Jay Harvey, D.O. Answers Questions On: Epilepsy Symptoms

Although convulsions often come to mind when people think of epileptic seizures, convulsions are actually relatively uncommon when epilepsy is effectively managed. 

Broadly speaking, seizures are recurrent episodes that can come on abruptly and do not last very long. Almost any sort of episode that comes and goes fairly quickly can be considered a seizure.

Epileptic seizures can manifest themselves in a number of ways, including visual or auditory hallucinations, odd sensations, anxiety, staring or "zoning out," and the perception of smells or tastes that aren't there.

Patients commonly talk about having a very strong sense of familiarity (déjà vu) - or a sudden sense of unfamiliarity (jamais vu) - before  a seizure. Seizures can also cause people to experience brief alterations of awareness.

Typically, seizures manifest themselves the same way in people - meaning that the symptoms someone has during one seizure will be the same with the next one.

More than 25 prescription anticonvulsant drugs, two devices – the vagus nerve stimulator and the responsive neurostimulator, surgery and drug studies are currently available to treat the seizures caused by epilepsy.

UT Southwestern is one of only several Texas centers to offer the Robotized Stereotactic Assistant (ROSA). This state-of-the-art technology enables  the epilepsy team to “map” the brain, precisely locate the origin of the seizures and outline important function of underlying brain. ROSA coupled with specialized EEG provides the pathway to seizure surgery (traditional removal of abnormal brain or by laser therapy) or to a responsive neurostimulator (device used to shock the brain and stop the progression of a seizure).

We also treat many of the peripheral symptoms that go with having seizures. Two  comorbidities are depression and anxiety. People with epilepsy have three times the risk of developing depression and anxiety than people without the disorder. And that's not from having seizures; it just associated with epilepsy and likely represents the effect of epilepsy on the brain.

Many patients also experience post-seizure migraine headaches, and it’s not uncommon for people to injure themselves during a seizure.

Absolutely. In addition to trying to maintain overall good health and a low stress level, people with epilepsy need to take care of themselves and not overdo.

Factors that can sometimes precipitate a seizure include sleep deprivation, excessive alcohol, and a high fever. These aren’t the reasons for the seizure, but they can be triggers in some people.

The big advance on the horizon in treating epilepsy is the use of cannabidiol (CBD) oil. CBD is the medicinal, non-psychoactive ingredient found in cannabis plants - the source of marijuana and hemp - and preliminary study results show a dramatic impact on certain epilepsy syndromes. In the next year or so, there may actually be a prescription CBD-oil product on the market.