​Symptomatic Epilepsy

Epilepsy is a neurological disorder (that is, a disorder related to the brain) that causes recurrent seizures. Symptomatic epilepsy is a type of epileptic disorder and is a symptom of an underlying problem, such as:

  • Head injury or trauma: This may be caused at birth or later during life. Older teenagers and young adults are more likely to develop epilepsy as a result of injury, since they are more active and more likely to be injured than younger children.

  • Lack of oxygen to the brain: If this occurs before, during, or shortly after birth, it can damage the brain and result in neonatal seizures (seizures in the first month of life). This may be due to labour complications. Lack of oxygen from an accident, drowning, or heart attack, can also result in seizures in older children and adults.

  • Infection: Many different infections can result in seizures either at the time of infection or afterward, including meningitis, encephalitis, sepsis and parasitic infections.

  • Brain tumour: Brain tumours can cause epilepsy in children and young adults, but it is rarer.

  • Cerebrovascular problem: This means that there is a problem with the blood vessels in the brain, or stroke related seizures.

  • Congenital malformation: This means that there was a problem with the baby’s brain development before birth.

  • Neurocutaneous syndromes: These are congenital disorders (that is, occurring before birth) that cause abnormal lesions to grow in the brain, spinal cord, or nerves, leading to epilepsy.

  • Metabolic disorder: Metabolic disorders are problems with producing, absorbing, breaking down, or storing specific substances in the body, including sugars, fats, proteins, vitamins, or other substances. They usually happen when a child lacks a specific enzyme, often because of a genetic mutation.

The most common symptoms of symptomatic epilepsy are seizures that can occur when you are awake or asleep. Doctors classify seizures by the clinical presentation. There are:
  • Partial (or focal) seizures, where only a small part of the brain is affected

  • Generalized seizures, where most or all of the brain is affected

There are two main types of partial seizures: a. simple and b. complex.

Simple partial seizure is where you remain fully conscious throughout. Symptoms of a simple partial seizure can include:

  • A strange feeling that is hard to describe

  • An intense feeling that events have happened before

  • Experiencing an unusual smell or taste

  • A tingling sensation, in your arms and legs

  • A sudden intense feeling of fear or joy

  • Stiffness or twitching in part of the body, such as an arm or hand

Complex partial seizures are when you lose your sense of awareness and can’t remember what happened after the seizure has passed. During a complex partial seizure, you will not be able to respond to anyone else, and you will have no memory of the event. The symptoms of a complex partial seizure normally involve strange and random behaviour, such as:

  • Smacking your lips

  • Rubbing your hands

  • Making random noises

  • Moving your arms around

  • Fiddling with objects

  • Adopting an unusual posture

  • Chewing or swallowing

The types of Generalized seizures experienced may include:

  • Myoclonic seizures, that is, sudden and very short duration jerking

  • Absence seizures, that is staring spells

  • Generalized tonic-clonic seizures, that is, grand mal seizures including loss of consciousness and violent muscle contractions.

If you or a loved one is experiencing seizures, absent spells or any of the symptoms mentioned above, it is recommended that you consult with your doctor immediately. You can obtain additional information and expert medical advice from the highly trained and internationally accredited staff at the <Mind and Brain Service Line> at The Aga Khan University Hospital.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Epilepsy is usually difficult to diagnose quickly. In most cases, it cannot be confirmed until you have had more than one seizure. It can also be confusing to diagnose because many other conditions, such as migraines and panic attacks, can cause similar symptoms. If you have had a seizure, you will be referred to a neurologist, that is, a doctor who specializes in conditions affecting the brain and nervous system.

Your doctor will ask you for detailed description of your seizures, and any symptoms you may have had before it happened, such as feeling strange before the seizure or experiencing any warning signs. He/she may also consult with anyone who was present at the time and ask them exactly what they saw, especially if you cannot remember the seizure.

The doctor will also ask about your medical and personal history and whether you use any medicines, drugs or alcohol. The doctor will usually run further tests such as:

  • EEG (Electroencephalogram): this is a test that can detect unusual brain activity associated with epilepsy by measuring the electrical activity of your brain through electrodes placed on your scalp by help of a cream. This is a painless procedure. You will be asked to breathe deeply or close your eyes and you may be asked to look at a flashing light. The test will be stopped immediately if it looks like the flashing light could trigger a seizure.

  • MRI (Magnetic Resonance Imaging) scan: This is a type of brain scan which uses strong magnetic fields and radio waves to produce detailed images of the inside of your body. It can be used to detect possible causes of the condition, such as defects in the structure of your brain or the presence of a brain tumour. An MRI scanner is a large tube that contains powerful magnets. You will have to lie inside the tube during the scan and it will produce a picture of your brain.

The treatment for symptomatic epilepsy depends very much on the specific cause. If possible, the doctor will treat the underlying condition that may be causing the seizures.  This may reduce or eliminate the seizures. Some types of symptomatic epilepsy also respond to anti-epileptic drugs, and surgery can have very good results in some cases.

Medical specialists working with the Mind and Brain Service Line at The Aga Khan University Hospital are equipped to provide comprehensive, state-of-the-art medical care, and discuss with you the measures being undertaken. 

Partial seizures are usually treated with anti-epileptic drugs. The right course of treatment usually produces good seizure control in majority of partial seizure cases. AEDs (Antiepileptic Drugs) should be used carefully, with consideration to medication interactions and potential side effects including:

  • Drowsiness

  • Lack of energy

  • Agitation

  • Headaches

  • Uncontrollable shaking (tremor)

  • Hair loss or unwanted hair growth

  • Swollen gums

  • Rashes

AEDs are available in a number of different forms, including tablets, capsules, liquids and syrups. It is important you follow any advice about when to take AEDs and how much to take. You should never stop taking your medication suddenly because doing so could cause a seizure. Your doctor will ask you to start with a low dose of an AED, and then gradually increase it within safe limits until your seizures stop. The aim is to achieve maximum seizure control with minimum side effects, using the lowest possible dose of a single medicine.

However, if a child has an obvious abnormality in the structure of her brain or if the seizures do not respond to anti-epileptic drugs after one or two years, he/she may be considered for surgery. This is only the case if removing the area of the brain where epileptic activity starts would not cause damage or disability. As with all types of surgery, this procedure carries a number of risks. This includes a risk of serious problems such as memory problems and strokes after the operation. However, majority of people who have epilepsy surgery become completely free of seizures depending on the cause.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.