Epilepsy

Epilepsy occurs as a result of abnormal electrical activity originating in the brain. Brain cells communicate by sending electrical signals in an orderly pattern. Sometimes the brain cells communicate in an abnormal or uncontrolled manner leading to a seizure or epileptic episode.

This is where the work of a neurologist comes in. If you suffer from an epileptic seizure, you may start behaving differently. Or you may feel a brief loss of awareness. Sometimes patients would experience convulsions or even unconsciousness.

Anyone of us can have a seizure in certain circumstances - about one person in 20 has a seizure at some point in their life. However, we would only call it epilepsy only if you are likely to have recurring seizures. About one person in 200 has epilepsy, making it quite a common condition.

So how can a neurologist like myself help you with the treatment of epilepsy? Generally, epilepsy is successfully treated with antiepileptic medications. About 60-70% of people with epilepsy will be able to control their seizures by simply taking medication. The remaining 30-40% may continue to have seizures but they would occur less frequently.

There are many different antiepileptic medications. The choice of antiepileptic medication depends on a number of factors including:

• your type of seizure or epilepsy
• your age
• your gender
• your other medical conditions or general health
• your informed opinion

This is where, in my work as a neurologist in Perth, I take the time to go over your specific situation and your medical history. It’s essential to look at the bigger picture and to listen to your own story and your experiences, before making decisions about medication.

When you start taking medication to control your epilepsy symptoms, and you still have seizures, we may consider other treatment options. They can include vagus nerve stimulation or surgery.

If you suspect you have had a seizure, I recommend that you see your doctor as soon as possible. A seizure can be a symptom of a serious medical issue. In order to diagnose epilepsy, your GP will most likely refer you to a neurologist. And the role of the neurologist is then to confirm the diagnosis of epilepsy, and to discuss which treatment is most appropriate for your situation.

You may wonder if there is a cure for epilepsy. The straightforward answer is no, at this stage there is no known cure for the condition. But research and the advancements in modern medicine allow us to work out the best possible treatment. And that, in most patients, leads to dramatic improvements, and to a better quality of life.

On the other hand, not seeking help or not having access to a qualified neurologist, may mean that your epilepsy is left undiagnosed, untreated, and causes complications. During a seizure, an epilepsy patient can sustain serious injuries. In other cases, we have seen that uncontrolled or prolonged seizures lead to brain damage. As we have established, epilepsy is all about abnormal electric activity in the brain, and if this abnormal situation is not treated, it causes abnormal functioning of the brain. Experts also agree that epilepsy may increase the risk of sudden unexplained death.

At my practice in Perth I often get questions about the exact cause of epilepsy as a condition. Through scientific research in this area, we have learned that there are quite a few main causes:

• Genetic predisposition: something in your genes that makes certain people more prone to developing the symptoms.
  
  
• Developmental disorders of the brain: a disorder in the early stages of life, causing this abnormal electrical activity.
  
  
• Perinatal brain injury: a lack of oxygen at birth can cause this type of brain damage.
  
  
• Febrile convulsions in infancy
  
  
• Infectious diseases of the brain: infections such as meningitis or encephalitis
  
  
• Traumatic brain injury: brain damage caused by an accident, for example
  
  
• Scarring on the brain after a brain injury (post-traumatic epilepsy)
  
  
• Stroke or other vascular diseases
  
  
• Brain tumour
  
  
• Neurodegenerative disorders such as Alzheimer’s disease

Part of my role is to create clarity around the exact cause of your epilepsy. And another role your neurologist plays, is to create clarity around the triggers. They are not the direct cause, but they are specific situations that initiate a seizure.

For example: you may be tired, or suffer from some form of sleep deprivation. You may be stressed. Another trigger could be the use of alcohol. Or, simply the fact that you have been given epilepsy medication and forgot to take it.

To assess if you suffer from epilepsy, at my practice in West Leederville Perth, I may recommend one or several of the common neurological tests:

• Neurological examination
• Blood tests
• EEG
• Video-EEG monitoring
• CT Scan
• Cranial MRI
• PET
• SPECT

The tests I recommend will be based on your personal situation. And the next important step is to make sure that you get a clear explanation of what the test has told us, so you are clear about the results and about your diagnosis.