Determining the Severity of Your Epilepsy

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If you’ve been diagnosed with epilepsy, you’re not alone. It’s the fourth most common neurological disorder in the United States. But not everyone with epilepsy experiences the same types of seizures or the same number of seizures. Over the years, researchers have tried to come up with ways of measuring how severe someone’s epilepsy is. For example, adults who are diagnosed with epilepsy may be measured with the Liverpool Seizure Severity Scale, but children may be assessed with information based on the Early Childhood Epilepsy Severity Scale (E-Chess). Regardless of the method or scale used, this information helps your neurologist plot the course of your treatment. But aside from the scales, what’s most important to you is how you understand your own epilepsy.

Mild Epilepsy

People with mild epilepsy generally have few seizures, although they may have periods when they are more frequent than others.

Absence seizures are often considered to be a milder form of epilepsy. During an absence seizure, you may look like you’re day dreaming or just staring off into space. They are more common among children than adults, but adults can have them. Absence seizures can slip under the radar since they might not be noticed by others and sometimes you may not even realize that you had one, as it can seem that you just lost track of time. This type of seizure may not cause the physical harm that a generalized seizure could, but an absence seizure while you’re doing something that requires concentration, such as driving, could have serious consequences.

Focal seizures are a bit different from absence seizures. With focal seizures, you may repeat certain behaviors, like picking at something or swallowing frequently. These seizures may be seen as strange or odd behaviors, which could be mistaken for other disorders. Again, they may not cause physical harm, but they can be disturbing.

Partial seizures, ones that affect only part of your body may also be considered as mild epilepsy. A simple partial seizure may affect one side of your body or even how you sense things, such as smell, hearing and vision.

Severe Epilepsy

Severe epilepsy involves frequent and usually generalized (grand mal) seizures. These are the seizures that affect the whole body as the muscles tense and jerk rapidly (tonic-clonic) for up to three minutes. People who have grand mal seizures could injure themselves if they fall or if their body strikes nearby objects during a seizure.

Although focal seizures, mentioned above, are generally not harmful, if you have many of these seizures throughout the day, this could be considered severe epilepsy, because they can affect your quality of life.

With treatment, severe epilepsy may be controlled, if the seizures stop.

Controlled Versus Uncontrolled Epilepsy

If you have epilepsy, whether it’s mild or severe, and you’re taking medications or you had surgery that effectively prevents you from having seizures, it’s said that you have controlled epilepsy. If you still have seizures, despite your treatment, this is uncontrolled epilepsy – also called refractory epilepsy. While some people may say that their epilepsy is controlled if they have fewer seizures than before they started treatment, the true definition of controlled epilepsy is no seizures at all.

Living with epilepsy can be hard, especially while you’re working with your doctor to find the right treatment to get your seizures under control. Fortunately, there are many different types of medications available today and, although it may take a bit of trial-and-error, you should be able to find the right one for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jun 15

  1. What is Uncontrolled Epilepsy? Epilepsy Foundation. http://epilepsynyc.com/2012/05/what-is-uncontrolled-epilepsy/

  2. What Is Epilepsy. Epilepsy Foundation. http://www.epilepsy.com/learn/epilepsy-101/what-epilepsy

  3. Epilepsy. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/epilepsy/home/ovc-20117206

  4. The Epilepsies and Seizures: Hope Through Research. National Institute of Neurologic Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm

  5. Types of Epilepsy. Johns Hopkins Medicine. http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/types/

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