Epilepsy and Seizures | Treatments and Diagnosis | MedStar Health
Electroencephalogram

Specialized expertise for addressing this seizure disorder

MedStar Health epilepsy specialists across Maryland, Washington, D.C., and Virginia have made it their life’s work to study the disease and find innovative solutions and treatments.

In Washington, D.C., we offer the region’s first level-four epilepsy center as designated by the National Association of Epilepsy Centers. That means our team provides the highest level of medical and surgical evaluation and treatment for both adults and childrens with seizures.

In the videos below, Tricia Ting, MD and Gholam Motamedi, MD answer your questions about the disease, its diagnosis, and treatment options.

What is epilepsy?

Normal brain activity involves a flow of electrical energy. When the energy flows in a controlled manner, you function well. When the brain cells malfunction and keep firing electrical signals, you experience an epileptic seizure. The energy surging through your brain causes the seizure. The electrical disturbance always begins in the brain, but may affect any part of your body.

Symptoms

Minor symptoms may include:

  • Clouded awareness

  • Difficulty communicating

More extensive symptoms may include:

  • Loss of consciousness

  • Uncontrolled muscle movements

The severity of your symptoms depends on several factors, including where the disturbance is occurring in your brain and how long your seizure lasts. While most seizures last only a minute or two, you may experience lingering confusion afterwards.

In order to be diagnosed with the condition, you must have had at least two unprovoked seizures.

Seizures

There are two main categories of epileptic seizures, generalized and partial. Within each category, there are different types of seizures.

Generalized seizures involve the entire brain. Because of the extensive area affected, symptoms always include loss of consciousness. Types of generalized seizures include:

  • Absence seizures were formerly referred to as petit mal seizures. They cause a 10- to 20-second loss of consciousness and staring. Symptoms are so fleeting that they may go unnoticed for some time. This type of generalized seizure is more likely to affect children.

  • Myoclonic seizures cause you to lose consciousness and experience rapid, brief muscle contractions. The affected muscles will usually contract on both sides of the body at the same time. To a bystander, it may look like sudden jerks or clumsiness.

  • Atonic seizures can be particularly dangerous. Along with loss of consciousness, abrupt, sudden muscle weakness occurs without any warning. This can cause you to fall down suddenly, sometimes resulting in head or face injuries.

  • Tonic-clonic seizures were formerly referred to as grand mal seizures. They can cause you to cry out or fall as your seizure begins. You will lose consciousness for 1 to 2 minutes and begin to experience stiffening of the limbs (the tonic phase), followed by jerking of the limbs and face (the clonic phase). Afterwards, you will have a recovery period. Do not be surprised if you experience amnesia regarding seizure events, confusion, and deep sleep.

Partial seizures originate in a single area of the brain. Depending on the affected area, partial seizures can affect different physical, emotional, or sensory functions. While partial seizures can vary in their symptoms, they all tend to be brief, lasting at most a minute or two.

  • Simple partial seizures do not involve loss of consciousness. You may experience sudden jerking or unusual sensations or movements.

  • Complex partial seizures involve impaired consciousness or total loss of consciousness. You may experience an aura, have a period of staring (30 to 60 seconds), and be generally unaware of your environment. After the seizure is over, you may be somewhat confused and sleepy.

  • Secondarily generalized tonic-clonic seizures: Occasionally, a partial seizure may lead to a generalized, full-blown tonic-clonic seizure. When this occurs, the resulting seizure is called a secondarily generalized tonic-clonic seizure. The symptoms are the same as if the tonic-clonic seizure occurred spontaneously.

Nonepileptic seizures

Not all seizures are caused by a disturbance in brain activity. These are known as nonepileptic seizures. They are not caused by electrical discharges and do not show on an electroencephalogram (EEG). These types of seizures are very common. They are found in about 40 percent of patients with seizures. They can affect adults, teens, and children, but occur more often in females and people in their 30s and 40s.

Some nonepileptic seizures can be caused by migraine headaches, drops in blood pressure, movement disorders, or other medical problems. The most common type is the psychogenic seizure, which can be caused by mental or emotional stress or past trauma. This trauma can rest underneath the surface of a person's day-to-day life and come out in the form of these seizures. To stop them, the patient must address the trauma.

Counseling is an effective treatment for past trauma and stress and may include:

  • Hypnosis

  • Stress reduction

  • Behavioral therapy

With proper treatment, nonepileptic seizures disappear in about 70 percent of adults. Children and adolescents have even higher rates of improvement after treatment.