Epilepsy

What is epilepsy?

Epilepsy is a neurological condition in which abnormal bursts of electrical activity in the brain cause seizures. These events are usually brief but can affect awareness, movement, or behaviour depending on where in the brain they occur.

It is typically diagnosed after two or more unprovoked seizures more than 24 hours apart, or after one unprovoked seizure with a high risk of recurrence based on brain imaging or EEG findings. Seizures caused by identifiable factors, such as low blood sugar, electrolyte imbalance, or fever, are considered provoked and do not indicate epilepsy.

Seizures vary widely: some involve brief staring or confusion, while others cause shaking or loss of consciousness. Epilepsy does not affect intelligence or personality, and with appropriate treatment, most people achieve good seizure control and live full, active lives.

Symptoms of epilepsy

Seizures can look very different and symptoms depend on where in the brain the irregular activity occurs. Common signs include:

• Focal aware seizures: The person stays conscious but may notice unusual sensations, such as tingling, a rising feeling in the stomach, strange smells or tastes, a strong sense of déjà vu, or sudden fear. These can sometimes be a warning sign of a larger seizure.

• Focal impaired awareness seizures: A short period of reduced awareness. The person may stare, seem confused, or make repetitive movements (such as lip-smacking or hand rubbing) and usually does not remember the event afterwards.

• Tonic-clonic seizures: Loss of consciousness with body stiffening followed by rhythmic jerking of the arms and legs. This is the most widely recognised type of seizure.

• Absence seizures: Very brief lapses in awareness, often lasting only a few seconds and sometimes mistaken for daydreaming. These are more common in children.

After a seizure, it is common to feel confused, tired, or have a headache or sore muscles. This recovery phase can last from minutes to several hours.

Not every episode of blackout, jerking, or confusion is a seizure, and not every seizure means epilepsy. A careful medical assessment, including a detailed description of the events, is important for making the correct diagnosis.

What causes epilepsy?

Epilepsy has many possible causes. In approximately half of cases a specific cause is identified; in the other half, no clear structural or metabolic cause is found (idiopathic epilepsy), which often has a genetic basis. Causes may include:

• Hippocampal sclerosis: scarring in a part of the brain called the hippocampus, a common cause of temporal lobe epilepsy, visible on MRI.

• Brain tumours: both benign (such as meningiomas) and malignant tumours can trigger seizures.

• Vascular malformations: abnormal blood vessels (such as cavernomas or AVMs) that can cause focal seizures.

• Cortical dysplasia: areas of abnormal brain development that can generate seizures.

• Previous brain injury: stroke, bleeding, or head trauma can leave scar tissue that leads to seizures.

• Brain infections: conditions like meningitis or encephalitis can cause seizures and sometimes lead to epilepsy.

• Genetic factors: some types of epilepsy, especially those starting in childhood, have a hereditary component.

Metabolic imbalances (such as low blood sugar or abnormal sodium levels) can also cause seizures, but these are usually temporary and are not considered epilepsy.

How is epilepsy detected?

Epilepsy is diagnosed clinically through seizure history and examinations. While tests alone cannot confirm it, brain imaging and blood markers are vital for identifying underlying causes or metabolic triggers.

MRI is the gold standard for identifying structural seizure causes like tumors or vascular malformations. While Elfcare’s full body MRI is a screening tool rather than a dedicated epilepsy protocol, it is highly effective at detecting these major abnormalities.

EEG electroencephalogram) records the brain's electrical activity to detect abnormal patterns and classify seizure types. While not performed by Elfcare, it is a vital part of a neurologist's formal diagnostic workup.

Blood tests rule out metabolic triggers and systemic conditions that lower the seizure threshold. Relevant markers in Elfcare's panel include:

• Electrolytes: low or high sodium, calcium, or magnesium can trigger seizures.

• Glucose and HbA1c: low blood sugar can mimic seizures; poor control affects brain stability.

• Folate and B12: deficiencies impact nerve health and can cause neurological symptoms.

• TSH, Free T3, Free T4: severe thyroid dysfunction can lower the seizure threshold.

• Liver & Kidney Markers (ALT, AST, creatinine, and eGFR): essential for ruling out metabolic causes and ensuring safe medication dosing.

Why early detection matters

Early detection is vital because many structural causes of epilepsy can be identified on brain MRI before symptoms escalate, allowing for more targeted treatment. Identifying reversible metabolic triggers, such as electrolyte imbalances or thyroid dysfunction, can sometimes resolve episodes without the need for long-term medication. By recognizing subtle neurological signs early, you can reduce uncertainty and implement proactive lifestyle adjustments that protect your brain health and daily routine.

How Elfcare can help

Elfcare provides detailed brain imaging and blood testing to support the assessment of possible seizure causes.

• Full body MRI - brain: Elfcare's full body MRI detects structural abnormalities such as tumours, vascular malformations, prior strokes, or cysts that may explain recurrent seizures.

• Blood panel: Our 80+ biomarker blood test cover key metabolic markers, including electrolytes (sodium, calcium, magnesium), glucose, thyroid function, B12, folate, and liver and kidney function — helping identify reversible causes of seizures.

Elfcare does not diagnose epilepsy. Diagnosis requires a clinical history, neurological examination, and EEG, typically performed by a neurologist.

What Elfcare provides is structural brain imaging and metabolic assessment that forms a critical part of the investigative picture. If we identify a concerning finding, we arrange further investigations or refer you to the appropriate specialist.