Seizures happen when your brain cells, which communicate through electrical signals, send out the wrong signals. Having just one seizure doesn't mean you have epilepsy. Generally, several seizures are needed before there is a diagnosis of epilepsy.
Epilepsy can happen at any age, but it is most common in the elderly. Many children with epilepsy outgrow the condition. However, even mild seizures that happen more than once should be treated. Seizures can be very dangerous if they happen while you are driving, walking, or swimming, for example.
Seizures are classified in 2 main categories:
Partial seizures involve a part of the brain. They can be:
- Simple partial seizures -- Symptoms may include involuntary twitching of the muscles or arms and legs; changes in vision; vertigo; and having unusual tastes or smells. The person does not lose consciousness.
- Complex partial seizures -- Symptoms may be like those of partial seizures, but the person does lose awareness for a time. The person may do things over and over, like walking in a circle, rubbing the hands together, or staring into space.
Generalized seizures involve much more or all of the brain. They can be:
- Absence seizures (petit mal) -- Symptoms may include staring and brief loss of consciousness.
- Myoclonic seizures -- Symptoms may include jerking or twitching of the limbs on both sides of the body.
- Tonic-clonic seizures (grand mal) -- Symptoms may include loss of consciousness, shaking or jerking of the body, and loss of bladder control. The person may have an aura or an unusual feeling before the seizure starts. These seizures can last from 5 to 20 minutes.
Seizures are caused by overexcited nerve cells in the brain that fire abnormally. In about half of cases, the cause isn't known. Some things that can cause seizures include:
- Head injury
- Genes -- researchers have linked specific genes to epilepsy
- Injury to the brain before birth
- Some medical conditions, such as meningitis and lupus
- Stroke and heart attack
Your doctor will take your medical history and ask about anything that may have caused your seizure, such as an injury to your head. Your doctor will also ask about risk factors, such as family or personal history of seizures. Be sure to tell your doctor how you felt before and after the seizure. Your doctor will do blood tests and an electroencephalogram (EEG), which records the electrical activity in your brain. You may also have a computerized tomography (CT) scan, a magnetic resonance imaging (MRI) scan, and a positron emission tomography (PET) scan.
The goal of therapy is to stop seizures, reduce any drug side effects, prevent seizures from coming back, and help you readjust to your home life and work after a seizure.
Your doctor will probably prescribe medication to help control your seizures. About 30 to 70% of people who have one seizure will have a second seizure within 1 year. You may need to try several medications or combinations before you find one that works for you. There are a number of drugs available to help treat seizures, including anticonvulsants (antiseizure drugs) and sedatives.
If medications do not work, ask your doctor about a procedure called vagus nerve stimulation.
Complementary and Alternative Therapies
You should always see a doctor if you or your child has a seizure. Taking certain supplements and changing one's diet may reduce the frequency of seizures. But the same supplements may increase the frequency of seizures in some people.
You should never take any supplements or prescription medication without your doctor's knowledge. Be sure to tell all of your doctors about any medications, herbs, and supplements you are using.
Nutrition and Supplements
A ketogenic diet -- a diet that is high in fat and low in protein and carbohydrates -- may help control the frequency of seizures. This type of diet is most commonly used in children, and seems to work better for children than adults. If you are on a ketogenic diet, your doctor should monitor you both for side effects and effectiveness. You may need to take vitamin and mineral supplements, because this diet is very restricted. Do not attempt a ketogenic diet on your own. Work with your physician to make sure you're doing it safely.
Some studies have shown a connection between food allergies and seizures in some children. But the evidence isn't clear. Avoid alcohol, caffeine, and any supplements that have stimulating effects. A holistically-oriented health care provider may help you identify possible food allergies.
Some supplements may make certain antiseizure medications less effective. Ask your doctor before taking any herbs or supplements.
- Taurine is an amino acid that may be involved in the brain's electrical activity and is often low in people with seizures. It acts like GABA (gamma aminobutyric acid, 500 mg, 2 times per day), another amino acid that is often low in people with seizures. But there is no scientific evidence that taking either supplement will reduce seizures. Taurine may interact with many medications. Do not take taurine of GABA supplements without your doctor's supervision. Do not take taurine or GABA if you have a history of bipolar disorder, or if you take psychoactive medications.
- Folic acid levels may drop during seizures and may be low in some people with seizures, however, taking extra folic acid may make anticonvulsant drugs less effective. That could raise your risk for more seizures. Do not take folic acid without your doctor's supervision.
- Vitamin B12 -- Some anticonvulsant drugs may cause low levels of B12 in the body.
- Vitamin E may help reduce the frequency of seizures when used with prescription drugs. But some studies show that it doesn't help. Do not take vitamin E if you take blood thinners. Vitamin E can interact with a number of medications. So ask your doctor before taking it.
- Anticonvulsant drugs may cause low levels of calcium, vitamin D, and vitamin K. If you take anticonvulsant drugs, ask your doctor about taking a supplement. Calcium can interfere with anticonvulsant drugs. So do not take calcium without your doctor's supervision.
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Many of the herbs used to treat seizures have sedative effects, and they interact with other herbs, supplements, and prescription medications. Take these herbs only under a doctor's supervision. It's important for a health care professional to monitor side effects and interactions. Most of these herbs have been used traditionally for seizures, but lack scientific evidence showing they work.
- Bacopa (Bacopa monnieri) -- An herb used in Ayurvedic medicine to treat epilepsy. Some studies found that bacopa may reduce the frequency of seizures. More research is needed. Take special care if you have a history of lung or urinary problems.
- Chamomile (Matricaria recutita) -- A sedative herb. Ask your doctor to help you find the right dose. Chamomile can make the effects of other sedatives stronger. It also interacts with many other medications.
- Kava (Piper methysticum) has been used traditionally as a sedative herb for seizures. However, there is some concern that kava can damage the liver, even if taken for a short time. Take kava only under your doctor's supervision, so he or she can monitor liver function. Kava may interact with a number of other drugs. Do not take kava if you have Parkinson's disease.
- Valerian (Valeriana officinalis) is a sedative and anticonvulsive. It interacts with several medications, herbs, and alcohol, so take it only under your doctor's supervision. Valerian is sometimes combined with lemon balm (Melissa officinalis), another herb that has sedative effects.
- Passionflower (Passiflora incarnata) may help treat and prevent seizures.
Do not take the following herbs:
- Ginkgo (Ginkgo biloba) and ginseng (Panax ginseng and Panax quinquefolius) have caused seizures in some people.
- There is some evidence that GLA, a kind of fatty acid found in evening primrose oil (Oenothera biennis) and borage oil (Borago officinalis), may worsen epilepsy. More research is needed.
- St. John's wort (Hypericum perforatum) interacts with a number of medications and herbs used to treat epilepsy.
- White willow (Salix alba) may interact with epilepsy medications.
Avoid these essential oils:
- Eucalyptus (Eucalyptus globulus)
- Fennel (Foeniculum vulgare)
- Hyssop (Hyssopus officinalis)
- Pennyroyal (Mentha pulegium)
- Rosemary (Rosmarinus officinalis)
- Sage (Salvia officinalis)
- Tansy (Tanacetum vulgare)
- Thuja (Thuya occidentalis)
- Wormwood (Artemesia absinthium)
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for seizure disorders based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
- Belladonna -- For seizures that occur in individuals with a high fever
- Causticum -- For individuals whose seizures may be triggered by receiving bad news or by feelings of sadness such as from grief; this remedy is most appropriate for individuals who tend to feel hopeless and fearful
- Cicuta -- For individuals who develop seizures after a head injury
- Cuprum metallicum -- For individuals whose seizures are accompanied by mental dullness; may be triggered by menstruation or vomiting
Chiropractic, osteopathic, or naturopathic manipulation may help, especially in children, or for seizures after head trauma.
In some cases, specific acupressure points may have been used to stop seizures. However, one study for people with severe epilepsy found they didn't work. Chinese medical literature has examples of treating seizure disorders through traditional acupuncture, as well as scalp and auricular (ear) acupuncture or a combination of all these techniques. If you decide to have acupuncture, work with a qualified acupuncturist and let all your other health care providers know about your treatments.
Finding the right dosage or drug combinations for you may take some time. Your doctor will monitor you until your seizures are under control. People who have epilepsy are at high risk of developing depressive disorders.
Bope & Kellerman: Conn's Current Therapy 2014, 1st ed. Elsevier, Philadelphia, PA: 2013.
Cheuk DK, Wong V. Acupuncture for epilepsy. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD005062. Review.
Coman DJ, Sinclair KG, Burke CJ, Appleton DB, Pelekanos JT, O'Neil CM, Wallace GB, Bowling FG, Wang D, DeVivo DC, McGill JJ. Seizures, ataxia, developmental delay and the general pediatrician: Glucose transporter 1 deficiency syndrome. J Paediatr Child Health. 2006;42(5):263-7.
Duncan JS, Sander JW, Sisodiya SM, Walker MC. Adult epilepsy. Lancet. 2006;367(9516):1087-100.
Gaby AR. Natural approaches to epilepsy. Altern Med Rev. 2007 Mar;12(1):9-24. Review.
Guerrini R, Parmeggiani L. Practitioner review: Use of antiepileptic drugs in children. J Child Psychol Psychiatry. 2006;47(2):115-26.
Hanly JG et al. Seizure disorders in systemic lupus erythematosus results from an international, prospective inception cohort study. Ann Rheum Dis. 2012;71(9):1502-9.
Jackson N, Ridge CA, Delanty N. Imaging in patients with a first seizure. Ir Med J. 2006;99(6):173-5.
Kanner AM. Can neurobiological pathogenic mechanisms of depression facilitate the development of seizure disorders? Lancet Neurol. 2012;11(12):1093-102.
Kossoff EH, Rho JM. Ketogenic diets: evidence for short- and long-term efficacy. Neurotherapeutics. 2009 Apr;6(2):406-14. Review.
Levy RG, Cooper PN, Giri P. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst Rev. 2012 Mar 14;3:CD001903.
Li Q, Chen X, He L, Zhou D. Traditional Chinese medicine for epilepsy. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006454. Review.
Muller M, Byres M, Jaspars M. et al. 2D NMR spectroscopic analyses of archangelicin from the seeds of Angelica archangelica. Acta Pharm. 2004;54:277-85.
Perucca E, Aldenkamp A, Tallis R, Kramer G. Role of valproate across the ages. Treatment of epilepsy in the elderly. Acta Neurol Scand Suppl. 2006;184:28-37.
Schachter SC. Botanicals and herbs: a traditional approach to treating epilepsy. Neurotherapeutics. 2009 Apr;6(2):415-20. Review.
Towne AR. Epidemiology and outcomes of status epilepticus in the elderly. Int Rev Neurobiol. 2007;81:111-27.
Vining EP. Tonic and atonic seizures: medical therapy and ketogenic diet. Epilepsia. 2009 Sep;50 Suppl 8:21-4. Review.
Yuen AW, Flugel D, Poepel A, Bell GS, Peacock JL, Sander JW. Non-randomized open trial of eicosapentaenoic acid (EPA), an omega-3 fatty acid, in ten people with chronic epilepsy. Epilepsy Behav. 2012 Mar;23(3):370-2.
Yuan CS, Mehendale S, Xiao Y, et al. The gamma-aminobutyric acidergic effects of valerian and valerenic acid on rat brainstem neuronal activity. Anesth Analg. 2004;98:353-8.
Zupec-Kania BA, Spellman E. An overview of the ketogenic diet for pediatric epilepsy. Nutr Clin Pract. 2008 Dec-2009 Jan;23(6):589-96. Review.