Epilepsy can be disruptive, but medication and advanced treatment can help.
Our brains constantly produce electrical activity. “That’s what allows us to talk, move and function,” says Brad Kamitaki, MD, a neurologist at Robert Wood Johnson University Hospital (RWJUH) and Rutgers Robert Wood Johnson Medical School.
But in some people, the brain’s electrical activity fires abnormally and can cause a seizure—a condition known as epilepsy that is one of Dr. Kamitaki’s specialties. “Seizures vary widely in severity depending on what part of the brain is affected,” he says.
Fortunately, epilepsy can be managed, beginning with greater understanding. Dr. Kamitaki explains more about this sometimes misunderstood neurologic condition.
What are some different types of seizures?
Some people have what used to be called grand mal seizures, which we now refer to as generalized tonic-clonic seizures. These are significant events with whole-body shaking and loss of consciousness.
Adults may have temporal lobe seizures, which often start with an aura, or a sense of the seizure coming on, sometimes through feelings such as déjà vu, nausea, fear or abnormal tastes or smells. These progress to loss of awareness that may or may not include shaking, often of the limbs.
Children commonly have absence seizures, which involve brief, sudden losses of consciousness—usually less than 20 seconds—that may look as if the person is just zoning out or staring into space.
And there are more severe childhood seizure disorders that can be associated with delays in language and cognitive function, probably due to both the disease and the consequences of frequent seizures.
What causes epilepsy?
Epilepsy includes a range of seizure disorders that can be caused by any process affecting the brain’s cortex and higher cognitive function. Sometimes the cause is genetic—either inherited or the result of a unique mutation. Other causes include lack of oxygen to the brain when a baby is delivered, brain tumors, strokes and brain infections. But in up to half of people with epilepsy, seizures are unexplained.
What are common misconceptions about epilepsy?
One is “Put something in the mouth of a person having a seizure so they don’t swallow their tongue.” You can’t swallow your tongue, and putting something in someone’s mouth might cause choking. Instead, roll the person on their side to keep them from choking or aspirating saliva or vomit.
Another is “You can never drive if you have epilepsy.” In New Jersey, if you’ve been seizure-free for six months or more, you’re allowed to drive.
And some people say, “Epilepsy means you can’t live a normal life.” Many people with epilepsy work, go to school and have complete and fulfilling lives.
How can epilepsy be managed?
Some children grow out of absence seizures, but most people with epilepsy are at risk for future seizures. My goal for patients is zero seizures. Medication leaves about two-thirds of patients seizure-free with the first or second drug they try. Those who try at least two and keep having seizures should see a specialty-trained epileptologist at an epilepsy center like RWJUH, which is ranked at the highest level by the National Association of Epilepsy Centers.
We offer a full range of advanced epilepsy services, including several surgeries found to be effective against drug-resistant epilepsy. We’re also involved in clinical trials, including studies of an inhaled medication to stop seizures as they’re happening and a transcranial direct current stimulation unit, which, unlike other devices for treating epilepsy, is noninvasive.
To learn more about epilepsy treatment at Robert Wood Johnson University Hospital, call 732-235-7733.