Understanding Epilepsy
- Apr 10
- 4 min read
Causes, Diagnosis & Treatment
What is Epilepsy?
Epilepsy is a neurological disorder characterised by repeated seizures. A seizure is a sudden alteration in behaviour caused by temporary changes in the brain’s electrical activity. Normally, the brain generates tiny electrical impulses in an orderly pattern, which travel along neurons and throughout the body via neurotransmitters.
In epilepsy, the brain’s electrical rhythms become imbalanced, leading to recurrent seizures. These sudden bursts of electrical energy can affect consciousness, movement, and sensations.
How is Epilepsy Diagnosed?
Epilepsy is usually diagnosed after a person has had at least two seizures that were not caused by another medical condition (such as alcohol withdrawal or low blood sugar).
If seizures originate from a specific area of the brain, the initial symptoms may reflect the functions of that brain region. For example, if a seizure begins in the right side of the brain, which controls movement on the left side, the seizure may start with jerking of the left thumb or hand.
Types of Seizures
Seizures are broadly classified into two categories:
1. Primary Generalised Seizures
Begin with a widespread electrical discharge that involves both sides of the brain.
Hereditary factors are more likely to play a role in primary generalised epilepsy.
2. Partial Seizures
Begin with an electrical discharge in a limited area of the brain.
Some are related to brain injury, infection, stroke, or tumors, but in most cases, the cause is unknown.
Consciousness may be impaired or preserved depending on the seizure type.
Risk Factors for Seizures
The following factors can increase the risk of seizures in individuals predisposed to epilepsy:
Stress
Sleep deprivation or fatigue
Skipping meals
Alcohol or drug use
Failure to take prescribed anticonvulsant medication
Approximately 50% of individuals who experience one unprovoked seizure will have another within six months. The risk of developing epilepsy increases if the seizure is associated with a brain injury or abnormality.
Prevalence of Epilepsy
According to the Epilepsy Foundation:
50 million people worldwide have epilepsy.
Three million people in the U.S. are affected.
10% of the population will experience a seizure at some point in life.
More than 300,000 children under the age of 15 have epilepsy.
570,000 adults over 65 suffer from epilepsy, often due to strokes or neurodegenerative diseases like Alzheimer’s.
Common Causes of Epilepsy by Age
Children – Birth defects, infections, or head injuries.
Young Adults – Severe head injuries or brain infections.
Middle Age – Strokes, tumors, and injuries.
Older Adults (65+) – Stroke is the leading cause, followed by Alzheimer’s disease.
Epilepsy Risk Factors
Premature birth or low birth weight
Brain trauma (lack of oxygen during birth, severe head injuries)
Abnormal brain structures
Brain tumors or stroke
Infections such as meningitis or encephalitis
Family history of epilepsy
Alcohol or drug abuse
Diagnosing Epilepsy
A doctor diagnoses epilepsy using:
Electroencephalogram (EEG) – Measures electrical activity in the brain.
MRI or CT Scan – Detects brain abnormalities such as tumours or structural issues.
Video-EEG Monitoring – Records seizures and brain activity.
Neuropsychological Testing – Assesses memory and cognitive function.
Proper diagnosis is essential to determine the type of epilepsy and seizures.
Treatment Options for Epilepsy
1. Medications (Antiepileptic Drugs – AEDs)
First-line treatment for epilepsy.
Prevent seizures by reducing abnormal brain activity.
Effective in 70% of patients.
2. Diet Therapy
Ketogenic Diet – High-fat, low-carbohydrate diet.
Modified Atkins Diet – Less restrictive alternative.
Used for children with drug-resistant epilepsy.
3. Surgical Treatment
For patients with medically-resistant epilepsy, surgery may be the best option. Dr. Prem Pillay, an expert in epilepsy surgery at Singapore Brain Spine Centre, explains that surgical intervention is considered for patients:
✅ Whose seizures originate from a specific part of the brain.
✅ Who do not respond to medication.
✅ Who have a brain tumor, AVM, or other structural abnormality causing epilepsy.
Surgical Procedures Include:
Lesionectomy – Removes a tumour or lesion causing seizures.
Lobectomy – Removes the affected brain lobe (most commonly the temporal lobe).
Corpus Callosotomy – Cuts nerve fibers connecting the left and right brain hemispheres.
Vagus Nerve Stimulation (VNS) – A device implanted in the chest to reduce seizure frequency.
Responsive Neurostimulation (RNS) – A device implanted in the brain to detect and stop seizures.
Living with Epilepsy
People with epilepsy may face risks such as:
Status Epilepticus – Prolonged seizure activity, a medical emergency.
Sudden Unexpected Death in Epilepsy (SUDEP) – Rare but serious condition.
Despite these risks, 70-80% of epilepsy patients can successfully control seizures with medication or surgery.
Key Takeaways for Managing Epilepsy:
Follow prescribed treatments carefully.
Identify and avoid seizure triggers.
Maintain a healthy lifestyle with proper sleep, nutrition, and stress management.
Regularly consult with your doctor for optimal care.
Comprehensive Epilepsy Care at Singapore Brain Spine Centre
At Singapore Brain Spine Centre, we offer:
✅ Expert epilepsy diagnosis & management.
✅ Advanced medical imaging (EEG, MRI, CT scans).
✅ Surgical treatment options for drug-resistant epilepsy.
Take Control of Epilepsy, Seek Expert Care Today
If you or a loved one is struggling with seizures, nerve pain, or chronic epilepsy, expert neurological assessment and treatment can help improve quality of life.
📞 Book a consultation today at Singapore Brain Spine Centre and take the first step toward better epilepsy management.
