The difference between Seizures and Epilepsy
Seizures or fits may sound terrifying to those who have witnessed one, by experiencing themselves or even seeing one happening around. Sudden onset of continuous muscle spasms, stiffening of limbs, staring into spaces, collapsing, rolling of eyes, rapid blinking, associated with changes in sensation, behavior, and altered consciousness. One of the most striking problems many of the persons who have had a seizure have is, “am I having epilepsy?” However, all the people who have got seizure attacks not necessarily have epilepsy. In fact, less than 1 in 10 that have had a seizure is epileptic. In this article, let’s try to clear up this confusion.
What is a Seizure?
Before getting on to the difference between seizures and epilepsy, it is useful to understand what seizure is.
Our brain is comprised of neurons or nerve cells which generate and send signals as electrical impulses. Usually, this generation of signals is kept under control by various mechanisms. Yet individual neurons can still spontaneously fire but may not cause much harm. But occasionally due to various causes, multiple neurons may misfire at the same time leading to a seizure. Thus, simply, seizure is an abnormal electrical activity in brain which may sometimes go unnoticed or may be significant enough to cause convulsions. Seizures has a spectrum of presentation depending on the location of brain of which, the abnormal electrical activity occurs.
Seizures fall into one of these categories: Generalized or focal (partial) depending on the involvement of brain i.e., if your entire brain is involving from the beginning of the seizure, it is known as generalized whereas involvement of a part of the brain is known as focal seizures. They have subtypes depending on the nature and mechanism. But we won’t get into detail of each of them in this article.
What Triggers a Seizure?
Seizures of course, can happen without an obvious cause. However, there are identified triggers of seizures as well. Seizures due to an obvious cause is called provoked seizures. Some of such causes are trauma to head, stroke, tumors in brain, head injuries, electrolyte imbalances, hypoglycemia in diabetic patients caused by too much insulin, repetitive sounds or flashing lights at a certain frequency, medications, narcotics, withdrawal from narcotics or alcohol, or high fever.
What is Epilepsy?
Epilepsy is a chronic non-communicable disease of the brain that is defined as having two or more unprovoked seizures. Now we can even diagnose epilepsy after one unprovoked seizure with testing showing high risk for seizure recurrence above 60% based on the EEG, MRI and clinical evaluation and the last opportunity will be diagnosing an epilepsy syndrome. According to WHO, the incidence of epilepsy is about 4-10 per 1000 people which is obviously much less than the incidence of seizures.
What Causes Epilepsy?
The underlying cause of epilepsy is unknown in more than half of the cases. However, some of the known causes include brain damage due to prenatal or perinatal causes, congenital abnormalities or genetic conditions, severe head injury and infections. Thus, causes of epilepsy show high individual variability as some people don’t have an identifiable cause whereas some have one which is found by tracing genetics, brain trauma, inborn errors or metabolism, infectious causes or autoimmune disorders.
How is Epilepsy Diagnosed?
Epilepsy is mainly a clinical diagnosis which can be difficult to make. The diagnosis will greatly depend on your clinical history and investigations. History is very important as the information on events before, during and after the occurrence of seizure has very high value in identifying what type of seizure you had and whether it is actually epilepsy. Performing a neurological examination will give an idea about how well your brain and nervous system is functioning. EEG which looks for the electrical activity of your brain and brain imaging i.e., CT scan, CAT scan or MRI scan are the most important investigations for coming to a diagnosis.
After performing all these tests, your doctor will arrive at a diagnosis. However, the tests may look completely normal even though you have epilepsy. That’s why it is more of a clinical diagnosis.
So, is Epilepsy and Seizures the Same?
As we already discussed above, epilepsy is a neurological disease which can cause recurrent, unprovoked seizures. Seizures can be a result of epilepsy or one of the other underlying diseases or causes mentioned above (provoked seizures). Thus, it is clear, that having a seizure/seizure does not necessarily mean that you are having epilepsy.
How is Epilepsy/ Seizures Managed?
The treatment for your seizures/ epilepsy depends on the diagnosis. If your doctors diagnosed your condition as epilepsy on the clinical scenario and results of the tests, you will be started on anti-seizure medications to minimize the risk of recurrence. If epilepsy was ruled out and your seizures was identified to be caused by a specific trigger factor, that particular cause will be treated, and you will be advised on how to avoid the exposure to that particular cause. Health education is a must in management of epilepsy/ seizures as it has a profound effect on reducing the risk of recurrence as well as side effects.