Epilepsy - Outlook and Effects

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The condition is defined as recurrent convulsions that last for more than 20 minutes and are interrupted by only brief periods of partial relief. Some experts believe these criteria are too strict, and that the condition should be diagnosed if seizures last at least 5 minutes or more, or when the patient does not fully recover consciousness between two or more seizures. Although any type of seizure can be sustained or recurrent, the most serious form of status epilepticus is the generalized convulsive or tonic-clonic type. In more than a third of cases, status epilepticus occurs with the first seizure. The trigger is often unknown, but can include the following:

• Failure to take anti-epileptic medications (accounts for about a third of status epilepticus events)
• Abrupt withdrawal of certain anti-epileptic drugs, particularly barbiturates and benzodiazepines
• High fever
• Poisoning
• Electrolyte imbalances (imbalance in calcium, sodium, and potassium)
• Cardiac arrest
• Stroke. In one study, about 9% of stroke patients with seizures had status epilepticus, which resulted in higher disability after the stroke, particularly if these severe seizures occurred within a week of the stroke.
• Low blood sugar in people with diabetes

Survival Rates

Epileptic patients who are cured have a normal lifespan. Their long-term survival rates are lower than average, however, if medications or surgery fail to stop the seizures. The lower survival rate is partly due to a higher-than-average risk for death due to accidents and suicide. The specific cause of the seizure may also contribute to fatalities.

There is a very low risk for sudden death in patients with epilepsy. Although the causes of such events are not fully known, experts suspect heart arrhythmias in many cases. There is some evidence, in fact, that a malfunction in the autonomic nervous system (which controls heart rate) may be responsible for some of these deaths. Some researchers believe that temporal lobe surgery in appropriate patients may reduce the risk. Drugs that block arrhythmias may also be helpful in reducing this risk.