Does epilepsy have symptoms when it is not causing seizures?

Written by Yuan Jun Li
Neurology
Updated on November 16, 2024
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When epilepsy is not active, there are no symptoms. Patients mainly show recurrent epileptic seizures, usually lasting three to five minutes. After the seizure stops, the patient does not exhibit any symptoms or signs. Clinically, epilepsy is categorized into primary and secondary types. For primary epilepsy, if a patient experiences more than two episodes, routine use of anti-epileptic drugs is recommended. The choice of medication varies depending on the type of epilepsy. Typically, monotherapy is preferred initially. However, if monotherapy is ineffective or causes substantial side effects, a combination of two or more anti-epileptic drugs may be used to try to control the seizures. In cases of secondary epilepsy, which often has a clear cause, the primary focus is on treating the underlying condition. This includes long-term cerebrovascular diseases like cerebral hemorrhage and cerebral infarction, as well as conditions like encephalitis and brain tumors. Treatment should be tailored to the specific disease.

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Written by Yan Xin Liang
Pediatrics
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Precursors to epileptic seizures in children

The majority of childhood epilepsy seizures occur without any precursors, as they arise and cease suddenly with stereotyped movements. However, some seizures are preceded by prodromes, such as sudden onset of consciousness disturbances, or fainting symptoms. Other seizures can present with motor dysfunctions, displaying sudden weakness or fatigue in certain limbs, followed by an epileptic attack. Additionally, some may experience abnormal sensations, such as numbness in a specific area or visual disturbances, including sudden flashes or even visual distortions, leading to convulsive seizures.

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Written by Yuan Jun Li
Neurology
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What are the signs before the onset of epilepsy?

Before the onset of epilepsy, most patients do not exhibit any signs and can suddenly experience an epileptic seizure. Different types of epilepsy have different symptoms. For example, during a major seizure, symptoms can include limb twitching, eyes rolling upwards, frothing at the mouth, clenched teeth, loss of consciousness, and abnormal blood pressure, which can lead to severe falls and injuries. During a minor seizure, the patient mainly shows transient loss of consciousness, objects in hand may suddenly drop, unresponsiveness when called, and a vacant stare. Most patients do not fall, and the symptoms generally last for only a few seconds to tens of seconds. If autonomic epileptic seizures are considered, symptoms may include nausea and vomiting. Psychotic symptom seizures can present with hallucinations and delusions.

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Written by Liu Shi Xiang
Neurology
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Can mild epilepsy be treated?

Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.

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Written by Liu Shi Xiang
Neurology
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What can severe epilepsy lead to?

Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.

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Written by Tang Bo
Neurology
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How is epilepsy treated?

Epilepsy treatment can be divided into the following aspects: First is etiological treatment. If epilepsy is caused by tumors or cerebrovascular diseases, surgical removal of the lesion can relieve epilepsy, but seizures often still occur, so medication must not be stopped. Secondly, pharmacological treatment is necessary for epilepsy induced by unclear causes or genetic metabolic diseases. Treatment involves taking and adjusting medications under medical guidance, based on different types of seizures and individual patient circumstances. Additionally, for some cases where the cause cannot be clearly identified and no epileptic foci are found, functional surgery can be performed for treatment.