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Children’s Section

Junior Encyclopaedia

A

Absence Seizures used to be called “petit mal” seizures.

If you had an absence seizure you would just look as though you were daydreaming. You would just stare into space, paying no attention to what is going on. You might even get told off at school for not paying attention!

You would not be aware of anything that is going on in class because your brain would be “switched off” for between 5 and 15 seconds. Sometimes the eyelids flutter during an absence seizure.

Absence seizures can happen lots of times a day, until somebody spots what the problem is and treats it properly with tablets of medicine. A lot of children have absence seizures.

An absence seizure is a type of Generalised seizure.
To adhere means “to stick to” and you are asked to stick to taking the medicine your doctor has prescribed for you.

When doctors use the word “adherence” they are talking about their patients taking their medicines properly – or in other words the right dose at the right time. The sensible thing to do to avoid having seizures is to do as the doctor tells you.

This is very important because medicines only work if they are taken regularly every day and not just when you feel like it. Sometimes people think that they can stop taking their medicines because they haven’t had a seizure for a long time. This is, of course, a big mistake – it is the medicine that is stopping the seizures.
If you had an Adversive seizure your eyes or head or both would turn slowly to one side. If it is both, sometimes your eyes move first, followed by your head, or sometimes your head moves first.

Sometimes even your whole body would follow the eyes. The eyes, head or body may turn to either the right or left side.

An adversive seizure is usually followed by another type of seizure, called a complex partial seizure, but may also be followed by a different type of seizure called a generalised seizure . It may start in the frontal lobes of the brain. An adversive seizure can be a simple partial seizure or the beginning of a complex partial seizure.
Alexander was King of Macedonia, a part of ancient Greece. Most people think he was the greatest general of ancient times. As a young prince he was extremely clever and his teacher, Aristotle, taught him how to think as a scientist.

As he grew up he became interested in treating the sick, and was widely loved by the people of his country. By the time he was 32 his kingdom stretched into Egypt and as far away as India. A huge amount of the eastern world was under his rule.

Alexandria, the second largest city in Egypt, is named after him. The fact that he had Epilepsy did not stop him from becoming one of the greatest warriors of the ancient world.
Sometimes an EEG at the hospital shows nothing unusual. If the doctors want to investigate further, the person might get an ambulatory EEG. This is an EEG, which is recorded whilst the person is moving about and doing things in everyday life (instead of lying down, as happens in an ordinary EEG).

Electrodes (tiny wires) are fixed to the head and the leads are connected to a small cassette recorder which is carried around like a personal stereo. The EEG is recorded onto the cassette throughout the day and night. It doesn’t matter whether the person is at school, playing or watching the TV – the recording is made wherever the person is.

The recorded tape is then taken to the hospital and put into a computer. The computer shows the EEG recording, so that any problems can be noticed. This information may help the doctor in deciding what seizures might be happening and which treatment to use.
All animals have brains and so they can have epilepsy.

It is not unusual for pet dogs and cats to be treated by a vet for epilepsy.

Obviously, animals in the wild can’t visit a vet, so they can’t take advantage of medicines to control seizures .
Medicines which are used to stop epileptic seizures are called antiepileptic medicines

Over the years, scientists and doctors have worked hard to find medicines which will control epileptic seizures. They have made a lot of progress and many very good medicines are now available to treat epilepsy.
Antiepileptic medicines are also called antiepileptic drugs or anticonvulsants. Choosing the best medicine for each individual person is also very important. It is just as important to make sure that it is taken regularly. If the drugs are not taken properly then they will not be able to do their job.
Anyone who doesn’t take the drugs as and when they are prescribed by the doctor, runs a big risk of having more seizures.

Antiepileptic medicines usually come in tablets. Sometimes, however, they can be in a syrup, or in sachets containing medicine as a powder or granules which dissolve in water to make a drink or to be sprinkled over food.

The medicines do not cure epilepsy but they do usually control seizures. Some people may need to take the medicine for all of their lives, while other people only have to take antiepileptic medicine when they are children. Some people seem to just grow out of having seizures. If they have had no seizures for a long time the doctor might think that they no longer need the medicine.

Every antiepileptic medicine has two names. One of the names is the name of the main chemical from which the medicine is made. The other name is the one used by the company which produces the drug and is called the trade name of the drug.

Sometimes the same drug is produced by more than one company so it can have more than one trade name.
If you had an atonic seizures , your muscles would suddenly relax and you would fall or flop to the ground.

This might cause a head injury and those who have many atonic seizures sometimes have to wear protective helmets.

Atonic seizures are sometimes called “drop attacks”.

An atonic seizure is thought to be a type of generalised seizure.
This is a word which simply means “warning”. It comes from a Greek word meaning “breeze”.

An aura is actually a very short simple partial seizure. Some people get an aura just before they have a longer seizure, especially if it is going to be a complex partial seizure.

In children this warning might be a strange and sometimes uncomfortable feeling in the stomach which rises into the throat, or it might even be a strange taste or smell, which can be unpleasant. Others may feel that they are “looking in on themselves” or may become aware of a familiar noise or piece of music which is not really there.

One strange aura is called “deja vu” which means feeling as though you’ve been in exactly the same situation before – but you haven’t.

B

Hans Berger was a German scientist who, in 1929, discovered that tiny electrical currents coming from the surface of the brain could be measured and recorded on a machine called an electroencephalogram (EEG).

This was a very important discovery and it is still used today in helping doctors to treat patients with epilepsy.
You have to have a brain to have epilepsy. Your brain controls every single action of your body. How clever you are, how you think, talk, hear, see, feel and move – all these things depend on your brain. It works 24 hours a day, every day!

The brain is made up of thousands of millions of cells called neurons (nerves). To give you an idea of how many neurons there are in the brain, imagine a container the size of a bath being full to the top with salt. There are still more neurons in your brain than there would be grains of salt in that bath!

As you get bigger, the number of cells in the rest of your body increases. This doesn’t happen with neurons. Instead, each neuron just gets bigger and links up more and more with other neurons.

In fact, as we get older the number of neurons actually gets smaller because a few die every day.This doesn’t matter because there are so many to start with!

The links between neurons allows them to communicate with one another. They do this by sending tiny electrical signals to each other. The number of connections possible between all the neurons in your brain is impossible to count, just because there are so many. It is these links which make your brain far more powerful than the biggest and best computers ever invented.

Like any complicated thing, however, the brain can develop faults. Sometimes the fault could be that the electrical signals, which constantly flash backwards and forwards between the neurons, become uncontrolled, and this can cause a seizure. Many people will have at least one seizure during their lives.

If they have seizures regularly then doctors say that the person has epilepsy. The type of epileptic seizure depends on the sort of fault and where it is happening in the brain. This is because the brain is organised into different parts, with each part doing different jobs.

The human brain has 3 major parts, the Cerebrum, the Cerebellum and the Brain Stem.

The cerebrum, or the outside part of the brain, is divided by a deep groove, into two halves called hemispheres.

The left hemisphere controls what is happening down the right hand side of the body, while the right hemisphere controls what is happening down the left hand side of the body.
The two hemispheres take up 2/3 of the total weight of the brain and each one is divided into four main areas called lobes

– the frontal lobe
– the parietal lobe
– the temporal lobe
– and the occipital lobe.

Although there is still a lot to be found out about the work done by the different lobes, it is thought that the frontal lobes control voluntary movement; the parietal lobes control such things as touch and involuntary movement; the temporal lobes control such things as speech and hearing; and the occipital lobes control vision.

The cerebellum, which is just underneath the back of the hemispheres, makes sure that all the jobs are organised properly and that everything works together in the correct way and at the right time. This is particularly important for how we balance on our feet.

Right underneath the hemispheres is the brain stem which controls important jobs like breathing and heartbeat. It also ‘loins’ the brain with the spinal cord.

The brain stem was the first part of the brain to develop or evolve – it existed even in prehistoric apes, which are our distant ancestors.

No one part of the brain is entirely responsible for any one job. All the parts are interconnected and share their work.

The human brain is still the most wonderful and complicated thing that we know about in the whole universe.
This is a special way of using EEGs.

The EEGs are fed into a very special computer to try to find out exactly where the seizure may be starting in the brain.

Most children don’t need this test.

C

Nearly every type of job is open to people with epilepsy . There are a few, however, which would be unsuitable and it is better to know which these are before deciding what sort of work to look for after leaving school.

A lot of young people, with well controlled epilepsy, leave school to study at colleges and universities. After finishing their studies they start work where they have to use their brains more than their hands. Lots get jobs as doctors, nurses, civil servants, lawyers and teachers. The list is endless.

Other people learn skills which allow them to work in factories, shops or perhaps outside. A person with well controlled epilepsy should have no problem for most jobs. For example, there are international sports stars who have epilepsy and they haven’t let it get in the way of reaching the very top in their own sports.

The jobs which are not open to people with epilepsy include driving heavy lorries or buses, trains, aeroplanes, etc.

A person with epilepsy would have great difficulty in joining the army, navy, air force, fire brigade or the police force. It would not be a good idea for somebody with epilepsy to become a deep sea diver or a scaffolder.

As long as these jobs are avoided, young people with epilepsy can have a very successful and satisfying career.
Carbamazepine is the name of the chemical used in the drug Tegretol® and also Tegretol Retard®

See Antiepileptic Medicines
Julius Caesar was one of the greatest generals who ever lived – he was extremely clever and courageous. One writer described him as a superman and genius for the way he led the Roman Empire.

Caesar arrived on the shores of Britain in the year 54 BC . His invasion made him a great hero in the city of Rome. He remained the world’s most powerful man until March, 44 BC, when he was stabbed to death by a group of men led by Brutus and Cassius.

Throughout his life he kept in very good health. The fact that he had epilepsy didn’t affect his success in any way.
A CAT Scanner is a special type of X-ray machine.

CAT stands for Computer Assisted Tomography.

When doctors need clear pictures of the brains they can use X-rays. Ordinary X-ray machines aren’t much use for this.

A CAT scanner takes a few X-ray pictures and then feeds them into a computer. This computer makes very clear detailed pictures of the brain, rather like cross sections.

A specialised doctor (called a radiologist) looks at these pictures for any problems in the brain.

To have a CAT scan you lie down on a type of bed, which is moved by an operator (called a radiographer) so that your head is surrounded by the special X-ray scanner. You have to lie still until the machine has finished the job. It only takes a few minutes. There is no pain and it is not at all uncomfortable.

Most important of all, it is quite safe.

Most children with epilepsy do not need to have a CAT Scan.

This is not always a sensible activity if you have epilepsy scrambling across low objects is no problem, but climbing up trees, cliffs and mountains can be dangerous. If you lose consciousness in a seizure, whilst half way up a tree or a ladder, there is only one way you are going to go and that is downwards!

The problems which that can cause are obvious. It is far better not to climb than to finish up in hospital with broken bones or perhaps a serious head injury.

Clobazam is the name of a chemical used in the drug Frisium®

See Antiepileptic Medicines
Clonazepam is the name of the chemical used in the drug Rivotril®

See Antiepileptic Medicines
The word clonic comes from the word “clonus” which means to contract and relax alternately.

If you had a clonic seizure the muscles in your body would contract, relax, contract again and so on. This would cause you to jerk or twitch repeatedly.

Clonic seizures are a type of convulsion.

A clonic seizure is usually a type of generalised seizure.
These types of seizure happen when one part of the brain, usually a part called the temporal lobe or frontal lobe, doesn’t behave as it should do.

Complex partial seizures are different from a generalised seizure because only part of the brain is involved in partial seizures – not the whole brain. However, although a complex partial seizure may start in one part of the brain it can then go on to affect the whole brain.

When this happens it is called a secondarily generalised seizure. They are different from the other main type of partial seizure, simple partial seizures, because in complex partial seizures the person is not fully conscious.

There are two temporal lobes, one on the left side and one on the right side of the brain. They are very complicated and control such things as our memory and our senses of smell and taste. They also organise our sense of timing and such things as our understanding of music. Imagine the problems when a temporal lobe fails to work properly.

If you have epilepsy which involves complex partial seizures, the start may be a funny feeling in your tummy which rises up into the throat. You might have a funny taste in your mouth or think that there is a strange smell or you might even believe that there is a familiar piece of music being played. Such feelings are called auras but, in fact, they are seizures in themselves.

After the aura you might behave in strange ways by smacking your lips or plucking at your clothes. You might wander about the room without any purpose and appear confused or dazed. Complex partial seizures are the usual type of seizure that occurs in temporal lobe epilepsy. These seizures can last anything from a few seconds up to a few hours.

Complex partial seizures can also start in the frontal, parietal or occipital lobes. When they start in the frontal lobe they often cause adversive seizures.
A convulsion is when the muscles of the body move out of control. All the muscles of the body can become stiff and then jerk. This can involve the arms, legs and face. This can last for between 2 and 5 minutes. Very occasionally it can last for longer. If this happens doctors call it status epilepticus.

When the bladder is full and the muscles controlling it contract, people having convulsions sometimes wet themselves.

A convulsion can look frightening to those who have never seen one before.

People having convulsions which affect the whole body are unconscious and do not feel a thing. They are not painful.

Many people with epilepsy do have convulsions. The most common type of epilepsy with convulsions is called “grand mall) epilepsy.

The correct name is tonic-clonic seizures. A tonic-clonic seizure is a type of generalised seizure.

When people use the word convulsion, they are usually talking about a tonic-clonic seizure. It is possible, however, for somebody to have convulsions which don’t affect the whole body.

The convulsions might just affect one side of the body. This is often called a clonic convulsion. In these cases, the person doesn’t always lose consciousness during the convulsions.
Many children are told that they can’t ride a bicycle because they have epilepsy. This is not correct. Children with epilepsy can ride bicycles provided that they ride them in safe areas. What they must not do is to ride them on busy roads where there is danger from traffic.

Everybody should wear a helmet when riding a bicycle, not just people with epilepsy.

D

A trip to the swimming pool is great fun, and all children should learn to swim whether they have got epilepsy or not.

Diving boards can be dangerous for people with epilepsy because if they have a seizure and fall from the diving board they can suffer serious injury or fall on somebody else.
Fyodor Dostoevsky was born in Moscow, the capital of Russia.

After leaving school, he joined the army and became an engineer. He disliked army life, and, when he left, he took up writing books, something he had always wanted to do.

He wrote many short stories and articles in magazines but he is most famous for his books. His most famous books are “The Idiot” and “The Devils”.

In some of his books he wrote about his epilepsy . Experts say that he was one of the greatest story tellers that ever lived.
Most young people look forward to the day when they can drive a car, and it is no different for those with epilepsy. People with epilepsy can qualify for a driving licence if they have been free from any type of seizure for at least one year, even if they are taking anti-epileptic tablets or medicine.

If they have seizures, but only while they are asleep, they can still qualify, as long as there have been no daytime seizures for the previous 3 years in the UK or 2 years in Ireland.

The details of the rules and regulations can be obtained from the Epilepsy Associations.

It can be very difficult, however, for a person with epilepsy to obtain a licence to drive LGVs (large goods vehicles) or PCVs (passenger carrying vehicles) in the UK and it is not possible in Ireland.

E

By law, all children have to receive a full education to prepare them for later life. Children with epilepsy are no exception.

If you have epilepsy then, as a rule, you can take part in all lessons taught in a school and are expected to do homework when it is set. You are treated as a normal child who just happens to have epilepsy.

Having epilepsy is no excuse for not working hard. By the time you leave school you should be educated well enough to live confidently as an adult.

Some children with severe epilepsy, or perhaps those for whom epilepsy is not the only problem, do attend special schools. The vast majority of children with epilepsy, however, should be able to attend their local neighbourhood schools.
This is a machine which is used to record the tiny amounts of electricity given off by the brain.

Wires, called electrodes, are attached to your head, sometimes using a rubber net or by a special glue.

The brainwaves, which the brain gives off all the time, are picked up by the electrodes and fed into the machine. A picture of these brainwaves is traced onto a piece of paper or a video screen for doctors to study.

The tracings are called an electroencephalograph. The letters EEG also stand for electroencephalogram.

At some time during the test, the EEG operator will flash lights in your eyes (this is to look for photosensitivity). You will also be asked to blow at a tissue in order to breathe quickly (this is called hyperventilation).

Electricity does not go from the machine into the brain ; it is the brain which gives off the electricity. There is absolutely no pain during the test.

The machine is just an amplifier – it amplifies or enlarges the tiny amounts of electricity from the brain so that they are big enough to show up on the graph.

This is a trace of the brainwaves recorded by the electroencephalogram. Each line on the graph gives a picture of the brainwaves being produced by a different part of the brain.

Sometimes, although a person has epilepsy the EEG does not pick up any epileptic type patterns. In this case, the person might be asked to wear an ambulatory EEG for a while.

This is a normal EEG trace. The trace changes towards the right because the eyes were opened for a short while.

The brainwaves are abnormal over the whole of the brain for the short spell of this seizure (an absence seizure in this case).
Emeside® is a trade name for the drug ethosuximide. Ethosuximide is taken as soft orange capsules or as a syrup which can be blackcurrant or orange flavoured.

It is used in the treatment of absence seizures and, occasionally, myoclonic seizures. It is of no use in treating partial seizures or tonic-clonic seizures.

See Antiepileptic Medicines.
Epanutin® is the trade name for the drug Phenytoin. It is taken as capsules or as cherry red syrup. It is used in the treatment of both generalised tonic-clonic (or grand mal) seizures and partial seizures.

See Antiepileptic Medicines.
As long as there have been men and women on earth there have been those with epilepsy. The word “epilepsy’ comes from a Greek word meaning to take hold of”. In ancient times it used to be called “the falling sickness”. In those days this was a good description because people thought that there was only one type of seizure -the person fell to the ground and had convulsions. These days we call these tonic-clonic seizures.

Today, however, we know a lot more about epilepsy and have learned that there are many different types of epileptic seizure. The term “falling sickness” is no longer used.

Epilepsy is not a disease which you can catch, it is just a symptom that part of the brain is not always working normally. When the brain is working normally it gives off tiny amounts of well organised electricity. Electricity pylons carry electricity in a well organised way, just like neurons in the brain when everything is working normally. However, when somebody is having a seizure the electricity becomes very disorganised – a bit like flashes of lightning during a thunderstorm. The type of seizure the person has depends on the place in the brain where the “storm” happens.

Epilepsy is a condition where a person has reported seizures. A single “one off” seizure is not epilepsy – at least two or three seizures must have occurred before a doctor will label the condition as epilepsy. A great many people will have a single seizure at some point during their lives, but this won’t be epilepsy.

It is thought that at least one person in every two hundred has got epilepsy. This means that in the UK and Ireland there are at least 110,000 children with epilepsy – more than enough to fill a large football ground, like Cardiff’s Millennium Stadium and Dublin’s Croke Park.

Every day you are bound to pass at least one person who has epilepsy, whether you know it or not. Most schools have more than one pupil with epilepsy. Epilepsy is very common, so it is hard to understand why so many people know so little about it.
These are voluntary groups of people who work hard to make life as good as possible for people with epilepsy.

Epilepsy Associations offer all sorts of support such as setting up groups of people with an interest in epilepsy, producing leaflets and providing expert help for parents and children who live with epilepsy every day. They also raise money to help scientists and doctors find out more about the condition and come up with better treatments.

The two associations who have produced this CD are

Brainwave
The Irish Epilepsy Association
249, Crumlin Rd, Dublin 12
Tel: 00 353 1 455 7500
Fax: 00 353 1 455 7013
Email: info@epilepsy.ie
Website: www.epilepsy.ie

Mersey Region Epilepsy Association
PO Box 1348, Warrington, WA4 9UB
Tel: 07795 345 280
info@epilepsymersey.co.uk
www.epilepsymersey.org.uk

A full list of epilepsy organisations can be obtained from the Joint Epilepsy Council of the UK and Ireland (JEC) website: www.jointepilepsycouncil.org.uk

In some hospitals there are nurses who are specially trained to help people with
Epilepsy
. These nurses work in both children’s hospitals and in adult’s hospitals. They help people to get the best out of life though they have epilepsy. There are also some Epilepsy Nurses who work out in the community.

Very often the epilepsy nurse will explain a lot about epilepsy to people such as teachers and other nurses, who are working with children who have seizures, so that they understand what is happening and how best to help.

Epilim® is a trade name for the drug sodium valproate. It is taken as lilac-coloured coated, or plain white tablets. It can also be taken as a red cherry flavoured liquid. It is used to treat all types of generalised seizures and partial seizures.

See Antiepileptic Medicines.
Ethosuximide is the name of the chemical used in the drugs Emeside® and Zarontin®

See Antiepileptic Medicines

F

There are very few things which have to be done to help someone who is having a convulsive seizure.

These are:
Move objects out of the way which could hurt the person having the seizure.
In the photograph the coffee table is being moved so that the girl will not bang her head against any hard or sharp edges.

If possible, place something under the person’s head so that the head doesn’t bang against the floor, causing injury. In the photograph a cushion is being used, but a rolled up coat or jumper would do just as well.

Let the seizure run its course.

When it is over, move the person to a comfortable place. Sometimes the person needs to be carried because of extreme tiredness, but usually only a little help is needed.

Let the person have a sleep or at least a good rest.

Never force anything into the mouth during the seizure.

Some people wrongly think that you need to do this in order to prevent the person’s tongue getting bitten. The worst that can happen with a bitten tongue is that it will hurt for a day or two – it heals very quickly.

The worst that can happen if something is forced in the mouth is that teeth will get badly broken -these will never heal.

If one seizure follows another without the person regaining consciousness, or if a seizure lasts longer than 5 minutes, get help immediately.
This is the old fashioned word for a seizure or a convulsion.
Focal seizures (motor)
OR Focal Motor Seizures
The word ‘focal’ comes from ‘focus’ which means centre point and ‘motor’ means movement. Put the two together to get ‘movement from a centre point’.

If, therefore, the point of the brain which controls the movement of the left arm goes out of order then that arm will move out of control. So it is with other parts of the body. This movement is, in fact an epileptic seizure. A focal motor seizure is a type of simple partial seizure. When talking about Epilepsy and seizures the words “focal” and “partial” mean the same thing.
Focal seizures (sensory)
OR Focal Sensory Seizures
The word ‘focal’ comes from ‘focus’ which means centre point and ‘sensory’ means ‘feeling’. Put the two together to get ‘feeling from a centre point’.
So, if the part of the brain which looks after such feelings as tingling in the fingers goes out of order then the person will get a tingling feeling in the fingers. These feelings are, in fact, an epileptic seizure. A focal sensory seizure is a type of simple partial seizure. A simple partial sensory seizure is the same as an aura.
Frisium® is a trade name for the drug clobazam. It is rarely used in the treatment of epilepsy but is sometimes taken along with another antiepileptic drug. It comes in capsules or, occasionally, as a tablet or special liquid.

See Antiepileptic Medicines.
These are important parts of the Brain at the front of the head, just behind the forehead.

The job of the frontal lobes is still something of a mystery, but scientists and doctors do know that they are very important with personality, some emotions and how we plan and organise things.

A seizure can start from inside a frontal lobe and give rise to complex partial seizures and adversive seizures.

G

Gabapentin is the name of the chemical used in the drug Neurontin®

This medicine is used to treat generalised tonic-clonic (grand mal) seizures and partial seizures.
In this type of seizure the whole brain is affected by the electrical disturbance. People having a generalised seizure are completely unaware of what is going on because they are unconscious.

Types of generalised epilepsy are: tonic-clonic seizures, absence seizures, myoclonic/jerk seizures, atonic (drop attacks) tonic seizures and clonic seizures. Seizures which aren’t generalised are called partial or focal seizures.

Generalised seizures are different from partial seizures because the whole brain is involved. Only part of the brain is affected in partial seizures.
Antonius Guanarius lived in the 16th century and was one of the first doctors to study epilepsy.

He advised people how to avoid seizures and also gave first aid advice. His methods were very strange and quite useless although he meant well.

He recommended that on seeing a person having a seizure the onlooker should kill a dog and give the bile to the patient. This, he said, would make the patient completely well.

The tablets for preventing seizures were to be made from the rib of a man who had been hanged or beheaded. These were to be taken with water!

You won’t be surprised to know that neither of these cures made the slightest difference (except to the dog!).

H

Hammurabi was King of Babylon. He ruled his kingdom using laws which were carved on to a long stone pillar and placed in the Hanging Gardens of Babylon. He called this his Code.

Two of his laws were for people with epilepsy. One was that people with epilepsy were not allowed to marry. The other said that they were not allowed to appear in a court of law, either as a witness or as a member of a jury.

He thought that these were good laws but really they were very unfair. The problem was that he didn’t understand epilepsy. He thought that if people with epilepsy got married and had children then the children would have epilepsy too.

He also thought that people with epilepsy were not clever enough to judge other people. In other words he didn’t know what he was talking about!

The actual stone pillar can be seen today at the Louvre Museum in Paris.
George Frideric Handel was one of the world’s most brilliant and best loved musicians. He was born in Germany and when he was very young his parents noticed his love of music.

His father wanted him to be a lawyer but Handel just wanted to write and play music. He left Germany and moved to England, where he continued writing his wonderful music.

Two of his most famous works are “The Messiah” and “Water Music”. The Messiah was first performed in Fishamble Street, Dublin in 1742 and a re-enactment of a performance takes place there each year.

This great genius, who had epilepsy is buried in Westminster Abbey in London.
In 1912 this German scientist discovered that the drug phenobarbitone was very good at preventing seizures. It was the first real breakthrough in treating people with epilepsy.

Many thousands of people with epilepsy started to take the drug and it improved their lives tremendously.
Everybody at some time or other has a headache. People with epilepsy for various reasons, can have more headaches than others.

Very often a person can complain of a severe headache after tonic-clonic seizures. Fortunately this usually goes away after a good rest or sleep. Very rarely can a headache happen during a partial or focal seizure.
A hemisphere is part of the Brain. Every brain has two hemispheres. The two hemispheres are not totally separated.

They are joined together by a thick bundle of nerves called the corpus callosum.

The left hemisphere controls the right side of the body, while the right hemisphere controls the left side.

Partial or focal seizures may start in either of the two hemispheres (the whole hemisphere may be affected or just one part of the hemisphere).
Sitting under a plane tree on the Greek island of Kos, Hippocrates taught his students about causes and treatment of sickness. One of the disorders he studied closely was epilepsy.

In those days, many people thought that epilepsy had something to do with the position of the Moon! Hippocrates taught that this wasn’t true. Also, he said that epilepsy was nothing to do with being possessed by the devil, which many people had previously believed.

He taught his students that epilepsy was caused by something going wrong in the Brain. His explanation was that epilepsy was due to an excess of liquid in the brain. The explanation was wrong but nevertheless he was the first person to link epilepsy with a disorder of the brain.

All his work on epilepsy was published in his writings called “On the Sacred Disease”.
Hyperventilation means overbreathing.

Some children’s seizures are brought on by breathing too deeply or too quickly. This causes sudden changes in the amounts of carbon dioxide and oxygen in the bloodstream. The body often cannot cope with these changes and, if the person has generalised seizures there is a chance that an absence seizure will happen. Overbreathing does not usually bring on tonic-clonic or partial seizures.

During an EEG test, children, particularly younger ones, are asked to blow rapidly at a tissue held in front of them. This is to see if there is any change in the pattern of the graph being printed or displayed on a screen. If the blowing brings on an absence seizure then obviously the child can’t blow any more while the seizure is happening (because he or she is unconscious) and the tissue remains still. The doctor will look at the EEG trace to see what happens to the brainwaves when the child is hyperventilating.

I

IBE these are the initials of the “International Bureau for Epilepsy” which tries to improve public understanding of epilepsy throughout the world.
This term is used to describe epilepsy with no known cause. Doctors try very hard to find out what might be causing epileptic Seizure.

If no obvious cause can be found, the epilepsy is called idiopathic epilepsy.

Most people who have epilepsy have an idiopathic epilepsy .
ILAE These are the initials of the “International League Against Epilepsy” which is an organisation of doctors, with members all over the world. It tries to help doctors to find better treatments for epilepsy.
Infantile spasms are a severe type of Seizure which usually happen between the ages of 3 and 10 months.

The seizures are sometimes called “Salaam Attacks”. The infant’s head bends forward suddenly and with force, while the arms and the knees bend or straighten very quickly. The infant is often very upset and cries afterwards.

Each spasm lasts a second or less. These seizures or spasms may happen many times a day.

Adults who see this happening often just think that the baby has wind or ‘colic’.

J

John Hughlings Jackson is known as the “Father of English Neurology”. He became interested in epilepsy because of his wife. She would be quite relaxed and for no apparent reason her thumb would start twitching.

He realised that she was having some sort of epileptic Seizure and so he gathered information about other people who had the same type of problem.

He found out that some epilepsies start with a movement in a particular part of the body and can spread to other parts.

These seizures usually start in the fingers and then spread up the hand, arm and into the face. Other doctors agreed with his findings and called these movement seizures “Jacksonian Epilepsy”. Jacksonian seizures often start in a frontal lobe. Today they are called “focal motor seizures” .
This is an organisation of all registered charities working for and with people who have epilepsy.

Information about the work of JEC and of its its members can be found on the JEC website:www.jointepilepsycouncil.org.uk

K

Keppra® is the trade name for the drug levetiracetam.

Keppra® is used to treat partial and generalised seizures.

It is available as different coloured tablets containing different strengths or as a fruit flavoured liquid.

See Antiepileptic Medicines.
This is food which is rich in fat and oils. Ketogenic diets are sometimes recommended when seizures are not controlled properly by drugs.

People are only allowed to eat what is in this diet. It is occasionally successful but is not a very pleasant diet.

L

Lamictal® is the trade name for the drug lamotrigine.

It is taken as yellow tablets which may be swallowed whole or crushed and is used alone or with other drugs in the treatment of partial seizures and generalised tonic-clonic, absences and myoclonic seizures.

See Antiepileptic Medicines.
Lamotrigine is the name of the chemical used in the drug Larnictal®.

See Antiepileptic Medicines.
This type of epilepsy usually begins between the ages of 1 and 5 years and rarely after the age of 8 years.

It is named after two doctors called Lennox and Gastaut, who did a lot of research into epilepsy in children. Children with this Lennox-Gastaut Syndrome have Seizures of different kinds, and so it is a condition which is difficult to treat.

All types of seizures can occur in this epilepsy syndrome – particularly Tonic, Atonic, tonic-clonic, absence and complex partial seizures. Children (and adults) with this type of epilepsy may have status epilepticus.

Children with this type of epilepsy usually have some learning difficulties and may have to go to a school which specialises in teaching children who have learning problems.
This is the chemical name for the drug Keppra®.

M

People with epilepsy usually carry some form of identification to explain what sort of epilepsy they have and what sort of help they need should they have a seizure.

This information can either be on a simple card, or can be included on a piece of jewellery such as a necklace or bracelet.

An example of such jewellery is a Medic Alert. Information about the person’s epilepsy, together with a special telephone number and identification number, are engraved on the back of the jewellery.

Full details of Medic Alert’s jewellery can be obtained from the Medic Alert Foundation
Freephone: 0800 81420
Telephone: 020 7833 3034
An MRI scanner produces extremely clear and detailed pictures of the brain. It doesn’t use X-Rays like a CAT scanner. MRI stands for Magnetic Resonance Imaging. If you had this test you would have to lie still for a few minutes, surrounded by what looks like a CAT scanner. The test takes a little bit longer than a CAT scan but gives much better pictures of the brain.

The doctor studies the pictures to see if there is anything in the brain causing the person to have seizure. If the problem can be seen, sometimes it can be treated and, hopefully, the seizures will cease. Very often, nothing at all is found. .

Only a small number of children with epilepsy will need to have an MRI Scan.
“Myo” means muscle and “clonic” means jerk. So when a myoclonic seizure happens the muscles jerk. These jerks may look like sudden electric shocks and may cause the person to fall.

The most usual jerks happen in the arms and very often they happen early in the morning, just after waking, or in the evening before bedtime when the person is starting to get tired.

The person having the seizure loses consciousness, but does not seem to do so because the seizure is so short.

A myoclonic seizure is a type of generalised seizure.

N

Your nervous system links together all the nerves in your body. Nerves from all over your body are gathered together in the spinal cord and their electrical messages are carried to your brain. Nerve cells are sometimes called neurons.

The body’s nervous system is divided into two parts -the central nervous system and the peripheral nervous system.

The central nervous system, centred in the brain, controls such things as memory, thought and understanding. It receives messages from nerves outside the brain and organises them before sending the organised message back.

The peripheral nervous system is that part of the system which is outside the head and spinal cord. It is split into three major parts – the motor system, the sensory system and the autonomic system.

The brain and spinal cord make up the central nervous system (yellow/orange in this picture). There are 31 pairs of nerves that branch off the spinal cord.

These carry nerve impulses from the central nervous system to the various parts of the body and back again.

Nerves which are not part of the central nervous system (light blue) are part of the peripheral nervous system.

The motor system is responsible for the movement of the muscles. For example, when we walk the nerves in the muscles of the legs are sending messages back to the brain which then organises these messages to make sure that the muscles move correctly and we walk in a straight line. If a person drinks too much alcohol, this can badly affect the workings of the brain. The messages going back to the nerves in the legs are not organised properly and so it is not possible to walk in a straight line.

The sensory nervous system is responsible for senses and feelings. The brain organises messages sent from the eye so that we see clear pictures, messages sent from the ear so that we hear clearly, messages which give the ability to enjoy the sweet scent of a flower, to learn through touch and to enjoy the taste of the food we eat. The autonomic nervous system is responsible for the automatic workings of the body . For example, as the body sleeps the nerves connected to the breathing system continue to work and keep us alive. When we eat, the nerves in the digestive system work without us knowing to make sure that we get all the goodness out of our food. The autonomic nervous system also makes us sweat (when we are too hot) and shiver (when we are too cold).

Seizure happen when neurons in the brain give off haphazard electricity instead of organised messages. Since the brain is the part of the nervous system that controls everything else it is easy to see why a seizure can cause a person’s body to go out of control.
This is the name given to a doctor who specialises in treating disorders of the brain and the nervous system.

Some of these doctors have a particular interest in epilepsy and advise other hospital doctors and family doctors how best to treat people’s epilepsy.

They treat adults, rather than children, since the children have specialists of their own called paediatric neurologists.
The body is made out of tiny parts called cells. The cells that make up the brain are called neurons. They are far too small to be seen without a microscope.

Neurons have a main part, called the cell body, and a long tail, called the axon. There are short tails branching off the axon, called dendrites. The axon acts like a sort of wire, carrying messages. A neuron’s dendrites attach themselves to other neurons, making an incredibly complicated network.

This complicated network allows the messages from one neuron to be received by many others. Messages travel from neuron to neuron along the axon and dendrites in the form of tiny electrical pulses. If these electrical pulses get badly out of control, or out of the correct sequence, then a seizure occurs.
Neurontin® is the trade name for the drug gabapentin.

It is taken as capsules which are either white, yellow or orange depending on the strength, and is used to treat partial and secondarily generalised seizures.

See Antiepileptic Medicines
This is the name given to a doctor who operates on the brain or nervous system.

Many people call them brain surgeons, but neurosurgeons can operate on any part of the body that has nerves.

Only a small number of all those who have seizures can be helped by an operation.
Because of all the research taking place new antiepileptic medicines are sometimes discovered and, when first used, they are only used to treat grown ups.

For the first few years after they have been discovered, and until doctors find out how they best control seizures, they are given to be taken with other antiepileptic medicines It takes a long time after these medicines become available before they are given to children.

Two of the newest antiepileptic medicines are pregabalin which is the chemical name for Lyrica® and zonisamide which is the chemical name for Zonegran®. Only a very few children reading this encyclopaedia will have ever been given either of these medicines to control seizures. In the future more and more children will probably take these medicines either with another antiepileptic medicine or by itself.

Both Lyrica and Zonegran® have been around for a long time. Lyrica® has been known to control nerve pain for many years but it is only in recent years it has been found to be useful in treating epilepsy. Zonegran® has been used for many years in the USA and Asia but has only recently become available in the UK and Ireland even though it is made in Athlone.
These are seizures that people have when they are asleep.

The word nocturnal means “night time” and so, because most people sleep during the night time, it is a good word to describe the seizures.
In this attack, the person experiences movements that are very similar to an epileptic seizure, but these movements are usually caused by other problems and sometimes by stress.

Some people have both epileptic and non-epileptic seizures. This condition is very hard to recognise because the non-epileptic seizures are similar to epilepsy.

O

Oxcarbazepine is the name of the chemical used in the drug Trileptal®.

See Antiepileptic Medicines

P

Paediatric neurologists are doctors who specialise in treating disorders of children’s nervous systems.

Some of these doctors have a great interest in epilepsy and are experts at treating children who have seizures.

They advise other hospital doctors and family doctors how to treat children with epilepsy.
Only part of the body is affected by these seizures. They are also called focal seizures. The part of the body affected depends on which part of the brain is having the disturbance.

Partial seizures are different from generalised seizures because only part of the brain is affected by partial seizures. In generalised seizures the whole brain is affected right from the start of the seizure.

Partial seizures may go on to involve the whole brain – it is then called a secondarily generalised seizure. The type of generalised seizure is nearly always a tonic-clonic seizure.

There are two main types of partial seizures – simple partial seizures and complex partial seizures. The brain is organised into main areas called lobes. These are shown in the diagram, along with the effects that a partial seizure in that part of the brain might have.

Frontal lobe
Adversive Seizures (eyes, head or both turn to one side)
Jacksonian Seizures (tingling feeling in hand or arm)

Parietal lobe
Tingling in, or Jerking of: Leg Arm Face

Occipital lobe
Flashing lights or spots Vomiting

Temporal lobe
Strange smell or taste
Altered behaviour
Feeling of Deja Vu
Lip smacking or chewing movements
This is an old fashioned name for absence epilepsy ; the term “petit mal” should not really be used any more.

See Absence seizures
Some people are affected by certain types of lighting which causes them to have seizures. This affects more girls than boys. The lighting may be from a television set, computer video games, from the lights of a disco or from any other flickering light.

What happens is that the flickering light triggers part of the brain into acting abnormally. This causes the seizure .

A flashing light is used during an EEG test to see if the person is affected by flickering lights. If the EEG shows abnormal activity during the flashing light test then this is called photosensitivity. It is not common amongst people with epilepsy, and it hardly ever occurs in people without epilepsy. It is sometimes seen in people with generalised seizures.

Only a small number of all people who have seizures have them as a result of flickering lights.

If watching the television causes you to have seizures, it is helpful to sit as far away from the screen as possible (at least a metre) and to have a lamp on top of the television set. If you use a computer it is unwise to use an ordinary television screen as the display. Proper computer monitors are much better and cause very few problems.

If you play video games on a television set, it is sensible to sit at least one metre from the screen and to have other lights on in the room. Video games should not be played by people who have photosensitive epilepsy when they are very tired.

There is not a lot that can be done about the flashing lights of a disco other than to keep well away from the lights even if it means not going to a club where the disco is playing.
Phenytoin is the name of the chemical used in the drug Epanutin®

See Antiepileptic Medicines
Some people are affected by certain types of lighting which causes them to have seizures. This affects more girls than boys. The lighting may be from a television set, computer video games, from the lights of a disco or from any other flickering light.

What happens is that the flickering light triggers part of the brain into acting abnormally. This causes the seizure .

A flashing light is used during an EEG test to see if the person is affected by flickering lights. If the EEG shows abnormal activity during the flashing light test then this is called photosensitivity. It is not common amongst people with epilepsy, and it hardly ever occurs in people without epilepsy. It is sometimes seen in people with generalised seizures

Only a small number of all people who have seizures have them as a result of flickering lights.

If watching the television causes you to have seizures, it is helpful to sit as far away from the screen as possible (at least a metre) and to have a lamp on top of the television set. If you use a computer it is unwise to use an ordinary television screen as the display. Proper computer monitors are much better and cause very few problems.

If you play video games on a television set, it is sensible to sit at least one metre from the screen and to have other lights on in the room. Video games should not be played by people who have photosensitive epilepsy when they are very tired.

There is not a lot that can be done about the flashing lights of a disco other than to keep well away from the lights even if it means not going to a club where the disco is playing.
PE is very good for all children, including those with epilepsy.

There are very few parts of a PE lesson that a child with epilepsy should not join in.

One example is climbing up wall bars or ropes.
As young girls mature they start to have monthly periods. Those with a tendency towards epilepsy can have seizures before or at the start of each period. Doctors often call this catamenial epilepsy. Nobody really knows why this can happen. It could be due to a change in the balance of fluids in the body, which can affect the brain.

On the other hand, it could be to do with a change in the balance of hormones within the body ; these hormones are oestrogen and progesterone.
Prognosis means how doctors think that a person’s epilepsy (or any other condition) will progress. If they think that in the future a person’s seizures will be well controlled then the prognosis is good.

If, however, the outlook is for the seizures to increase or get no better then the prognosis is poor. Most people with epilepsy will have a good prognosis, but this will depend on how old the person was when the epilepsy started, what type of seizures the person has and how quickly the antiepileptic medicines work to stop the seizures.
These are not epileptic seizures at all. The word “pseudo” means false and this is exactly what they are – false seizures.

See Non Epileptic Seizures

Q

You may have questions about your diagnosis or epilepsy in general.

Speaking to a doctor or your parents may help you to understand your condition further.

R

It takes a long time and a huge amount of money before a new antiepileptic medicine is ready to be used to control seizures.

Every day some of the cleverest scientists and doctors in the world are working to develop these new drugs. Many scientific discoveries happen by accident, while others are the result of many years of painstaking work.

Researchers take every possible care to make sure that a new drug is safe before it can be given to people. Volunteers are used to test the new drugs to see how well they work and what side effects, if any, there might be. If these trials are successful then, after a lot of careful procedures have been followed, the drug becomes available for doctors to prescribe.

One thing is sure – new drugs will always be developed, and so the outlook for people with epilepsy gets better all the time.
Rivotril® is the trade name for the drug clonazepam.

It is taken as small white tablets and used in the treatment of myoclonic, absence and very rarely partial seizures.

See Antiepileptic Medicines

S

Sabril® is the trade name for the drug vigabatrin.

It is used alone or alongside other antiepileptic tablets when the doctor is finding it difficult to control partial and secondarily generalised tonic-clonic seizures . It is also used to treat infantile spasms.

The tablets are the same shape as a rugby ball and are white.

Sabril® can also be taken as a powder which is dissolved in water, juice or milk and taken as a drink.

See Antiepileptic Medicines.
Saint Mark wrote some of the Bible . In Chapter 9 (Verses 14 -19) of his writings in the New Testament part he gives a very accurate description of a tonic-clonic seizure. This shows that epilepsy is nothing new – it has been with us for as long as there have been people on Earth .

This piece of writing by Saint Mark also shows how important it is to care for the parent as well as the child.
Sometimes somebody might have a partial seizure and then go on to have a generalised seizure. If this happens, the generalised seizure would usually take the form of an atonic, tonic, or tonic-clonic seizure.

When somebody has a partial seizure which leads on to a generalised seizure, doctors call it a secondarily generalised seizure.
People often talk about somebody having “fits”, “funny turns”, “attacks” and even “wobblers”. Now you’ve read them, forget them! The correct term is seizure, which comes from a Greek word meaning “to take hold of”.

A seizure happens when part of the brain stops working properly for a short time. When the brain is operating properly, tiny amounts of electricity rush around from place to place, making everything work normally. During a seizure some of the electricity goes a bit haywire, so that the part of the brain where this is happening doesn’t work in the right way. Actually, it might only be a small part of the brain that is affected, or it might be most of it. This means that there are many different types of seizure, depending on which part of the brain is affected.

Obviously, if any part of the brain stops working properly, even for a short time, then this can cause some unusual things to happen to the person having the seizure. The person might twitch and jerk, or go blank for a few seconds, or even fall to the ground, perhaps with convulsions. It is even possible that strange noises or music might be heard, or the person might experience a strange smell or taste. It just depends on what part of the brain is having the seizure.

Doctors group (or classify) all the known seizures into a few main types. There are generalised seizures and partial seizures.

Generalised seizures, which affect the whole brain, are spilt up into tonic-clonic, absence, myoclonic, atonic and clonic seizures.

Anybody who has a generalised seizure loses consciousness during the seizure. Partial seizures, which only affect part of the brain, are split up into two main types: complex partial and simple partial seizures.

Simple partial seizures are further split up into focal motor and focal sensory seizures. People who have a partial seizure don’t lose consciousness, but their consciousness may still be affected.

There are actually many other types of seizure. This shows just how complicated the human brain really is.
A seizure diary is a simple chart or a small book for keeping a record of seizures. It is very useful for noting the dates of seizures and for writing a brief description of what actually happened before, during and after a seizure. Noting the date is easy but a witness usually has to give the information about what actually happened.

The diary of events helps the doctor to get to the root of the problem and to decide the best treatment.

Some people, as well as keeping a diary, make arrangements for themselves to be videoed on a camcorder when a seizure occurs. If a video recording can be made then the doctor may find it very useful. The doctor may then be able to tell precisely what sort of seizure someone is having. This will then help the doctor to prescribe the best treatment.
These are the unwanted effects of all drugs and medicines. Although drugs are used to cure and control illness, they can also cause problems themselves. For example, penicillin is a very widely used drug to cure infection but it can cause a rash in some people.

Nicotine is a drug that some people smoke in cigarettes. In fact, there are many chemicals in a cigarette, and some of them can have very nasty side effects. The side effects of smoking cause tremendous health problems. Thousands of people die every year as a result of smoking.

Like any other drugs, antiepileptic medicine can cause side effects and people taking it should find out what the possible side effects are so that they can be aware of any likely problem. Fortunately, the side effects are generally quite harmless and most people don’t suffer any side-effects at all. People should ask their hospital doctor, family doctor or pharmacist (chemist) about these side effects.
In a simple partial seizure there is no loss of consciousness. During the seizure the person remains completely aware of what is happening. They are different from complex partial seizures because the person’s consciousness is not affected at all. Simple partial seizures, like complex partial seizures, are different from generalised seizures because only part of the brain is affected.

There are many different types of simple partial seizures. It could be that an arm or leg may jerk (focal motor seizure) or there could be a numbness or tingling in a part of the body or a strange taste or smell (focal sensory seizure). The most common type of simple partial seizure, however, is an aura.

The abnormal electrical discharge is happening in a single part of the brain and so, for example, if it is in the part of the brain which controls the left arm then the problem will only occur in the left arm.
Sodium valproate is the name of the chemical used in the drug Epilim®.

See Antiepileptic Medicines
This is piece of jewellery such as necklace or bracelet which contains a piece of paper.

People who wear a Talisman can write all necessary information about their epilepsy on the piece of paper in case it is needed in an emergency.

The Talisman can he bought from any high street jewellers.
This is an EEG pattern which often shows up if a trace is done on somebody with epilepsy.

However, not everybody with epilepsy produces these patterns, so the doctor still relies very much on a detailed description of what is happening in a seizure before deciding that epilepsy is the problem.
This is an EEG pattern which is usually seen in children with absence seizures who have ‘petit mall epilepsy.

It may also be seen in other generalised seizures.
Children with epilepsy can do nearly all sports. Team games such as football, netball and tennis are enjoyed by many thousands of children who have the condition.

There are stars of sport who have epilepsy, and there is no reason why children who are good at sport, and who have epilepsy, should not be tomorrow’s stars.

Some sports are obviously dangerous for people with epilepsy. For example, deep sea diving is not advisable and neither is steep mountain or rock climbing.

The number of sports that can be enjoyed is far greater than those which are unsuitable. If there is a sport you want to do it is important to ask the hospital doctor how suitable it is for you.
This is when a seizure continues for a long time or when one seizure follows another without the person regaining consciousness in between. It is a dangerous condition and needs special and urgent treatment.

So, if a seizure lasts for longer than 5 minutes, or there are groups of seizures without the person regaining consciousness in between, the person is in danger of going into status epilepticus. An ambulance should be called to get the person to hospital, where the seizure can be stopped by giving certain drugs.

The drugs are given by doctors or specially trained people. One of these drugs is called diazepam or Stesolid®.

Other useful drugs are midazolam, also called Epistatus® and lorazapam, also called Ativan®.
Every child who has epilepsy should learn how to swim. Special precautions might be needed but these are easy and straightforward. The main thing is to make sure that there is somebody on the side of the swimming pool who can make a rescue in case a seizure happens. The pool attendant should be told by the swimmer about the epilepsy so that an eye can be kept on the situation.

Whereas swimming in a supervised pool is fine for people with epilepsy, it is unwise for them to go swimming in the open sea, where there could be strong currents and tides.

This can make rescue dangerous or even impossible.

T

Tegretol® is the trade name for the drug carbamazepine.

It is taken as an ordinary tablet or as a chewable tablet. Ordinary tablets are white and the chewable ones are orange-coloured. It can also be taken as a white liquid which tastes of caramel.

It is used in the treatment of partial and generalised tonic-clonic seizures. However it should not be used to treat the other types of generalised seizures such as absence and myoclonic seizures because it can make these seizures worse.

See Antiepileptic Medicines
These tablets are designed to release the drug carbamazepine slowly throughout the day. The lower dosed tablet is pale orange in colour and the higher dosed tablet is coloured brick red.

It is used in the treatment of partial and generalised tonic-clonic seizures. However it should not be used to treat the other types of generalised seizures such as absence and myoclonic seizures because it can make these seizures worse.

See Antiepileptic Medicines
Telemetry means using a closed circuit video camera which is linked to an EEG machine. This is so that the doctor can watch what is happening to the patient while the EEG is being recorded. Telemetry can be carried out for a few hours for many days at a time.

One half of the TV screen shows a picture of the patient and the other half shows the EEG pattern.

So, if a seizure happens, the camera will record what effect this has on the person, and the EEG records the brainwaves.

This is a great help because the person can be viewed over long periods and even throughout the night. Once the testing is completed, the doctor can play the recordings back to see what exactly has been going on.
Temporal Lobe Epilepsy/Seizures

See complex partial seizures
Doctors know how much of a drug should be in the blood for it to work best.

This amount is called the therapeutic range of the drug. If the amount of the drug in the bloodstream is outside the therapeutic range it means that there is too much drug or not enough.

A simple blood test can show up how much of the drug is present in the person’s bloodstream. If the doctor thinks that the test might be necessary it can be done at the hospital during a normal clinic visit.

Most people with epilepsy do not need to have this blood test done, unless they are being treated with phenytoin.
Known as the “father of epilepsy”. Todd was born in Dublin. Having studied at Trinity College he worked in London and founded Kings College Hospital.

He proposed and confirmed the electrical basis of epilepsy 20 years before Hughlings Jackson did similar work.
If you had a tonic seizure then your muscles would stiffen and, if you were standing up, you would fall down. There is a good chance that this would injure you.

People who have regular tonic seizures are advised to wear a protective helmet. A tonic seizure is a type of generalised seizure.
This is the proper name for what some people call “Grand Mal” seizures . Most people who have heard of epilepsy usually think of somebody having a tonic-clonic seizure.

If you had a tonic-clonic seizure then it would probably start with you crying out, then going unconscious.

You would, of course, fall down. You would go stiff (tonic stage) then your muscles would start twitching (clonic stage).

As the muscles twitch it is possible that the bladder will empty if it is full. Finally, you would recover, but you might be confused and dazed. You might want to sleep, and you might have a headache for a while.

A person watching such a seizure may notice the lips turning blue and, if the tongue has been bitten, blood may be seen to trickle from the mouth. An abnormal amount of saliva is produced, but the person is not able to swallow it, so it collects in the mouth and foams.

This can look very alarming, although there is really not much danger.

The whole seizure usually lasts 2 – 4 minutes if the seizure lasts more than 5 minutes help must be called for.

A tonic-clonic seizure is a type of generalised seizure.
This is the trade name for the drug Topiramate.

It comes white, light yellow or pink tablets depending on its strength. It also available as a clear coloured capsule containing tiny white spheres. The capsule can be swallowed whole or emptied over food such as yoghurt.

It is used in the treatment of partial seizures and most types of generalised seizures, but not absence seizures.

See Antiepileptic Medicines
Topiramate is the name of the chemical used in the drug Topamax®

See Antiepileptic Medicines
A trigger is something which makes it more likely for a person with epilepsy to have seizures.

Some examples of triggers are:
Not taking tablets regularly
Tiredness
Menstrual periods
Drinking too much alcohol
Flashing lights
High body temperature
Hyperventilation
This is the trade name for the drug Oxcarbazepine.

It comes as yellow scored tablets or as a liquid and is used in the treatment of partial and generalised tonic-clonic seizures.

It may worsen absence and myoclonic seizures.

See Antiepileptic Medicines

U

Scientists are constantly investigating epilepsy with the aim to fully understand the condition.

MREA is lucky to have close links with the Epilepsy Research Group at the University of Liverpool, benefiting from their years of experience and research in the clinical trials of anti-epileptic drugs, neuroimaging and genetics. We believe that scientific research holds the key to improving the lives of those that live with epilepsy.

V

He was a German scientist who discovered the drug phenobarbitone.

He found that it was very good at calming people down and from 1886 to 1912 it was used only to make people relaxed.

In 1912 a doctor called Hauptman used it to control seizures.
Vincent van Gogh was born in the Netherlands (Holland). He started off being a preacher, but soon turned to painting beautiful pictures.

In 1886 he left Holland to live in France where, between 1888 and 1890, he painted his most famous pictures. The best known of all his pictures is the Sunflowers, which is worth many millions of pounds.

As well as being one of the greatest artists ever Vincent van Gogh just happened to have epilepsy.
Vigabatrin is the name of the chemical used in the drug Sabril®

See Antiepileptic Medicines

W

A Japanese neurologist called Dr John Wada invented a special test which is now named after him.

This test is done if there is a chance that an operation might stop some complex partial seizures. It used to find out whether the operation would affect every day actions like speaking. This is because your brain controls speech. The test is also used to test a person’s memory.

The part of the brain that controls speech is in the left temporal lobe in most people – but it could be in the right temporal lobe.

If the seizures are caused by damage in the temporal lobe controlling speech, then the surgeon won’t want to operate to stop the seizures because this might affect the person’s ability to talk.

One half of the brain is put to sleep using medicine. The other side is still awake (so the person is still awake). The doctor asks the person questions to see how well the awake part of the brain is working. After a while, the test is done again on the other side of the brain (you can be totally awake with only one half of your brain working).

If the person is able to talk properly, then the side of the brain that is awake must be controlling the person’s ability to talk. If the person isn’t able to talk properly, then the side of the brain that is awake doesn’t control speech – the part that controls speech must be asleep.

Very few children have this test because very few need to have surgery to treat their epilepsy.

Children must usually be 12 years or older before they can have a WADA test.
People who have been taking antiepileptic medicine for many years, and have not had a seizure for a very long time, sometimes decide to suddenly stop taking their drugs.

Their bodies have become so used to the drugs that there is a risk that seizures will start again. These seizures are called withdrawal seizures because of the withdrawal of the drugs.

They usually only happen if the drug is withdrawn very quickly. If the drug is withdrawn very slowly, over a couple of months, then withdrawal seizures do not usually happen.

The withdrawal of drugs should be very carefully supervised by a doctor.

X

Ordinary X-Rays used to look at broken bones are of no use in trying to find out the cause of epilepsy.

Special X-Rays used in a CAT scanner, however, can sometimes be very useful in helping the doctor to find the fault in the brain causing the seizures.

Y

It’s very important for children diagnosed with epilepsy to hear the word ‘Yes’.

It’s not all about the things that you cannot do, but also about the things you can do.

Z

Zarontin® is a trade name for the drug ethosuximide.

It can either be taken as a blackcurrant or orange flavoured syrup or as a soft orange capsule.

It is used to treat absence seizures and sometimes myoclonic seizures.

It is of no use in treating partial or tonic-clonic seizures.

See Antiepileptic Medicines