What Types of Epilepsy Do Elderly People Suffer From?

According to the NHS, epilepsy is a common condition that affects the brain and causes frequent seizures. It can start at any age but usually starts either in childhood or in elderly people over the age of 60.

In the UK, around 600,000 people are living with epilepsy, which is around one in a hundred. Every day around 80 people are diagnosed. Even so, it remains a much-misunderstood condition. Symptoms are often misdiagnosed, and people can go for some time without receiving the right kind of treatment. Epilepsy comes in many different forms and it’s not a single condition with a single type of treatment.

We know epilepsy can be a worrying prospect, especially as an elderly person, but if you understand the type of epilepsy you or a loved one has, you can learn to treat it more effectively. Most people with the condition are able to live normal lives if their seizures are well controlled.

What is epilepsy?

Broadly speaking, epilepsy is defined as a neurological condition that causes unprovoked, recurrent seizures. A seizure is a sudden rush of abnormal electrical activity in the brain which temporarily alters the way it works.

Seizures are the main symptom of epilepsy – they can be mild or stronger. A mild seizure can be difficult to recognise and may only last a few seconds, while a stronger seizure can cause spasms and uncontrollable muscle twitches. They can last anywhere from a few seconds to several minutes and may cause confusion or loss of consciousness.

There currently isn’t a cure for epilepsy, however it can be managed with medications and other strategies. Symptoms can differ from person-to-person and can vary on the type of epilepsy you have, for example some people may experience strange sensations, go through periods of staring blankly into space or experience changes to their sense of smell.

What are the types of seizures?

Epilepsy can be grouped into ‘generalised’, ‘focal’ and ‘unknown onset’ epilepsy:

• Generalised epilepsy: This type of epilepsy occurs when abnormal electrical activity which triggers seizures occurs in both hemispheres of the brain at the same time. Seizures can take many forms including violent convulsions (grand mal) or absences (petite mal) in which people appear to be staring into space. Treatment will vary according to the individual and may or may not include medication.
• Focal Epilepsy: These occur in part of the brain and are often described as partial seizures. These can be both motor seizures which your body will move to some extent. This can take the form of twitching, spasms, walking around or rubbing your hands. Non motor seizures, on the other hand, change how you feel or think. For example, you might suddenly experience strange feelings or emotions. Your heart might feel like it’s racing, or you could experience sudden waves of intense warmth or chills. In some cases, you’ll be aware of the seizures. During these ‘focal seizures’, you’ll retain consciousness throughout the process. Partial focal seizures on the other hand could impair your awareness leaving you feeling confused and disorientated.
• Unknown onset seizures: Doctors will often have difficulty diagnosing which of these types of epilepsy they have. This might be because you have only had seizures at home so nobody can report what happened or if your test results are unclear. If this happens, they may list your epilepsy as an ‘unknown’ type.

As well as this, some people may have both focal and generalised onset seizures. Sometimes the electrical signals affect the whole brain in which case they lose consciousness; other times, just a single part in which case they will retain some degree of awareness.

What are the triggers of an epileptic seizure?

Identifying triggers isn’t always easy as a single incident doesn’t always mean something is a seizure. Usually, a combination of factors triggers a seizure. Some of the most common triggers are:

• A lack of sleep
• Illness or a fever
• Stress
• Bright lights, flashing lights and patterns
• Caffeine or alcohol consumption
• Medications or alcohol withdrawal
• Skipping meals, overeating or specific food ingredients
• Very low blood sugar
• Head injury

Epilepsy syndromes

In addition to all these, there are several epilepsy syndromes. These are more specific and can be diagnosed due to multiple symptoms which generally go together as well as MRI or EEG tests which are used to diagnose epilepsy. These could be present at birth or can develop at some point during your life. They may also continue as a chronic condition or get better with time.

There are several different types of epilepsy syndromes including:

• West’s Syndrome: Also known as infantile spasms, these can occur between the ages of three and 12 months. Spasms can take the form of sudden jerks followed by a stiffness. They may last for only a second or two but tend to occur in a series with one seizure following another.
• Doose syndrome: Also known as Myoclonic Astatic Epilepsy (MAE), this form generally occurs in children between the ages of one and five. Children will often experience trance seizures in which they appear to be staring into space. The cause of this syndrome is not yet known, and it can be resistant to anti-seizure drugs. However, a ketogenic diet can be effective at treating it.
• Benign Rolandic Epilepsy: Another type which generally occurs during childhood and often clears up by adolescence. Seizures may take the form of twitching, numbness or a tingling on the tongue.
• Rasmussen Syndrome: This appears to be an autoimmune condition which causes one hemisphere in the brain to become inflamed. The most common symptoms are seizures although others may include feelings of weakness and other problems which can occur around three years after the start of the seizures.
• Surge Weber Syndrome: A disorder which affects the brain and skin. It can be identified by a stain which may appear around the forehead or eye. Children affected may also experience seizures, weakness down one side of the body or developmental delays.

Can you have a one-off seizure?

Identifying epilepsy can be difficult. It is possible for anyone to have a one-off seizure. However, this doesn’t necessarily indicate the presence of epilepsy. This usually only happens when symptoms keep happening. The seizure length of time can vary but will generally be over within a few seconds.

Stages of epilepsy in adults

Seizures can take many forms but generally go through several stages:

• Prodrome stages: This stage tells people that a seizure may be on its way. It can happen hours or even days before it actually happens and can include symptoms such as mood changes, anxiety, feeling lightheaded and difficulty sleeping.
• Aura: This is the early part of the seizure and can include symptoms of déjà vu, dizziness, odd smells or tastes, vision difficulties, numbness, and a feeling of intense fear or a sense of panic.
• Middle (ictal) phase: This generally covers the duration of the seizure and can include memory problems, loss of awareness, twitching, loss of muscle control, racing heart, body convulsions, and repeated movements such as lip-smacking.
• Ending (post-ictal) phase: After the active part of the seizure has finished, you may experience confusion, exhaustion, soreness, fear, anxiety, lack of consciousness and loss of bowel or bladder control. How long this lasts as the body returns to normal, may depend on the type of seizure you’ve had.

Understanding these stages and how the different types of epilepsy can affect you, can go a long way to helping you manage it more effectively. In some cases, anti-seizure drugs may be effective at mitigating the effects; in others, it may be a case of learning to live with the condition. In some instances, epilepsy surgery may be considered the only option. However, the more you know about the type of epilepsy you have the easier it will be for doctors to design a treatment plan which works for you.

Living with epilepsy as an elderly person

Although there’s no cure at this time, the right treatment and precautions can result in a dramatic improvement in your condition and quality of life. Many elderly people with epilepsy find that personal alarms can offer them the peace of mind that if they suffer a seizure, they can alert family or friends with the click of a button and someone will be there to help. Some personal alarms are also equipped with fall detection which can automatically detect if the wearer suffers a fall and calls for help without them needing to press the SOS button. This can be particularly useful if you suffer from a stronger seizure which can cause falls and loss of consciousness.

Call SureSafe’s team of experts on 0800 112 3201 to learn more about our personal alarms for people with epilepsy.