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Epilepsy FAQs - What is a seizure threshold?

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What is a seizure threshold?
A seizure threshold is the level of stimulation at which your brain will have a seizure. A very high fever, for instance, can sufficiently excite anyone’s brain to produce a seizure. People with epilepsy have a lower–than–normal seizure threshold, meaning that only slightly increased excitement will cause them to have a seizure. Your seizure threshold is mostly genetically inherited, but other factors can affect this level. Young age and high fever are two factors that may lower one’s threshold, making a child more likely to have a seizure.

Is epilepsy genetically inherited?
Some forms of epilepsy have now been linked to specific genes. In addition, scientists believe that everyone inherits a seizure threshold which determines how susceptible you are to seizures. In fact, in most cases epilepsy develops without any family history of the condition. Basically, unless both parents have a strong family history of epilepsy, the chances that any of their children will inherit the tendency to have seizures are quite low.

Is Epilepsy Contagious?
Epilepsy is in no way contagious. No one can get the disorder by talking to, kissing, or touching somebody with Epilepsy. Epilepsy can only be transmitted through hereditary transfer. Epilepsy that runs in families suggests an underlying metabolic or genetic etiology, and this is the least common of all Epilepsy causes.

Who has epilepsy?
Epilepsy most often starts in childhood or else late in life, but anyone can develop epilepsy at any time. Epilepsy affects people of all ages, all nations, and all races. Next to migraine headaches, it is the most common neurological disorder.

What is an EEG?
The electroencephalograph or EEG directly measures electrical activity in the brain–brain waves–through the skin. In this harmless test, small sensors called electrodes are attached to the patient’s scalp. The electrical activity picked up by each sensor is graphed onto an EEG printout. Tests done on people with epilepsy commonly show uneven activity or large changes in the voltage of brain waves . Different patterns of activity from different spots on the scalp point to different kinds of epilepsy.

How accurate is the EEG test?
The EEG is not foolproof. It can only measure abnormal electrical activity that occurs during the test period. Sometimes, the brain of the person with epilepsy functions perfectly normally during the test. Or the electric patterns that the device is looking for happen too deep in the brain to be picked up by the scalp electrodes of the EEG. When the EEG doesn’t find anything unusual, it is common for the patient to get a continuous, 24–hour EEG monitoring in hospital. About 20% of people with epilepsy have normal EEGs, and a small percentage who don’t have epilepsy have abnormal ones!

What other tests are sometimes used?
Neuroimaging tests are often recommended, even in cases of long–standing epilepsy, when its cause is unknown.
  1. CAT or CT scan stands for computerized axial tomography, which uses computer processing and x–rays to make a computer image of the brain in three dimensions.
  2. The Magnetic Resonance Imager (MRI) can better define the structures of the brain in three dimensions. All electric currents make magnetic fields, and the MRI measures the strength of these fields.
  3. MRS (Magnetic Resonance Spectroscopy) provides information about the brain’s functioning and biochemistry which can be used in conjunction with structural MRI or CT images.
  4. Functional MRI (fMRI) can look at discrete areas of brain activation.
  5. PET (Positron emission tomography) scanning is a highly specialized, expensive and largely unavailable technique that detects cerebral blood flow and metabolism.
  6. SPECT scanning is much cheaper and technically simpler than PET scanning for determining cerebral blood flow.
Does having epilepsy affect sex?
Epilepsy can have effects on sex, and sex has effects on epilepsy. Many people with well controlled epilepsy have a comfortable, satisfying sex life. Having a supportive partner who provides emotional closeness, as well as sexual intimacy, is perhaps the greatest asset in helping people with epilepsy feel positive about themselves, which in turn improves seizure control. Anxiety and stress are known seizure “Triggers”. Sex can release stress, and help relax people, thereby reducing seizure frequency.
People living with epilepsy frequently encounter sexual difficulties. These can be due to the epilepsy itself, the medications used to treat the illness, or due to reactions of partners.

Can epilepsy lower my sexual desire?
One of the commonest sexual effects of epilepsy is the decrease or loss of desire. This is variable depending on the type of epilepsy a person is dealing with. Erectile dysfunction is also a common problem for men with epilepsy. Desire changes appear similar for women.
Sexual difficulties are found to be more significant in people whose epilepsy started before adolescence. Epilepsy can affect a person’s self–confidence, body image, and mood, both of which are important when relating with others.

What effects do anti–seizure medications have on sex?
Drugs used to treat epilepsy have common side–effects than can depress sexual responsiveness, desire, arousal (erection problems for men, and lubrication problems for women), as well as orgasmic difficulties. Finding the right balance of seizure control and side–effect reduction can be challenging. Stopping drugs due to frustrating side–effects might feel like a good solution in the short term, but doesn’t help reduce seizures and can be dangerous.

Who can I talk to about sex and epilepsy?
Discussing sexual side–effects can feel embarrassing, but most doctors should be able to deal with them appropriately. As more and more drugs become available for epilepsy, as well as other diseases, quality of life issues are becoming significant factors in medication choices.

When should I tell someone new that I have epilepsy?
Potential partners are often scared of the unknown, which leads them to avoid someone with epilepsy. At times people with epilepsy will hide their illness from someone new. It is appropriate to know someone a bit before divulging such private information. At times this leads to increased anxiety. Partners have fears regarding the myths and realities of what epilepsy actually is.

Could having sex trigger a seizure?
It is rare than sex will trigger a seizure, although it does occasionally happen. An intimate partner needs to be taught how to deal with seizures in general.

What can I do if I’m encountering problems with sex?
Talk to your partner, which is the best solution for it. By talking with doctors, family physicians, neurologists, and others about your sexual concerns, they can change medications or other treatments accordingly. For example, treatments exist for erectile dysfunction; lubricants can help for dry vaginas. Love can be the best medicine for a couple living with epilepsy.

Is there a cure for epilepsy?
There is currently no cure for epilepsy, but there are ways to keep seizures under control.

Do anti–epileptic medications have side effects?
All anti–epileptic drugs can have side effects. These vary from drug to drug and only affect some people. In general, however, it is common for people on anti–epileptic medication to experience drowsiness, fatigue, weight change, upset stomach and difficulties with concentration and memory.

Is surgery used to treat epilepsy?
Yes, brain surgery for epilepsy is performed, but only in a small percentage of cases, and only when all other treatments fail to adequately control seizures. The area of the brain with abnormally discharging neurons is surgically removed, if it is possible to identify this area and remove it safely. Or, in certain patients without a well–defined epilepsy focus, surgically disconnecting or isolating the abnormal area so that seizures no longer spread to the neighbouring normal brain can help. As with any operation, there are risks to epilepsy surgery. In patients with an identified seizure focus, the success rate of surgery is up to 80%.

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