Common triggers include flashing lights and sudden noises. In certain types of epilepsy, seizures happen more often during sleep, and in other types they occur almost only when sleeping. Seizure clusters
Patients with epilepsy may experience seizure clusters which may be broadly defined as an acute deterioration in seizure control. The prevalence of seizure clusters is uncertain given that studies have used different definitions to define them. However, estimates suggest that the prevalence may range from 5% to 50% of epilepsy patients. Refractory epilepsy patients who have a high seizure frequency are at the greatest risk for having seizure clusters. Seizure clusters are associated with increased healthcare utilization, worse quality of life, impaired psychosocial functioning, and possibly increased mortality. Benzodiazepines are used as an acute treatment for seizure clusters. Post-ictal
After the active portion of a seizure (the ictal state) there is typically a period of recovery during which there is confusion, referred to as the postictal period, before a normal level of consciousness returns. It usually lasts 3 to 15 minutes but may last for hours. Other common symptoms include feeling tired, headache, difficulty speaking, and abnormal behavior. Psychosis after a seizure is relatively common, occurring in 6–10% of people. Often people do not remember what happened during this time. Localized weakness, known as Todds paralysis, may also occur after a focal seizure. It would typically last for seconds to minutes but may rarely last for a day or two. Psychosocial
Epilepsy can have adverse effects on social and psychological well-being.
Chronic alcohol use increases the risk of epilepsy: those who drink six units of alcohol per day have a 2.5-fold increase in risk. Other risks include Alzheimers disease, multiple sclerosis, tuberous sclerosis, and autoimmune encephalitis. Getting vaccinated does not increase the risk of epilepsy. Malnutrition is a risk factor seen mostly in the developing world, although it is unclear however if it is a direct cause or an association. People with cerebral palsy have an increased risk of epilepsy, with half of people with spastic quadriplegia and spastic hemiplegia having the disease. Mechanism
Normally brain electrical activity is non-synchronous, as large numbers of neurons do not normally fire at the same time, but rather fire in order as signals travel throughout the brain. Neuron activity is regulated by various factors both within the cell and the cellular environment. Factors within the neuron include the type, number and distribution of ion channels, changes to receptors and changes of gene expression. Factors around the neuron include ion concentrations, synaptic plasticity and regulation of transmitter breakdown by glial cells. Epilepsy
The exact mechanism for epilepsy is unknown, but a little is known about its cellular and network mechanisms. However, it is unknown under which circumstances the brain shifts into the activity of a seizure with its excessive synchronization. Changes in MicroRNAs (miRNAs) levels seems to play a leading role.