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Not all seizures are caused by epilepsy

As the fourth most common neurological disorder affecting one in every 26 people, you probably know someone with epilepsy

“Often, when a person has a seizure it may be due to epilepsy,” explained Geisinger neurologist Dr. Muhammad Bhatti. “Transient synchronous or abnormal, excessive electric activity in the brain is a hallmark of epilepsy that often results in seizures.” 

However, not all seizures are a result of epilepsy, as many seizures have other provoking factors. Here’s what you need to know about epilepsy and seizures, as well as their distinguishing factors. 

What is epilepsy? 
Did you know that you can have epilepsy even with just one seizure?

More than half of epilepsy diagnoses have no identifiable causes; however, epilepsy could run in the family and may be genetic or happen because of a stroketraumatic brain injury, infectious diseases, prenatal injury or developmental disorders

Doctors can screen for epilepsy with MRI of the brain and electroencephalogram (EEG) tests to locate abnormal electrical discharges in the brain. 

Epileptic seizures  
Seizures are a sudden surge of abnormal or synchronous electrical activity in the brain that can lead to multitude of clinical symptoms. These symptoms may be very subtle such as staring episodes or as obvious as a full body convulsion. 

“There are many types of seizures,” said Dr. Bhatti, “but they are organized into two major categories: focal onset or generalized onset.”

  • A focal onset seizure affects one area of the brain. A person experiencing a focal onset seizure may appear awake and aware during the episode or confused or unconscious. These types of seizures are marked by motor symptoms like jerking, limp or weak muscles, muscle twitching and spasms. There may also be repeated automatic movements like clapping, lip smacking or running. 

    Other symptoms may include a change in emotion, thinking or cognition, goosebumps or elevated heart rate.

  • Generalized onset seizures affect both sides of the brain at the same time and usually cause a person to lose consciousness. During these seizures, a person could also experience jerking, limp muscles, tense muscle twitching or spasms. However, a generalized onset seizure sometimes produces no outward symptoms—these are called absence seizures. Absence seizures can cause long staring spells, brief twitches and rapid movement of the eyelids. 

Factors like the person’s level of awareness during the seizure, environment during onset and motor symptoms can help to identify the seizure type, which is important for treatment.

Non-epileptic seizures 

Not all seizures are a sign of epilepsy. Often brought on by drugs or medications, emotional issues or an illness, non-epileptic seizures can occur once or multiple times over a lifetime.

  • Seizure as an isolated event is generally not considered epilepsy.  They don’t usually recur unless you have brain damage or a family history of seizures. Common provoking factors are:
    • Drugs (cocaine, marijuana, LSD, etc.)
    • Prescription drugs (tramadol, antibiotics, etc.)
    • Sleep deprivation
    • Fever or other illness
    • Alcohol and drug use
    • Stress
    • Low blood sugar
  • Febrile seizures occur in children with a high fever, with a 25 to 30 percent chance of recurrence in about 5 percent of these children. Majority of patients with febrile seizures never have another seizure.
  • Psychogenic seizures are not epileptic seizures at all. Brought on by psychological factors like narcolepsy or personal trauma, psychogenic seizures can be manifestations of Tourette’s syndrome, panic attacks, post-traumatic stress disorder or an abnormal heart rhythm. 

Muhammad Bhatti, M.D., is a neurologist who specializes in epilepsy. He sees patients at Geisinger Community Medical Center in Scranton, Geisinger Wyoming Valley Medical Center in Wilkes-Barre and Geisinger Medical Center in Danville. To schedule an appointment with Dr. Bhatti or another Geisinger neurorologist, call 800-275-6401 or visit Geisinger.org.