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Seizures
Confusion
Fainting
Blackout
Abnormal behavior
Memory loss
Convulsions
Loss of consciousness
Blank stare
Mental fogginess
Disorientation
Rigidity
Not seeing your symptoms? No worries!
What is Epilepsy?
Epilepsy is a neurological disorder where brain activity becomes abnormal, causing seizures of varying durations and severities. It can affect people of any age and may be caused by genetic disorders or brain injuries, such as stroke.
Typical Symptoms of Epilepsy
- Tremors of hands and body
- Seizure
- Unable to remember what I have done
- Pain at the back of the head
- Difficulty speaking, performing tasks, or recognizing things
- Neck turned abnormally after losing consciousness
- Body assumed an unnatural position when unconscious
- Fainting
Diagnostic Questions for Epilepsy
Your doctor may ask these questions to check for this disease:
- Are you experiencing tremors in your hands or body?
- Have you experienced any seizures?
- Have others mentioned increased forgetfulness?
- Do you have pain at the back of your head?
- Have you been experiencing difficulty speaking, performing tasks, or recognizing things?
Treatment of Epilepsy
Seizures can be controlled with medications and lifestyle changes. Treatment regimens vary from person to person. For some, surgery or implantable devices can help.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Dec 6, 2024
Following the Medical Content Editorial Policy
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- Shaky hands
- My body is jerking
- Hand tremors
- Shivering body
- Twitching
- Tremor of my fingers
- Antisocial behavior and language difficulty
- Finger twitching
- Fever seizures (with fever of >100.4°F / 38°C)
- Tremor of the limbs
- Fingertips tremble
- Seizures without fever
- Finger tremor
- Fingers and body shivering
- Can't say what I want to say
See full list
Symptoms Related to Epilepsy
Diseases Related to Epilepsy
FAQs
Q.
Strange Auras? Why Your Temporal Lobe Is Misfiring & Medically Approved Next Steps
A.
Strange auras like sudden deja vu, odd smells, a rising stomach sensation, or brief dreamlike episodes often reflect temporal lobe misfiring and can be focal aware seizures from temporal lobe epilepsy, though panic attacks, migraine, medication effects, head injury, infections, stroke, tumors, sleep loss, or alcohol changes can also mimic them. There are several key distinctions and red flags to consider; see below to understand causes, what is and is not epilepsy, and when to worry. Medically approved next steps include tracking episodes, avoiding triggers, and getting a prompt evaluation with history, neurological exam, EEG, and MRI since most people improve with anti-seizure medications and, in selected cases, surgery or nerve stimulation devices, and you should call emergency services if a seizure lasts over 5 minutes or repeats without recovery, with critical nuances that could change your next step outlined below.
References:
* Shorvon, S., & van Emde Boas, W. (2018). Temporal Lobe Epilepsy: A Comprehensive Review. *Epilepsia, 59*(1), 1-20.
* Noe, K. H., D'Alessandro, R., & Loddenkemper, T. (2021). The epileptic aura: Definition, clinical manifestations, and electrophysiological correlates. *Epileptic Disorders, 23*(5), 455-467.
* Sperling, M. R., & Sharan, A. D. (2022). Management of Temporal Lobe Epilepsy. *Seminars in Neurology, 42*(05), 586-592.
* Bartolomei, F., & Nicaise, C. (2017). Mechanisms of seizure generation in temporal lobe epilepsy. *Current Opinion in Neurology, 30*(2), 170-176.
* Bernasconi, N., Bernasconi, A., & Bernhardt, B. C. (2019). Neuroimaging of temporal lobe epilepsy: current status and future perspectives. *Current Opinion in Neurology, 32*(2), 200-207.
Q.
Oxcarbazepine Side Effects? Why Your Brain Reacts and Medically Approved Next Steps
A.
Oxcarbazepine side effects include dizziness, drowsiness, vision changes, nausea, and unsteady balance because it slows nerve firing in the brain; less common but serious risks include low sodium with confusion or seizures, severe rash, and mood changes including suicidal thoughts. There are several factors to consider. See below to understand more. Do not stop the medication suddenly; track symptoms and contact your clinician for dose adjustments, blood tests, and urgent care if you develop severe confusion, a spreading rash, allergic symptoms, or worsening seizures. Complete, medically approved next steps and key risk details are outlined below.
References:
* Alghafli B, Alshami I, Alkandari A, Alsarraf F, Alkhamees A, Almutairi E, Alkandari R. Therapeutic drug monitoring and adverse effects of oxcarbazepine in patients with epilepsy: A systematic review. J Pharm Pract. 2023 Dec;36(6):1099-1110. doi: 10.1177/08971900221147047. Epub 2023 Feb 1. PMID: 36722880.
* Trinka E, Marson A, Brodie MJ, Giorgi L, Gutter T, Holub M, Krämer G, Schachter SC, Schmitz B, Stephani U, Steinhoff BJ, Tinuper P. A review of oxcarbazepine as a monotherapy and adjunctive therapy for partial-onset seizures. Expert Opin Pharmacother. 2018 Jun;19(9):983-991. doi: 10.1080/14656566.2018.1472551. Epub 2018 May 11. PMID: 29750587.
* Verrotti A, Agostinelli S, Ruggieri M, Iannetti P. Oxcarbazepine-induced hyponatremia: incidence, mechanisms, and management. Seizure. 2019 Jun;69:230-234. doi: 10.1016/j.seizure.2019.04.015. Epub 2019 Apr 23. PMID: 31055271.
* Nevitt SJ, Tudur Smith C, Marson AG. Antiepileptic drugs for the primary management of epilepsy: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2019 Oct 1;10(10):CD010424. doi: 10.1002/14651858.CD010424.pub3. PMID: 31571246; PMCID: PMC6769165.
* Perucca E. Adverse effects of newer antiepileptic drugs. Expert Opin Drug Saf. 2011 Nov;10(6):917-31. doi: 10.1517/14740338.2011.606272. Epub 2011 Aug 2. PMID: 21809951.
Q.
Stuck on Repeat? Why Echolalia Happens and Your Medically Approved Next Steps
A.
Echolalia is the repetition of words or phrases; it can be normal in toddlers, but in older children and adults it may signal autism, language-processing differences, epilepsy, or neurological or psychiatric conditions. There are several factors to consider; medically approved next steps include speaking with a clinician, tracking patterns, and seeking urgent care for sudden onset, post-injury changes, seizure-like episodes, or confusion, with referrals to speech therapy, neurology, or developmental specialists and tests like EEG or imaging when indicated. See below to understand more and to find details that could change which steps are right for you.
References:
* Stiebel, D. B., & Sacks, N. J. (2023). Echolalia and its clinical significance: a systematic review. *Clinical Linguistics & Phonetics*, *37*(1), 1-17.
* Lim, M. C., Lim, N. X., Lee, B., Chiong, C. M., Tan, N. C., & Thia, E. (2021). Interventions for echolalia in children and adolescents with autism spectrum disorder: a systematic review. *Developmental Medicine & Child Neurology*, *63*(2), 146-155.
* Stiebel, D. B., & Sacks, N. J. (2020). The neurobiological basis of echolalia: a review of the literature. *Brain and Language*, *203*, 104746.
* Stiebel, D. B., & Sacks, N. J. (2019). Functional echolalia: a systematic review of the literature. *Journal of Autism and Developmental Disorders*, *49*(12), 4947-4959.
* Stiebel, D. B., & Sacks, N. J. (2018). Echolalia in autism: pathophysiology and treatment. *Developmental Medicine & Child Neurology*, *60*(9), 920-927.
Q.
Levetiracetam? Why Your Brain Reacts & Medically Approved Next Steps
A.
Levetiracetam controls focal, generalized tonic clonic, and myoclonic seizures by binding the SV2A protein to calm overactive brain signals; common effects include fatigue, dizziness, and mood or behavior changes such as irritability, anxiety, or depression, and you should seek urgent care for suicidal thoughts, severe behavior changes, allergic reactions, or increased or prolonged seizures. Do not stop it suddenly; instead track symptoms, review them with your clinician to adjust dose or timing, consider vitamin B6 only with medical approval, and discuss alternatives or kidney based dosing if side effects persist. There are several factors to consider. See below to understand more.
References:
* Bialer, M., & White, H. S. (2020). Targeting the synaptic vesicle protein 2A (SV2A) with levetiracetam: From molecular mechanism to clinical implications. *Epilepsia, 61*(6), 1109–1120. doi:10.1111/epi.16546.
* Trinka, E., & Brigo, F. (2019). Levetiracetam: A review of its current place in therapy. *Seizure, 65*, 229–236. doi:10.1016/j.seizure.2019.01.018.
* Trinka, E., Stogowski, M. D., & Brigo, F. (2018). Levetiracetam and its use in the current clinical practice. *Acta Neurologica Scandinavica, 137*(5), 455–465. doi:10.1111/ane.12920.
* Kamin, F., & Schäfer, M. (2016). Levetiracetam in the Treatment of Epilepsy: A Review of its Efficacy and Safety. *CNS Drugs, 30*(1), 19–32. doi:10.1007/s40263-015-0298-y.
* Rogawski, M. A. (2012). New developments in levetiracetam: mechanism of action and clinical utility. *Expert Review of Neurotherapeutics, 12*(2), 191–204. doi:10.1586/ern.11.173.
Q.
Seizure Fears? Why Your Brain Needs an EEG + Medically Approved Next Steps
A.
An EEG is a safe, painless test that records your brain’s electrical activity and is often the essential first step when a seizure is suspected, helping detect abnormal patterns, classify seizure type, and guide effective treatment. There are several factors to consider, including that a normal EEG does not fully rule out epilepsy and may require repeat or longer monitoring, plus when to seek emergency care and how MRI, medications, and lifestyle steps fit into a plan. See complete guidance below so you do not miss important details that could change your next steps.
References:
* Al-Qurainy R, Rammal A, Bin-Salem AA. Electroencephalography (EEG) in the Diagnosis of Epilepsy: A Narrative Review. Cureus. 2023 May 15;15(5):e38994. doi: 10.7759/cureus.38994. PMID: 37322964; PMCID: PMC10269389.
* Krumholz A, et al. Practice guideline update summary: Evaluating an apparent first unprovoked seizure in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2022 Jul 26;99(4):163-176. doi: 10.1212/WNL.0000000000200889. PMID: 35790430.
* Fisher RS. Treatment of Epilepsy. Continuum (Minneap Minn). 2021 Feb;27(1):154-177. doi: 10.1212/CON.0000000000000958. PMID: 33544254.
* Koul R, Chaurasia RN, Rai A, Mahajan R. Update on the Diagnosis and Management of Epilepsy. J Assoc Physicians India. 2023 Aug;71(8):69-73. doi: 10.1111/japi.12560. PMID: 37704047.
* Thijs RD, et al. Prognosis and management of patients with epilepsy. Lancet Neurol. 2019 Oct;18(10):949-960. doi: 10.1016/S1474-4422(19)30062-X. Epub 2019 Jul 25. PMID: 31358485.
Q.
Confused by Epilepsy? Why Your Brain Overloads and Medically Approved Next Steps
A.
Epilepsy is a common, treatable neurological condition where sudden bursts of abnormal brain activity cause repeated unprovoked seizures; most people achieve control with anti seizure medications, and surgery, nerve stimulation, or medically supervised diets are options when medicines are not enough. There are several factors to consider, including causes, seizure types, emergency red flags, diagnosis, lifestyle triggers, and mental health. See below to understand more and for step by step, medically approved next actions like when to call emergency services, how to prepare for your appointment, and key safety tips.
References:
* Löscher W. Pathophysiological Mechanisms and Novel Therapeutic Targets in Epilepsy. Handb Exp Pharmacol. 2020;257:29-57. doi: 10.1007/164_2018_203. PMID: 31802319.
* Stafstrom CE, Rogawski MA. Mechanisms of epilepsy. Cold Spring Harb Perspect Med. 2015 May 1;5(5):a022428. doi: 10.1101/cshperspect.a022428. PMID: 25883827.
* Trinka E, Kockelmann E, Rosati A. Pharmacological treatment of epilepsy. Acta Neurol Scand. 2019 Jun;139(6):449-462. doi: 10.1111/ane.13063. PMID: 30869850.
* Kanner AM, Ashindoitiang J, Schuele SU. Guidelines for management of epilepsy. Epilepsia. 2017 Dec;58 Suppl 3:1-20. doi: 10.1111/epi.13962. PMID: 29205315.
* Kwan P, Schachter SC, Brodie MJ. Practical guidelines for the treatment of drug-resistant epilepsy. Epilepsia. 2020 Mar;61(3):364-385. doi: 10.1111/epi.16450. PMID: 31950482.
Q.
Blinding Vice-Grip? Why Your Brain is ‘Misfiring’ & Medically-Approved Next Steps
A.
A blinding, vice-like headache is usually a migraine, a neurological disorder where pain pathways become overactive and brain chemicals shift, which can cause throbbing pain, nausea, and sensitivity to light and sound, sometimes with aura. Medically approved next steps include taking rescue medication early, considering preventive therapy if attacks occur 4 or more days per month, using steady sleep, hydration, meals, and exercise, and seeking urgent care for red flags like the worst sudden headache, fever with stiff neck, new weakness, or a new headache after 50. There are several factors to consider, including medication overuse and overlapping conditions, so see the complete guidance below to understand which steps fit your situation.
References:
* Chen Z, et al. Neuroinflammation and oxidative stress contribute to cognitive dysfunction. Exp Neurol. 2015 Mar;265:127-36. doi: 10.1016/j.expneurol.2014.12.016. Epub 2014 Dec 24. PMID: 25545308.
* Theoharides TC, et al. Brain "fog," inflammation and mast cells: Actions of flavonoids and tyrosine kinase inhibitors. Transl Psychiatry. 2015 Feb 10;5(2):e515. doi: 10.1038/tp.2015.15. PMID: 25668102; PMCID: PMC4355582.
* Picca A, et al. Mitochondrial dysfunction and its relationship with cognitive impairment: a narrative review. Exp Gerontol. 2018 Jun 15;107:81-89. doi: 10.1016/j.exger.2018.03.003. Epub 2018 Mar 8. PMID: 29526701.
* Maletic-Savatic M, et al. The synaptic dysfunction in neuropsychiatric disorders: a critical overview. J Neuropsychiatry Clin Neurosci. 2014 Winter;26(1):15-28. doi: 10.1176/appi.neuropsych.13080187. PMID: 24446342.
* Kourtidou E, et al. Targeting Neuroinflammation and Oxidative Stress in Cognitive Impairment: A Comprehensive Review of Current Therapeutic Strategies. Antioxidants (Basel). 2023 Apr 29;12(5):988. doi: 10.3390/antiox12050988. PMID: 37237936; PMCID: PMC10214643.
Q.
Emotional Static? Why Your Brain is Misfiring: Medically Approved Lamotrigine Steps
A.
Lamotrigine is a medically approved treatment that stabilizes misfiring brain signals, reducing seizures and helping prevent bipolar depressive episodes; it must be started low and increased slowly, taken consistently, and not stopped suddenly. There are several factors to consider, including watching for rash, important drug interactions like valproate or hormonal birth control, expected timelines, pregnancy guidance, and red flags such as severe rash or seizures over 5 minutes that need urgent care. See the complete details below to guide your next steps, including titration basics, missed dose plans, and when to see a specialist.
References:
* D'Souza, J., Dhaliwal, T., Dhingra, S., Dhingra, S., Dhingra, R., & Dhingra, R. (2022). Lamotrigine: A Review of Its Mechanism of Action, Pharmacokinetics, and Clinical Efficacy in Neurological Disorders. *Cureus, 14*(1). https://pubmed.ncbi.nlm.nih.gov/35058763/
* Kishi, T., Ikuta, T., & Iwata, N. (2018). Lamotrigine for the acute and maintenance treatment of bipolar depression: a meta-analysis of randomized controlled trials. *Bipolar Disorders, 20*(6), 509-519. https://pubmed.ncbi.nlm.nih.gov/29775438/
* Kauer-Unglesby, C. L., Viana, J., & McElroy, S. L. (2020). Lamotrigine in the Treatment of Bipolar Disorder: A Comprehensive Review. *CNS Drugs, 34*(3), 263-278. https://pubmed.ncbi.nlm.nih.gov/32095208/
* Tiihonen, J., Lehtonen, H., & Therman, S. (2013). Lamotrigine and glutamate: a review. *Psychopharmacology, 227*(3), 355-364. https://pubmed.ncbi.nlm.nih.gov/23620340/
* Salvi, V., Galioto, F., Rossi, M., Sisti, F., & Cuomo, A. (2017). Efficacy of lamotrigine in patients with anxiety disorders: a systematic review. *International Clinical Psychopharmacology, 32*(6), 285-293. https://pubmed.ncbi.nlm.nih.gov/28974577/
Q.
Why You Drop Things When You Laugh: It's Not Just Being Clumsy
A.
There are several factors to consider. Dropping things when you laugh can be normal grip changes, but repeated emotion triggered weakness with preserved awareness may signal cataplexy tied to narcolepsy type 1, often alongside daytime sleepiness, sleep paralysis, or vivid dreams. See below for how to tell it apart from fainting and seizures, the red flags that warrant medical care, what tests a sleep specialist may order, and practical treatments and safety tips that can guide your next steps.
References:
* Scammell TE. Cataplexy: mechanisms and treatment. Curr Opin Neurol. 2011 Dec;24(6):578-83.
* Bassetti CL. Cataplexy: clinical aspects, pathogenesis and management. J Clin Sleep Med. 2007 Oct 15;3(6):655-61.
* Patel N, Madiwala C, Shirodkar M, Vora N, Bhongade S. Laughter-Induced Transient Paralysis in a Child: A Case Report of Cataplexy. Cureus. 2021 Oct 27;13(10):e19036.
* Mignot E. Narcolepsy and cataplexy. Handb Clin Neurol. 2011;100:135-47.
* Balint G, Kiss K, Varga A, Málnási-Csizmadia A, Domján G. Cataplexy, a medical condition frequently misdiagnosed. Rev Med Interna. 2018 Jun;39(6):449-452.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Beghi E, Giussani G, Sander JW. The natural history and prognosis of epilepsy. Epileptic Disord. 2015 Sep;17(3):243-53. doi: 10.1684/epd.2015.0751. PMID: 26234761.
https://www.jle.com/fr/revues/epd/e-docs/the_natural_history_and_prognosis_of_epilepsy_305192/article.phtmlManford M. Recent advances in epilepsy. J Neurol. 2017 Aug;264(8):1811-1824. doi: 10.1007/s00415-017-8394-2. Epub 2017 Jan 24. PMID: 28120042; PMCID: PMC5533817.
https://link.springer.com/article/10.1007/s00415-017-8394-2Thijs RD, Surges R, O'Brien TJ, Sander JW. Epilepsy in adults. Lancet. 2019 Feb 16;393(10172):689-701. doi: 10.1016/S0140-6736(18)32596-0. Epub 2019 Jan 24. PMID: 30686584.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32596-0/fulltext