November is Epilepsy Awareness Month.
According the Epilepsy Foundation, one in 26 people will develop epilepsy at some time in their life. The incidence of epilepsy is higher in young children and in older adults.
One of those affected by epilepsy is 17-year-old Elisabeth Elliott, a ballerina who regularly performs with the Houston Ballet in its annual production of “The Nutcracker.” The Epilepsy Foundation profiled Elliott’s story, which began when she was 9. Her mother, Kimberly, looked at her daughter at a neighborhood yard sale and noticed her gulping with a blank look on her face.
Later, both Elisabeth and her mother realized she’d had previous seizures at school. Soon after, Elisabeth received her epilepsy diagnosis.
Dr. Reza Sadeghi, a neurologist at McGovern Medical School at UTHealth and affiliated physician with Memorial Hermann Greater Heights Hospital, said a person receives a diagnosis of epilepsy if they have two or more unprovoked seizures, meaning there were not any extenuating circumstances for the seizures.
“Sometimes trauma or an anxiety attack can cause abnormal movement or tremors,” Sadeghi said. “Those are not a true epileptic event.”
There are two main types of seizures, according to WebMD – focal or generalized. In the generalized group are tonic-clonic (or grand mal) seizures; clonic (or spasm-causing seizures); tonic seizures, which cause muscles to tense up; atonic seizures, which cause muscles to go limp; myoclonic seizures in which the muscles jerk; and absence (or petit mal) seizures.
Triggers for a seizure, according to Sadeghi, include lack of sleep, stress or patients not keeping up with their medication.
Sadeghi said seizures caused by idiopathic generalized epilepsy have a genetic cause and reveal themselves to patients in their childhood. Sometimes the patient can outgrow the seizures as a teen or young adult. These are different from localization-related epilepsies, which are most likely the result of trauma, like a car accident or a stroke.
The first line of treatment for those with epilepsy is medication, which can be administered in a variety of ways, like a pill or an injection. Surgery can be another option, especially if people do not respond to two or more different types of medication.
Sadeghi said that if imaging and other diagnostic tests can pinpoint the part of the brain that is causing a focal seizure, then a lesionectomy or a temporal lobectomy can help resolve the seizures.
That was the route that Elisabeth Elliott took as outlined in a 2016 KPRC story.
One of the other mothers who Kimberly Elliott met at a performance of “The Nutcracker” in which their children were both performing was a neurologist at Texas Children’s Hospital.
That doctor referred Elisabeth to a neurosurgeon at Texas Children’s Hospital who performed a left temporal lobectomy, removing the part of Elisabeth’s brain that was causing her epilepsy. Since then, she hasn’t had another seizure.
Death as a result of seizure is something many loved ones of epilepsy patients worry about. Most recently, Disney star Cameron Boyce died in his sleep. His family later released a statement that said Boyce had epilepsy, and said his death was caused by a seizure that occurred during his sleep.
The Epilepsy Foundation said that the sudden, unexpected death of someone with epilepsy, or SUDEP, occurs in about 1 in 1,000 people with epilepsy. Sadeghi said it is a fallacy that a seizure patient can swallow his or her tongue as there is tissue to hold it in place.
“(Death) is not very common if a patient is being managed properly,” Sadeghi said.
For more information, visit www.epilepsy.com.