HealthONE - November 10, 2021

This National Epilepsy Awareness Month, epilepsy expert Matt Mian, MD shares crucial information that everyone should know about the seizure disorder.

More than three million people in the United States are living with epilepsy. This neurological disorder is characterized by seizures—episodes of disruption to normal brain activity. “Epilepsy and seizures are sometimes misunderstood, and many people do not know how to help someone having a seizure,” explains Matt Mian, MD, a functional neurosurgeon at the Level 4 Epilepsy Center at Swedish Medical Center. “Each year, epilepsy advocates devote the month of November to spreading information and raising awareness about this disorder.”

To aid in this effort, Dr. Mian highlights five things that are important for everyone to know about epilepsy.

1. Epilepsy is a common condition.

Experts estimate that one in 10 people experience a seizure in their lives, and 1 in 26 develop epilepsy. While those with epilepsy have seizures, having a seizure doesn’t mean you have epilepsy. “An epilepsy diagnosis often comes after a person has had two or more seizures—and we know these seizures weren’t caused by another condition such as alcohol withdrawal, infection or a fever,” Dr. Mian explains. “Often, after experiencing several seizures, patients will undergo an EEG to confirm an epilepsy diagnosis.” An EEG –or electroencephalography—is a test that records brain activity. The brain’s electrical signals are recorded, and physicians review the patterns to determine the presence of epilepsy.

2. Epilepsy affects all types of people.

Epilepsy can happen to anyone at any age. For some people, genetics lead to the development of epilepsy. It is estimated that a third of those with epilepsy have a family member with the condition as well. Other conditions such as a severe brain injury, stroke, brain tumor, lack of oxygen during birth or drug/alcohol abuse can cause epilepsy. “But for about half of those with epilepsy, there is not a clear, identifiable cause,” Dr. Mian states. “What we often can determine is what triggers a person’s seizures and that can help the person manage and even thrive while living with epilepsy.”

3. Seizures don’t always involve convulsions or uncontrollable shaking.

There are many kinds of seizures, and the type is determined by where it begins in the brain. Seizures are organized into two groups: generalized and focal. During generalized seizures, the person may blink rapidly or stare off into space. Generalized seizures also include those when the person cries out, loses consciousness, or jerks and spasms. The other type is called focal seizures. These seizures often cause twitching, change in taste/smell and/or confusion. “Seizures are not always an emergency by themselves,” Dr. Mian clarifies. “If a seizure lasts more than five minutes, the person gets injured during the seizure, or the person has trouble breathing at any point, call 911.”

4. Everyone can be prepared to help someone with epilepsy.

Many people with epilepsy can lead normal, active lives, which means you may be placed in a situation in which you can help a person with epilepsy. Understanding epilepsy first aid is helpful for everyone—even if you don’t have a loved one diagnosed with the condition. Dr. Mian shares the following dos and don’ts if you are with someone who experiences a seizure.

  • DO stay with the person and reassure them during the episode and after it.
  • DO stay calm and keep others around you calm.
  • DO ease the person to the floor if they are shaking/jerking uncontrollably; gently turn them onto one side to help respiration.
  • DO clear the area around a person having a shaking/jerking seizure and put something soft and flat under the head.
  • DO NOT hold the person down or impede movements.
  • DO NOT put anything into the person’s mouth. People having seizures cannot swallow their tongues.
  • DO NOT give mouth-to-mouth breaths.
  • DO call 911 if the seizure lasts longer than five minutes, the person becomes injured during the episode, the person has trouble breathing or if the person is pregnant, diabetic or has heart disease.

5.Treatments are available for people with epilepsy.

Medication often is an effective treatment for those with epilepsy. But sometimes, medication is not effective on its own. “Any patient who continues to experience frequent or disruptive seizures despite trying several anti-seizure medications should have a surgical evaluation,” Dr. Mian encourages.

“One newer treatment we are providing at Swedish is laser interstitial thermal therapy—also called LITT,” Dr. Mian details. “Once we have determined that the epileptic brain tissue is not essential for normal functions such as speaking, vision and memory, we can remove or damage the tissue. LITT is a minimally invasive way to do that. This procedure is highly targeted and very effective in curing seizures. If we determine the brain tissue causing the epilepsy is in an essential part of the brain, we consider neuromodulation treatments such as deep brain stimulation, responsive neurostimulation or vagus nerve stimulation. These treatments may not eliminate seizures but will reduce the frequency and intensity.”

“Living well with epilepsy is attainable for most people,” Dr. Mian encourages. “If you or a loved one has been diagnosed, I highly encourage you to seek care from an epilepsy specialist. Together, we can determine where the seizures start and then create a treatment plan that meets your specific needs.”

Dr. Matthew Mian is the director of functional neurosurgery at Swedish Medical Center in Englewood, CO. Dr. Mian studied biomedical engineering and math at Duke University and then earned his medical degree with honors from a joint program between Harvard Medical School and Massachusetts Institute of Technology (MIT). While in Boston, Dr. Mian developed an interest in cognitive neuroscience, and his studies were published in prominent journals including Nature, The Journal of Neuroscience, and Cerebral Cortex. He completed his residency training in neurosurgery at Massachusetts General Hospital and then a fellowship in stereotactic and functional neurosurgery at Emory University. Dr. Mian is passionate about minimally invasive neurosurgical therapies for restoring neurologic function. He prioritizes clear and honest discussions with his patients. His practice focuses on bringing the latest advancements to the operating room, including technologies like robotic neurosurgery and laser interstitial thermal therapy and clinical trials for patients with brain tumors and Parkinson's Disease. Dr. Mian migrated out to Denver seeking sunshine and the outdoor offerings of the Rocky Mountains. In his free time, he enjoys scuba diving, cycling, skiing (badly), photography, and hiking.