The cause is unknown in over half the cases of epilepsy, especially in those with onset under age 20. Predisposing factors in other cases include familial history, head injury, alcohol withdrawal, infections (such as meningitis), and abnormalities (such as tumors) of the brain.
The recording of brain waves by electroencephalography is an important diagnostic test for epilepsy. Other diagnostic technologies include CAT scan and magnetic resonance imaging (MRI). Standard treatment of epilepsy is with anticonvulsive drugs, such as carbamazepine, phenytoin, and valproate; it requires a careful analysis of seizure motor activity, anatomical cause, precipitating factors, age of onset of the disorder, severity, daily rhythms, and prognosis. Some cases of childhood epilepsy (which is often eventually outgrown) have been successfully treated with surgery or a very high-fat "ketogenic" diet. The diet results in a natural buildup of ketones in the body, which appear to inhibit the seizures. First aid, such as cushioning the head, is used to prevent the person from self-inflicted injuries during seizures. With proper medication, most epileptics live normal lives. Repeated seizures that lead to unconsciousness, however, appear to be associated with damage to the hippocampus in the brain and sudden unexpected death.
See H. Reisner, ed. Children with Epilepsy (1988); R. J. Gunnit, Living Well with Epilepsy (1990); O. Devinsky, A Guide to Understanding and Living with Epilepsy (1994); publications of the Epilepsy Foundation of America.
Neurological disorder caused by paroxysmal malfunction of neurons in the brain (seizures). It is characterized by strange movements or sensations in parts of the body, odd behaviours, emotional disturbances, and sometimes convulsions and momentary lapses of consciousness. Seizures may result from abnormal electrical activity in most or all of the brain (generalized), or they may originate in a specific brain area (partial). Causes include brain tumours, infections, genetic or developmental abnormalities, stroke, and head trauma, although no cause can be found in most cases. Treatment is usually with anticonvulsant medications; brain surgery may be beneficial if drugs cannot control seizures.
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