Seizure disorders: The Optum Perks Guide

Table of Contents:

1. What is a seizure?
2. What are the main types of seizures?
3. What causes a seizure?
4. How long do seizures last?
5. How are seizures diagnosed?
6. Is there a difference between seizures and epilepsy?
7. What medications are used to treat a seizure disorder?
8. Do seizure medications have side effects?
9. What if seizure medication isn’t effective?

Not all seizures are alike. For some people, seizures can feel like an electric jolt. They drop to the floor, their bodies shaking. For others, seizures can feel as if they’re in a dream. They may stare into the distance or become confused or disoriented. But they don’t lose consciousness.

No matter how you experience seizures, they’re alarming and can take a toll on your quality of life. And they’re more common than you might think. Around 50 million people worldwide have recurring seizures. It’s a condition known as epilepsy.

But there’s good news. Up to 70% of people with epilepsy could live seizure-free with the right treatment. This is according to the World Health Organization. Our expert guide answers all your questions about why seizures happen, what to do if you have a seizure and how to treat it.

Make sure you’re getting the best price on your medication. Ask your pharmacist to check your prescription’s Optum Perks discount card price to see how much you could save.

What is a seizure?

A seizure is a burst of electrical activity in your brain. Your brain cells normally talk to one another using electrical currents. It’s how we’re able to walk, talk and perceive the world. But when that current goes off the rails, it can create issues.

A seizure usually starts suddenly, says Emily Klatte, MD. She’s the OhioHealth System medical chief for epilepsy in Columbus. “The neurons in the brain are firing off too much electrical current,” she explains. “And at the end of a seizure, the whole brain feels tired.”

The symptoms depend on the part of the brain that’s affected, says Stephen Wong, MD. He’s the medical director of clinical neurophysiology at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

“For example, if the electrical activity is in a part of the brain that connects to moving a person’s muscles, there will be muscle cramping,” Dr. Wong says. “If the activity is in the part of the brain that controls vision, the person may see auras or flashing lights.”

What are the main types of seizures?

There are 3 main types. And some people experience more than 1 type. They differ mainly depending on what part of the brain is impacted.

1. Focal onset seizures. These seizures are localized in 1 part of the brain, Dr. Wong says. They are typically caused by brain damage, such as from a stroke, tumor or infection. “This kind of seizure is common in older people,” he adds. If the person stays awake during their seizure, it’s most likely focal.

2. Generalized onset seizures. This type affects both sides of the brain. And it can cause more dramatic seizures with convulsions and loss of consciousness. “Most people who have generalized seizures are born with it, and it’s genetic,” Dr. Wong says.

3. Unknown onset seizures. This is a catch-all bucket for when the start of the seizure is unclear. For example, seizures can happen at night while you’re asleep. They could be subtle, such as staring without moving. Or they could happen when you’re by yourself (and you don’t remember).

What causes a seizure?

They’re caused by a chemical change that affects how your brain cells talk to one another, says Dr. Wong. The trigger for this change could be physical. Examples include a traumatic head injury, an infection or a stroke. It can also be related to chronic conditions — for example, if the blood sugar of someone with diabetes gets too high or too low.

Seizures could also be triggered by alcohol withdrawal or taking certain drugs, says Roy Sucholeiki, MD. He’s a neurologist and epilepsy specialist with Northwestern Medicine in Winfield, Illinois. These are what experts call “provoked seizures.”

That said, for up to half of people who have a seizure, the cause is unknown. Sometimes seizures run in families. So genetics may come into play for some people.

For people who have epilepsy, there are many possible triggers. They include:

• Missing your epilepsy medication
• Not getting enough sleep (a common sleep stealer is sleep apnea)
• Extreme stress
• Binge drinking or having 3 or more alcoholic drinks at a time
• Hormonal changes, such as those that happen around a person’s menstrual cycle

Flashing lights can be a trigger. But that’s true only for about 3% of people with epilepsy, according to Penn Medicine.

How long do seizures last?

A single seizure can last up to 3 minutes. But it can take longer to feel like yourself again, Dr. Sucholeiki says. “The recovery can be immediate, but it often takes minutes to hours.

“Seizures that last longer are considered a medical emergency,” says Dr. Sucholeiki. That’s also true if they occur back-to-back.

How are seizures diagnosed?

If you think you’ve had a seizure, the best course of action is to see a neurologist. The neurologist will want to know if there were witnesses to the seizure who can describe it. Then they may run some standard tests for epilepsy.

There are 2 important tests to run, says Dr. Sucholeiki. The first is brain imaging, such as a high-quality MRI. The second is an electroencephalogram (EEG). Electrodes are placed on your scalp to check the electrical activity of your brain.

Is there a difference between seizures and epilepsy?

Yes. A seizure is an event. It can be a symptom of other medical problems. Epilepsy is a diagnosis. It means you have recurring seizures.

There are certain criteria for an epilepsy diagnosis. One is that you have to have had 2 seizures more than 24 hours apart, says Rochelle Hines, PhD. She’s an associate professor of psychological and brain sciences at the University of Nevada, Las Vegas. And those seizures have to be unprovoked.

“Epilepsy is really a whole range of disorders,” Hines says. “We are working to learn more about the specific kinds of seizures in various forms of epilepsy. And we’re trying to develop new and better therapies.”

What medications are used to treat a seizure disorder?

There are more than 25 seizure medications available, says Dr. Sucholeiki. The choice of medication may be based on factors such as your age, health and the other medications you take. (Haven’t reviewed your medications with your doctor in a while? You could be putting your health at risk — and missing out on potential savings.)

In general, seizure medications curb the electrical bursts that cause seizures. They may change how brain chemicals move in and out of cells. Or they may change how excitable brain cells are.

“Most people with epilepsy will find a drug that works best for them,” Dr. Sucholeiki says. It may just take a bit of trial and error. “Sometimes you may require more than 1 medication to best manage the condition,” he adds.

Among the medications approved to treat epilepsy are:

• Keppra® (levetiracetam). This medication comes in an immediate- or extended-release tablet. It attaches to a protein in the brain that affects how brain cells talk to one another.
• Vimpat® (lacosamide). Electrical activity in your brain spreads through sodium channels. When brain cells open their gates, sodium floods in and carries that electrical pulse down the line. Lacosamide can help to slow down or turn off those sodium channels. It’s available as a tablet or a liquid injection.
• Lamictal (lamotrigine). This medication comes as a tablet. It prevents brain cells from working at the speed that’s needed to make a seizure.
• Depakote® (divalproex sodium). It’s a tablet that helps prevent seizures from happening. Experts aren’t sure exactly how Depakote works. But it’s effective against many kinds of seizures.
• Tegretol® (carbamazepine). Tegretol is an oral medication. It’s thought to work by changing how fast sodium channels in the brain can open or close. This helps prevent the burst of electrical activity needed to make a seizure.

Do seizure medications have side effects?

All medications have the potential for side effects. But seizure medications are by and large very safe, Dr. Sucholeiki says. And most people will find a medication with few to no side effects that works for them. “The goal of treatment is no seizures and no side effects,” he says. “And the first drug chosen may not work. One size does not fit all.”

Common side effects that can happen in the first few weeks of starting a seizure medication include:

• Feeling tired
• Upset stomach
• Dizziness
• Blurred vision

Serious side effects are possible. These could include skin conditions and damage to the liver or pancreas. In pregnant women, some of these medications could cause birth defects. It’s crucial to talk to your doctor if you are pregnant or are planning to become pregnant.

What if seizure medication isn’t effective?

If the seizures always occur in the same part of the brain, surgery may be recommended. They remove the part of the brain where seizures happen. Or the doctor may recommend a seizure device. For this, a small device is implanted along a nerve in your neck. It sends small electric currents to the nervous system. The idea is to make brain cells function the way they should.

Dr. Sucholeiki also suggests contacting a specialist at an epilepsy center. You may find a specialist at the National Association of Epilepsy Centers or the American Epilepsy Society. And if you need medication, don’t miss out on potential savings. Bring your Optum Perks prescription discount card with you each time you go to the pharmacy to get the best price.