Epilepsy is a neurological condition that causes recurring, unprovoked seizures. With an accurate diagnosis and a tailored care plan, most people can lead active, independent lives. Cape Fear Valley Health provides comprehensive evaluation, epilepsy treatment, and support for children and adults experiencing seizures and epilepsy.
Symptoms and Causes of Epilepsy
Underlying causes include genetic factors, traumatic brain injuries (including concussions), stroke, brain tumors, infections like meningitis or encephalitis, and developmental or metabolic disorders. In many people, a specific cause is not identified. Triggers do not cause epilepsy but can provoke an epileptic seizure in those with the condition. Common triggers include missed medications, sleep deprivation, alcohol or drug use, stress, illness with fever, and, in a small subset, flashing lights. In children, a febrile seizure may occur with high fever, which is distinct from epilepsy but should be discussed with a clinician.
Seek emergency care if a seizure lasts five minutes or longer, seizures occur back-to-back without recovery, injury occurs, breathing is difficult, the person is pregnant, has diabetes, or if it is a first-ever seizure. Status epilepticus—prolonged or repeated seizures—is a medical emergency that requires immediate epilepsy treatment.
Diagnosis and Tests for Epilepsy
Diagnosis begins with a detailed medical history and description of the events. Witness accounts and smartphone videos can be extremely helpful. A neurological exam evaluates strength, reflexes, coordination, and thinking. Your clinician will also review medications, substance use, sleep patterns, and family history.
Key tests include:
- Electroencephalogram (EEG) to record brain electrical activity and look for epileptiform patterns linked to an epileptic seizure.
- Brain imaging, typically MRI (or CT in urgent settings), to identify structural causes such as scar tissue, stroke, or tumors.
- Blood tests to assess infections, metabolic issues, and medication levels.
- Inpatient or ambulatory video-EEG monitoring when events are difficult to classify, to distinguish epileptic seizures from other conditions.
Several conditions can mimic seizures, including fainting (syncope), psychogenic nonepileptic events, sleep disorders, movement disorders, low blood sugar, electrolyte imbalances, and transient ischemic attacks. Careful evaluation ensures the right diagnosis and epilepsy treatment plan.
Management and Treatment for Epilepsy
Treatment is individualized based on seizure type, cause, age, and overall health. Anti-seizure medications are the first-line therapy and control seizures for many people. If medications do not provide adequate control, other options may be recommended:
- Dietary therapies such as ketogenic or modified Atkins diets under medical and nutrition supervision.
- Epilepsy surgery to remove seizure-generating brain tissue in carefully selected cases.
- Neurostimulation therapies, including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), or deep brain stimulation (DBS).
Daily strategies support seizure control and safety:
- Take medications exactly as prescribed and keep regular follow-up appointments.
- Maintain consistent sleep schedules and limit alcohol; avoid recreational drugs.
- Manage stress and identify personal triggers.
- Create a seizure safety plan for home, work, and school.
- Use precautions such as supervised swimming, avoiding unprotected heights, and using shower chairs if needed.
- Wear a medical ID and consider sharing a seizure action plan with close contacts.
Cape Fear Valley Health offers coordinated care across neurology, neurosurgery, imaging, and rehabilitation. See a specialist for a first-time seizure, ongoing seizures despite treatment, significant medication side effects, or questions about pregnancy and epilepsy. Our team provides evaluation, medication management, dietary counseling, advanced neurostimulation and surgical referrals when appropriate, and connections to community education and support. Regular follow-up helps track seizure control, adjust therapy, and support quality of life. From initial diagnosis to advanced epilepsy treatment, we are committed to improving outcomes for people living with epilepsy.
