Epilepsy – thunderstorms in the head

Epilepsy - thunderstorms in the head

Epilepsy is one of the most common chronic diseases of the central nervous system. 500,000 people in Germany are permanently affected by epilepsy, i.e. recurrent epileptic seizures. The term comes from the Greek and means “to be violently affected by something”. The disease, which was already known in ancient times, was already considered mysterious back then: those affected fall to the ground – often screaming – lose consciousness and move their entire body uncontrollably. In some cases, foam may also form in the mouth.

Definition: epilepsy or epileptic seizure?

Even today, the disease is still associated with many prejudices. Contrary to popular belief, epilepsy is not hereditary; at most, the tendency to develop epilepsy can be inherited. In addition, a distinction must be made between individual “epileptic seizures”  and the disease “epilepsy”. This is not diagnosed until the patient has had more than two seizures for no apparent reason. People who have epilepsy are severely restricted in many areas of life, depending on the severity of their disease.

To shed light on the seizure disorder and to break down prejudices against people with epilepsy, Epilepsy Day is celebrated every year in October.


Epilepsy: seizure as a thunderstorm in the head

To explain what epilepsy is, doctors and sufferers like to use the image of the “thunderstorm in the head”. However, they do not think of headaches. Instead, the focus is on the uncontrolled impulse discharges of the nerve cells, which make the regular, orderly functioning of the brain impossible.

In the case of a person with epilepsy, the signals sent out by the nerve cells are either too long or too short: the result of the “false reports” is uncontrolled muscle movements that are experienced as cramps. However, nerve cells responsible for thinking and consciousness can also be affected. Then, a person with epilepsy loses consciousness during a seizure.

Epileptic seizures can look very different. Some patients convulse very violently, while in others, the symptoms of epilepsy are so minimal that they are hardly noticed.

Caution: risk of confusion

However, not all seizures are epileptic seizures. Many infants and young children suffer from so-called “fever convulsions” when they have a fever, which also disappears after the underlying disease has subsided.

Nevertheless, after a febrile seizure, an epileptic disease must always be ruled out by measuring the brain waves.


forms of epilepsy

The International League Against Epilepsy has described a total of ten different forms of seizures and even more forms of epilepsy. A form of epilepsy can have different types of seizures. A person with epilepsy usually has only one kind of epilepsy, but they can experience several different types of seizures.

The intervals between the individual seizures are as different as the particular forms of epilepsy and seizures. In some patients, there are years or decades between attacks. For others, only seconds pass before the subsequent seizure.

A distinction is made between the  “focal” and the “generalized” seizure. A focal seizure affects only a specific area of ​​the brain, while a generalized seizure affects both hemispheres or the entire brain from the start.

Causes and diagnosis of epilepsy

Around 50 per cent of the diseases occur in childhood, with the possibility of “spontaneous” healing. Epilepsy can also develop as a result of a brain injury, for example, after an accident, when the cells in individual brain regions are no longer able to work in a coordinated manner. Other causes of epilepsy include:

If a patient has had a seizure for no apparent reason, the diagnosis is confirmed with an electroencephalogram ( EEG ).

therapy of epilepsy

There are several options for treating epilepsy:

  1. medication
  2. Operative
  3. line break
  4. Identifying and avoiding seizure triggers
  5. Vagus-Nerv-Stimulation


  1. Treatment with medication

In the drug treatment of epilepsy, the hyperexcitability of nerve cells is reduced, or inhibiting mechanisms are strengthened. This requires regular intake of medication such as gabapentin and medical supervision.

Although many anti-epilepsy drugs are easy to take, the side effects are often severe. These include allergic skin reactions, nausea and vomiting, dizziness, tiredness and blurred vision. The liver, lymph glands and bones can also suffer from the medication.

A drug is usually given, which is monitored using the EEG and drug levels. Combination treatments with two or more drugs are only used if all possible individual preparations have been unsuccessful. If patients have been seizure-free for three years, attempts are often made to discontinue the medication gradually.

  1. Surgical therapy for epilepsy

The seizure focus in the brain is surgically removed. However, this is only possible if the seizures always occur in the same place and this area can be removed from the brain safely and without other unacceptable disadvantages for the patient.

  1. Line break

The nerve tracts used to spread a seizure are severed if a line breaks. Pulse transmission is then no longer possible.


  1. Identifying and avoiding seizure triggers

This form of treatment requires a lot of self-discipline from those affected. As an adjunctive treatment to the other forms of treatment, however, self-monitoring has a value in epilepsy treatment that should not be underestimated.

  1. Vagus-Nerv-Stimulation

In this treatment, a pacemaker is used, which influences the vagus nerve and thus makes the discharge of the nerve cells controllable.

living with epilepsy

People with epilepsy today have good opportunities to control their illness. However, they are particularly at risk of accidents due to falls during seizures. One of the restrictions they have at work and in their free time is that they are not allowed to operate machines; for example, driving a car or even a job as a pilot is out of the question, and handling sensitive or dangerous substances is also not possible.

Many young people with epilepsy, therefore, have considerable difficulties finding an apprenticeship at all. While families with people with epilepsy can adapt to the disease over the years, employers and colleagues are often overwhelmed by the condition.

It must also be possible to act immediately in the event of an attack: Even if the patient is carrying an emergency card and the appropriate medication, the environment must be able to deal with the patient. People with epilepsy, therefore, need understanding and support – but not pity.


Adolescent epileptics

The Bethel Vocational Training Center, in particular, has made an effort to train young people with epilepsy. In our hotel, “Lindenhof”, young people with epilepsy are trained in all areas of the hotel and catering trade. The training model is unique in Germany.


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