30% chance that the person will have another seizure within five years.
“If there are abnormalities seen in the MRI or EEG, it is very important for the patient to discuss treatment,” she said.
The necessity of managing seizures through medication cannot be overstressed, according to Vargas, as it is important for a person to prevent injury to themself or others. For example, a seizure can occur while driving, with a fall, while swimming, cooking or operating heavy machinery.
“Patients with epilepsy who are untreated or poorly treated have a higher risk of sudden death,” said Vargas.
There are some restrictions for people who have experienced seizures: She restricts driving privileges in patients who have had a seizure for the first time with no underlying cause for the condition. Patients must experience three months without a seizure before privileges are reinstated. For patients whose EEG or MRI shows evidence of altered brain activity, Vargas requires three-months on anti-seizure medication with no seizures before driving privileges can be reinstated.
There are many anti-seizure medications with different side-effect profiles, and it can take time to tailor treatment to the individual. Vargas urges patience.
“Most people with epilepsy can now lead normal lives with current therapies and lifestyle modifications,” she said.
Mary Gay Broderick writes for UCHealth. She can be reached at email@example.com.
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