Epilepsy: Symptoms, Causes, Treatment and When to Seek Care

Epilepsy is one of the world’s most common neurological conditions, affecting around 50 million people. Although it is often associated with convulsions, epilepsy can cause many different symptoms, from brief staring spells and unusual sensations to loss of awareness or uncontrolled movements.

A single seizure does not always mean that a person has epilepsy. Diagnosis requires a careful neurological evaluation to determine what caused the episode, how likely it is to happen again, and whether treatment is needed.

With an accurate diagnosis and appropriate care, many people with epilepsy can control their seizures and lead active, independent lives. According to the World Health Organization, up to 70% of people living with epilepsy could become seizure-free with appropriate use of antiseizure medication.

At BlueNetHospitals Los Cabos, our Neurology specialists provide comprehensive evaluations to identify the possible cause of seizures, confirm the diagnosis, and develop an individualized treatment plan.

Epilepsy is a neurological disorder characterized by an ongoing tendency to experience unprovoked seizures. These episodes are caused by sudden changes in the brain’s electrical activity and may temporarily affect movement, sensation, behavior, memory, awareness, or consciousness.

According to the International League Against Epilepsy, epilepsy may be diagnosed when a person has:

• Two unprovoked seizures occurring more than 24 hours apart.
• One unprovoked seizure with a high probability of recurrence.
• A recognized epilepsy syndrome.

The condition can begin at any age, from early childhood through older adulthood. It affects people of all backgrounds and is not contagious.

A seizure occurs when a group of brain cells produces a sudden burst of abnormal electrical activity.

Symptoms depend on where the seizure begins and how far the electrical activity spreads through the brain. A seizure may cause:

• Uncontrolled movement in one part of the body.
• Stiffening or rhythmic jerking of the arms and legs.
• Loss or alteration of awareness.
• A fixed stare or brief period of unresponsiveness.
• Changes in vision, hearing, taste, or smell.
• Tingling or other unusual sensations.
• Sudden fear, anxiety, or déjà vu.
• Changes in speech, behavior, or memory.

Many seizures last only a few seconds or minutes. A seizure lasting five minutes or longer is a medical emergency.

Seizures are classified according to where they begin in the brain and how they affect awareness and movement.

Focal seizures begin in one area or on one side of the brain. A person may remain aware during the episode or experience impaired awareness.

Symptoms may include:

• Jerking or stiffening in one arm, leg, or side of the face.
• Tingling or numbness.
• Unusual smells, tastes, or visual sensations.
• Repetitive movements such as lip-smacking or picking at clothing.
• Confusion or difficulty responding.
• Sudden emotional changes.

Some focal seizures can spread to both sides of the brain and lead to loss of consciousness and generalized movements.

Generalized seizures affect both sides of the brain from the beginning. They may cause:

• Brief staring episodes.
• Sudden muscle jerks.
• Loss of muscle tone and falls.
• Muscle stiffening.
• Loss of consciousness followed by stiffening and rhythmic jerking.

When there is not enough information to determine where a seizure began, it may initially be classified as having an unknown onset. The classification can change after additional testing or observation.

In approximately half of all cases, a specific cause cannot be identified. When a cause is found, epilepsy may be associated with genetic factors, structural changes in the brain, infections, immune disorders, or metabolic conditions.

Some forms of epilepsy have a genetic component. This does not always mean that the condition passes directly from parent to child; genetic changes may simply increase susceptibility to seizures.

A significant traumatic brain injury can damage brain tissue and lead to seizures months or even years later.

Stroke is an important cause of new-onset epilepsy in older adults. Brain tissue damaged by interrupted blood flow or bleeding may later become a source of seizures.

Structural causes may include:

• Brain tumors.
• Congenital brain malformations.
• Scarring from a previous injury.
• Vascular malformations.
• Damage caused by a stroke.

Infections that affect the brain or its surrounding tissues may increase the risk of epilepsy. Examples include:

• Meningitis.
• Encephalitis.
• Neurocysticercosis.

Reduced oxygen supply, certain infections during pregnancy, premature birth, or abnormal brain development may contribute to epilepsy in some children.

Some congenital and developmental neurological disorders are associated with a higher likelihood of seizures.

Epilepsy does not look the same in every person. Symptoms depend on the type of seizure and the brain networks involved.

Possible signs include:

• Temporary confusion.
• Staring and not responding.
• Repeated episodes of disconnection from the surroundings.
• Uncontrolled movement of the arms or legs.
• Muscle stiffening.
• Sudden falls.
• Loss of consciousness.
• Speech difficulties.
• Temporary memory loss.
• Tingling or unusual sensations.
• Sudden fear, anxiety, or déjà vu.
• Repetitive movements without an obvious purpose.

Some people experience an aura before a more noticeable seizure. An aura is itself a focal seizure and may involve an unusual smell or taste, a visual disturbance, nausea, tingling, or a sudden emotional sensation.

Because some seizures are subtle, observations from relatives, friends, or coworkers can be extremely helpful during a neurological evaluation. If it is safe to do so, recording the episode may also help the neurologist understand what happened.

A person may have a higher risk of developing epilepsy if they have:

• A family history of epilepsy.
• A previous brain injury.
• A history of stroke.
• A brain tumor or structural brain abnormality.
• Dementia.
• A central nervous system infection.
• Certain developmental neurological conditions.
• A history of complex febrile seizures during childhood.

Having one or more risk factors does not mean that a person will necessarily develop epilepsy.

Epilepsy should be diagnosed by a qualified medical professional, usually a neurologist. The process begins with a detailed medical history and neurological examination.

The neurologist may ask:

• What happened before, during, and after the event?
• How long did the episode last?
• Was awareness affected?
• Were there abnormal movements or unusual sensations?
• How long did recovery take?
• Has anything similar happened before?
• Is there a family history of seizures?
• Which medicines, supplements, or substances does the person use?
• Was there fever, sleep deprivation, alcohol use, illness, or a recent injury?

Several other conditions can resemble seizures, including fainting, migraines, sleep disorders, movement disorders, metabolic disturbances, and psychogenic nonepileptic events. For this reason, the description of the episode and the circumstances surrounding it are essential.

An electroencephalogram, or EEG, records the brain’s electrical activity through electrodes placed on the scalp. It may detect patterns that support a diagnosis of epilepsy and help classify the type of seizure.

A normal EEG does not completely rule out epilepsy because abnormal activity may not occur during the recording. In some cases, a sleep-deprived EEG, prolonged ambulatory EEG, or video EEG monitoring may be needed.

A high-density EEG uses a larger number of electrodes to map electrical activity with greater spatial detail. It may be helpful in selected cases, particularly when specialists are trying to locate where seizures begin.

Brain magnetic resonance imaging, or MRI, can identify tumors, scars, malformations, stroke-related damage, or other structural abnormalities that may be causing seizures.

Computed Tomography

A computed tomography, or CT, scan is often used in emergency settings, especially after a first seizure, head injury, or when bleeding or another urgent brain condition is suspected.

Blood tests may help identify low blood glucose, electrolyte disturbances, infections, kidney or liver problems, or other conditions that can trigger a seizure.

Neuropsychological testing evaluates memory, language, attention, and other cognitive abilities. It may be especially useful when seizures are difficult to control or when epilepsy surgery is being considered.

Treatment depends on the type of seizure, epilepsy syndrome, possible cause, age, general health, pregnancy considerations, and the person’s daily needs.

Antiseizure medicines are the first treatment for most people. Selecting the right medication depends on the seizure type and the person’s individual medical profile.

Some people achieve control with the first medicine prescribed, while others require adjustments or a combination of treatments. Never stop or change an antiseizure medicine without medical supervision. Abrupt withdrawal can trigger prolonged or repeated seizures.

If pregnancy is planned or possible, medication should be reviewed with a neurologist and obstetrician before conception whenever possible. Do not stop treatment independently, because uncontrolled seizures can also create serious risks.

Surgery may be considered when seizures continue despite appropriate medication trials and testing identifies a brain area that can be treated without causing unacceptable neurological harm.

A presurgical evaluation may include video EEG monitoring, specialized MRI, functional imaging, neuropsychological testing, and consultation with a multidisciplinary epilepsy team.

Vagus nerve stimulation, or VNS, involves placing a device under the skin that sends regular electrical impulses through the vagus nerve. It may reduce seizure frequency in selected people whose seizures are not adequately controlled with medication.

Responsive neurostimulation, or RNS, uses an implanted device that monitors brain activity and delivers stimulation when it detects patterns associated with a seizure. It is available only in certain specialized centers and for carefully selected patients.

Deep brain stimulation, or DBS, delivers electrical impulses to specific brain areas involved in seizure networks. It may be considered for some adults with drug-resistant epilepsy.

A medically supervised ketogenic diet may reduce seizures in some children and adults with drug-resistant epilepsy. It is not simply a low-carbohydrate diet and should be planned and monitored by a specialized medical and nutrition team.

Many people with epilepsy work, study, exercise, travel, and enjoy independent lives. Good seizure control and a practical safety plan are key.

General recommendations include:

• Take antiseizure medication exactly as prescribed.
• Do not stop treatment without speaking to your neurologist.
• Maintain a regular sleep schedule.
• Avoid excessive alcohol and recreational drugs.
• Keep a seizure diary.
• Identify personal seizure triggers when possible.
• Manage stress.
• Exercise regularly after discussing appropriate precautions.
• Follow a balanced diet.
• Tell close relatives or coworkers how to respond to a seizure.
• Carry medical identification when recommended.
• Follow local driving regulations.
• Use extra care around water, heights, heat, machinery, and open flames.

Not every seizure has an identifiable trigger. Sleep loss, missed medication, illness, excessive alcohol, and stress may increase the likelihood of seizures in some people, but triggers differ from person to person.

Emotional health is also important. Anxiety, depression, fear of having a seizure in public, and social stigma can affect quality of life. Psychological support and open communication with the medical team can be valuable parts of treatment.

If someone is having a seizure:

1. Stay calm and note the time.
2. Help the person to the ground if they are falling.
3. Move furniture and dangerous objects away.
4. Place something soft and flat under the head.
5. Loosen tight clothing around the neck.
6. Remove eyeglasses.
7. Turn the person gently onto one side when possible.
8. Stay with them until they are awake and breathing normally.
9. Speak calmly during recovery.

Do not:

• Hold the person down.
• Try to stop the movements.
• Put your fingers or any object in the person’s mouth.
• Give food, water, or medication until the person is fully alert.
• Perform mouth-to-mouth breathing during the seizure unless breathing does not resume after the movements stop and emergency services instruct you to do so.

A person cannot swallow their tongue. Placing an object in the mouth can damage the teeth or jaw and may block the airway.

Schedule a neurological evaluation if you or a family member experiences:

• A first seizure.
• Repeated seizures.
• Unexplained episodes of lost awareness.
• Recurrent staring spells.
• Uncontrolled movements without a clear cause.
• Unusual sensations followed by confusion.
• Speech or behavioral changes after an episode.
• Seizures that continue despite treatment.
• Medication side effects.
• Questions about pregnancy, driving, work, or seizure safety.

Early evaluation can help identify conditions that need urgent treatment and reduce the risk of future complications.

Call emergency services immediately if:

• The seizure lasts five minutes or longer.
• Another seizure begins before the person fully recovers.
• The person does not regain consciousness.
• Breathing does not return to normal.
• The seizure occurs in water.
• The person has a serious injury.
• The person is pregnant.
• The person has diabetes or another serious medical condition.
• It is the person’s first known seizure.
• You are unsure whether the person is safe.

🚑 BlueNetHospitals Ambulance Service: +52 (624) 104 3911

Rapid medical attention can help prevent potentially serious complications.

If you or someone in your family has experienced a seizure, unexplained loss of awareness, or symptoms that may be related to epilepsy, an early neurological evaluation can make an important difference.

At BlueNetHospitals Los Cabos, our Neurology specialists use clinical evaluation and diagnostic testing to identify the type of seizure, investigate its possible cause, and create a personalized treatment plan focused on seizure control, safety, and quality of life.

📲 Schedule your appointment via WhatsApp: +52 (624) 151 0693

Important: Epilepsy requires ongoing medical follow-up. Never stop, reduce, or change an antiseizure medication without instructions from your neurologist.

Epilepsy is a neurological disorder characterized by an ongoing tendency to have unprovoked seizures caused by abnormal electrical activity in the brain.

No. A seizure can occur because of fever, low blood glucose, electrolyte disturbances, infection, head injury, alcohol withdrawal, medication, or other acute conditions. A neurologist must evaluate the event and determine whether it meets the criteria for epilepsy.

Some childhood epilepsy syndromes may resolve with age, and some people remain seizure-free after treatment. Others require long-term therapy. In carefully selected patients, surgery may eliminate or significantly reduce seizures. The outlook depends on the type and cause of epilepsy.

Common tests include an EEG, brain MRI, blood tests, and sometimes CT imaging. Prolonged video EEG, high-density EEG, neuropsychological testing, or additional imaging may be needed in complex cases.

Protect the person from injury, place something soft under their head, turn them onto one side when possible, and time the seizure. Do not restrain them or place anything in their mouth. Call emergency services if the seizure lasts five minutes or longer, repeats without recovery, causes injury, or is the person’s first known seizure.

Many people with epilepsy work, study, exercise, travel, and have families. Consistent treatment, adequate sleep, safety planning, and regular neurological follow-up help support an active life.

Possible triggers include missed medication, sleep deprivation, excessive alcohol, illness, stress, and flashing lights in a small group of people with photosensitive epilepsy. Some seizures occur without an obvious trigger.

Driving rules vary by country and region and usually depend on how long the person has been seizure-free. A neurologist can explain the medical recommendations, but the patient must also follow local licensing laws.

If seizures continue after appropriate trials of antiseizure medicines, the neurologist may refer the patient to a specialized epilepsy center. Options may include surgery, vagus nerve stimulation, responsive neurostimulation, deep brain stimulation, or dietary therapy.

Consult a neurologist after a first seizure, repeated episodes, unexplained loss of awareness, unusual movements, or persistent symptoms that could involve brain activity. A timely diagnosis allows treatment to begin when needed and helps reduce future risks.