Epilepsy is a brain disease where nerve cells don’t signal properly, which causes seizures. Seizures are uncontrolled bursts of electrical activities that change sensations, behaviors, awareness and muscle movements. Although epilepsy can’t be cured, many treatment options are available. Up to 70% of people with epilepsy can manage the disease with medications.
Epilepsy is a long-term (chronic) disease that causes repeated seizures due to abnormal electrical signals produced by damaged brain cells. A burst of uncontrolled electrical activity within brain cells causes a seizure. Seizures can include changes to your awareness, muscle control (your muscles may twitch or jerk), sensations, emotions and behavior.
Epilepsy is also called a seizure disorder.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Anyone, of any age, race or sex, can develop epilepsy.
In the U.S., about 3.4 million people have epilepsy. Of this number, 3 million are adults and 470,000 are children. There are 150,000 new cases of epilepsy in the U.S. each year. Worldwide, about 65 million people have epilepsy.
The cells in your brain send messages to and receive messages from all areas of your body. These messages are transmitted via a continuous electrical impulse that travels from cell to cell. Epilepsy disrupts this rhythmic electrical impulse pattern. Instead, there are bursts of electrical energy — like an unpredictable lightning storm — between cells in one or more areas of your brain. This electrical disruption causes changes in your awareness (including loss of consciousness), sensations, emotions and muscle movements.
Healthcare providers classify epilepsies by their seizure type. Seizure categories are based on where they start in your brain, your level of awareness during a seizure and by presence or absence of muscle movements.
There are two major seizure groups:
Focal onset seizures start in one area, or network of cells, on one side of your brain. This seizure used to be called partial onset seizure. There are two types of focal seizures:
General onset seizures affect a widespread network of cells on both sides of your brain at the same time. There are six types of generalized seizures.
As your healthcare provider learns more, your seizure type may change to focal or generalized onset seizure.
Seizure triggers are events or something that happens before the start of your seizure.
Commonly reported seizure triggers include:
Some people discover that their seizures occur consistently during certain times of the day or around certain events or other factors. You may want to track your seizures — and the events around your seizures — to see if there’s a pattern.
In your seizure diary, note the time of day each seizure happened, the events or special circumstances happening around the time of the seizure and how you felt. If you suspect you’ve identified a trigger, track that trigger to find out if it’s really a trigger. For example, if you think caffeine is a seizure trigger, do you have a seizure after consuming every caffeinated food or beverage, after “x” number of caffeinated foods/beverages or at certain times of day after consuming caffeine? Caffeine may or may not be the trigger when thoroughly reviewed.
The main symptom of epilepsy is recurring seizures. Your symptoms, however, vary depending on the type of seizure you have.
Seizure signs and symptoms include:
Most people with epilepsy tend to have the same type of seizure, so have similar symptoms with each seizure.
Most of the time (in up to 70% of cases), the cause of seizures is not known. Known causes include:
Technically, if you experience two or more seizures that weren’t caused by a known medical condition — for example, from alcohol withdrawal or low blood sugar — you’re considered to have epilepsy. Before making a diagnosis, your healthcare provider (or epilepsy specialist) will perform a physical exam, take your medical history and may order blood work (to rule out other causes). They may ask about your symptoms during the seizure and conduct other tests, as well.
Your healthcare provider will ask you or your family member (who’s witnessed your seizure) if you experienced any of the following during a seizure:
Treatments to control epilepsy include anti-seizure medications, special diets (usually in addition to anti-seizure medications) and surgery.
Anti-seizure medications can control seizures in about 60% to 70% of people with epilepsy. Anti-seizure medication treatment is individualized. The U.S. Food and Drug Administration (FDA) has approved more than 20 anti-seizure medications for treating epilepsy. Your healthcare provider may try one or more medications, doses of medications or a combination of medications to find what works best to control your seizures.
Choice of an anti-seizure medication depends on:
Because some anti-seizure medications are linked to birth defects, let your healthcare provider know if you’re pregnant or planning to become pregnant.
If anti-seizure medications don’t control your seizures, your healthcare provider will discuss other treatment options, including special diets, medical devices or surgery.
The ketogenic diet and the modified Atkins diet — diets high in fat, moderate in protein and low in carbohydrates — are the two most common diets sometimes recommended for people with epilepsy. Diets are mostly recommended for children where medication was not effective and who aren’t candidates for surgery. Low glycemic index diets may also reduce seizures in some people with epilepsy.
Your healthcare provider will consider surgery if anti-seizure medications don’t control your seizures, and if your seizures are severe and debilitating. Epilepsy surgery can be a safe and effective treatment option when more than two anti-seizure medication trials fail to control your seizures. It’s important to be evaluated at an epilepsy center to see if you’re a candidate for epilepsy surgery if anti-seizure medications don’t control your seizures.
Surgery options include surgical resection (removal of abnormal tissue), disconnection (cutting fiber bundles that connect areas of your brain), stereotactic radiosurgery (targeted destruction of abnormal brain tissue) or implantation of neuromodulation devices. These devices send electrical impulses to your brain to reduce seizures over time.
Although many causes of epilepsy are out of your control and unpreventable, you can reduce your chance of developing a few conditions that might lead to epilepsy, such as:
There’s no cure for epilepsy. But there are many options to treat epilepsy.
About 70% of people become seizure-free with proper treatment within a few years. The remaining 30% are considered to have drug-resistant epilepsy. These people should go to an epilepsy center to determine if they’re candidates for epilepsy surgery.
It depends on the type of epilepsy you have and your response to medication. Some people who remain seizure-free for several years may be able to stop their medication. Your healthcare provider makes this decision. They’ll consider a variety of factors when making this decision, including an absence of brain lesions on your MRI, EEG findings and your medical history. Some people may require life-long medication.
See your primary healthcare provider if you’ve never had a seizure before and think you’ve had one — or the people around you tell you you’ve “zoned out” or lost awareness. You may be referred to a neurologist for additional follow-up and testing.
Call 911 (or have a friend or bystander call 911) if you’ve had a seizure that lasts longer than five minutes or a series of seizures in a row without recovery.
To help manage your seizures:
In the U.S., each state has its own driving rules. People with epilepsy are required to report their condition to the Department of Motor Vehicles (DMV). However, states differ about the identity of the person who has to report. Some states require the healthcare provider report the person. Other states ask the person with epilepsy or seizures to sign a simple form at the time of application for a license or license renewal. On the form, the person states that they’ll notify the DMV of changes in their health status or driving ability.
Ask your healthcare provider if you can drive. Generally, you shouldn’t drive until your seizures are under control.
Seizures can lead to serious physical injuries. In addition, life-threatening conditions associated with epilepsy include status epilepticus and sudden unexplained death in epilepsy (SUDEP).
Status epilepticus is a long-lasting (five to 30 minutes) seizure or seizures that occur close together without time to recover between them. It’s considered a medical emergency.
Emergency treatment at a hospital may include:
Sudden unexplained death in epilepsy (SUDEP) is a rare condition in which an otherwise healthy young-to-middle-aged person with epilepsy dies without a clear cause. The person often dies at night or during sleep without witnesses. Researchers believe some of the causes might include:
About 1 in 1,000 people with epilepsy die from SUDEP each year. It’s the leading cause of death in people with uncontrolled seizures. Ways to reduce your risk of SUDEP include knowing and avoiding your seizure triggers, taking your medications as directed by your healthcare provider and following general healthy living practices (be well-rested, exercise, eat healthy foods, avoid smoking and avoid drinking too much or using recreational drugs).
A convulsion involves uncontrolled, jerky muscle movements and altered consciousness. But people often use the terms convulsion and seizure interchangeably. People also tend to use the word convulsion to refer to a tonic-clonic seizure.
Seizures result from abnormal electrical activity from cells in your brain. You can have a seizure without having any symptoms. Healthcare providers refer to this as an EEG seizure (picked up during EEG tests). Most of the time, seizures present with a variety of different symptoms that are described above. Seizures are a symptom of epilepsy, but not all seizures are caused by epilepsy.
Epilepsy is a neurological disease defined by having multiple, ongoing seizures. Epilepsy can be a life-long condition.
A note from Cleveland Clinic
Epilepsy is a fairly common condition, affecting 1 in 26 people in the U.S. at some point in their lifetime. There are many treatment options, including anti-seizure medications, special diets, epilepsy surgeries and devices to stop the seizures. The goal is to manage seizures as best as possible. In some cases, epilepsy is a life-long disease. In others, seizures might stop with proper treatment. You can play a part in better managing your seizures. Get an adequate amount of sleep, limit alcohol intake, eat a healthy diet, avoid your seizure triggers and take your medications exactly as directed by your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 03/11/2022.
Learn more about our editorial process.