In the News: Epilepsy and Seizures

The seizure that caused Supreme Court Justice John G. Roberts, Jr. to fall has raised the profile of epilepsy - a common and often misunderstood disorder of the brain.

On July 30, the 52-year-old Chief Justice fell and lost consciousness at his summer home. He was taken to a hospital, where doctors diagnosed "benign idiopathic seizure," according to a Supreme Court press release. This diagnosis means that doctors could not find an obvious underlying cause for the seizure. Roberts was released a day later when neurological evaluations "revealed no cause for concern," according to the press release.

Roberts experienced a similar seizure in 1993. Some doctors might classify Roberts' two seizures as epilepsy, even though they occurred more than a decade apart. But what exactly is a seizure, and when is it classified as epilepsy?

A seizure is often described as an electrical storm in the brain, when the neurons fire at a much faster rate than normal. Injuries and high fevers may cause seizures, although in about half of cases, the cause is unknown. Seizures are more common than epilepsy, occurring in about 10 percent of people in the United States.

Seizures can cause sudden changes in mood, behaviour, or result in involuntary muscle movement, hallucinations or, as in Roberts' case, loss of consciousness. The signs of seizure depend on which portion of the brain is affected.

For instance, partial seizures - which account for the majority of seizures - occur in specific areas of the brain. A person experiencing a partial seizure can have a wide range of sensations. They may look "out of it," or they may experience sudden intense feelings of joy or sadness. People may smack their lips, make repetitive motions or hallucinate.

Generalised seizures can be more severe and have several types. They involve both sides of the brain and can also involve looking blank for a few seconds. This type, called petit mal seizure, is very difficult to diagnose. Grand mal seizure is the most severe kind of generalized seizure. People may lose consciousness and shake violently.

Epilepsy is defined as having two more seizures without an identifiable cause. Epilepsy is more common than many people believe. About 1 percent of the U.S. population receives treatment for epilepsy. It is most common in children, and about 50 percent of all cases are diagnosed in people under 25, according to the Epilepsy Foundation. Epilepsy also can become more common as people age.

Many people shun the term "epilepsy" because they feel it is stigmatising. They (or their doctor) instead describe themselves as having "seizure disorder." However, about 80 percent of people successfully control seizures by avoiding triggers and taking anti-seizure medication as prescribed, according to the U.S. National Institutes of Health.

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