About 1% of the world's population has a form of epilepsy, a group of disorders that causes seizures. That's about 3.5 million people in the U.S. with a condition that can affect their lives to varying degrees. People develop epilepsy for genetic reasons, because of brain injury, infection or tumor, a systemic or metabolic problem in the body, or after a history of strokes. 

Epilepsy is still misunderstood by many in the public, but clinicians and researchers are learning more about how to better control and stop seizures to help patients navigate their condition and enjoy fulfilling lives. We spoke with Dr. Lisa Bateman, director of the Surgical Epilepsy program in the Cedars-Sinai Department of Neurology, about epilepsy myths and facts.

People with epilepsy are predisposed to have recurrent, unprovoked seizures that can affect brain functions, including motor control and consciousness. Seizures make people prone to injury or harm, but they don't always cause someone to collapse or shake. 

For some people, a seizure causes a lapse in attention or awareness for a few seconds or minutes. Some people experience momentary trouble speaking or uncontrolled movements. Depending on the patient and the type of epilepsy, it may take hours or days to recover from a seizure's resulting headache, exhaustion and brain fog.

Many people can recognize triggers, but seizures are mostly unpredictable. Some people do experience a sensation that signifies a seizure is starting—what is called an "aura."

"An aura may last long enough for a person to know a seizure is coming and be able to sit down or turn off the stove or otherwise protect themselves," Dr. Bateman says. "But an aura may also be fleeting, for a couple of seconds, and some people may not have one at all." 

A seizure happens when there's a misfire in electrical signals sent through nerve cells in the brain. For about 70% of people with epilepsy, the electrical interruption comes from one area of the brain, which is called focal epilepsy. Other people have an electrical imbalance all over the brain—this is called generalized epilepsy.

Dr. Bateman says wildly inaccurate misconceptions about epilepsy remain, leading to stigma that can make life more difficult for patients. People with epilepsy may face bullying and discrimination or even exclusion from education, employment and social activities—which can cause or worsen psychological distress and isolation. 

Patients still go undiagnosed and untreated, Dr. Bateman says, out of fear and shame, putting them at high risk for dangerous complications of seizures. Open conversations about myths and facts surrounding epilepsy, and advocating for patient rights, can help to perpetuate the truth and dismantle stigma.

Read: What Is a Seizure?

About two-thirds of patients who are diagnosed and treated for epilepsy with anti-seizure medications no longer experience seizures. Most people can control their condition with medication.

Patients who don't respond to medication might be able to have surgery to treat epilepsy. Specialists working at comprehensive epilepsy centers, such as the one at Cedars-Sinai, may be able to identify the part of the brain causing the seizures and remove it, which offers up to an 80% chance of seizure freedom and improved quality of life.

Sometimes this type of surgery isn't possible because it would jeopardize a patient's important brain functions, such as vision, movement, speech or memory, or because the seizures come from more than one spot in the brain. In these cases, neuromodulation devices—which provide stimulation to specific nerves or areas of the brain—regulate electricity to reduce seizures. Other patients may have their seizure control improved with specific diets or alternative and experimental therapies.

"For people in this situation, it doesn’t mean there's no hope," Dr. Bateman says. 

Read: What To Do When Someone Has a Seizure

New techniques to help monitor seizures have been developed in the past few years, Dr. Bateman says. Wearable devices can detect shaking movements that occur with some seizures, with the goal of identifying when a major seizure is happening. Certain devices also send an alert to a caregiver or a parent when a seizure is detected so they can intervene. 

"The idea is that they can detect a seizure, and the second key step is alerting somebody to that," Dr. Bateman says.

Some devices may also store data about when seizures occur that may help guide a patient's ongoing treatment. There is no evidence that current devices can detect more subtle seizures, prevent or treat seizures, or prevent sudden unexpected death in epilepsy, though these are all goals for future device development.

Read: Overcoming Epilepsy and Riding Again

New techniques to help monitor seizures have been developed in the past few years, Dr. Bateman says. Wearable devices can detect shaking movements that occur with some seizures, with the goal of identifying when a major seizure is happening. Certain devices also send an alert to a caregiver or a parent when a seizure is detected so they can intervene. 

"The idea is that they can detect a seizure, and the second key step is alerting somebody to that," Dr. Bateman says.

Some devices may also store data about when seizures occur that may help guide a patient's ongoing treatment. There is no evidence that current devices can detect more subtle seizures, prevent or treat seizures, or prevent sudden unexpected death in epilepsy, though these are all goals for future device development.

Read: Fainting vs. Seizure: How to Tell the Difference

An epilepsy diagnosis can be extremely disruptive. Seizures limit a person's ability to drive or perform certain occupations and can make everyday activities dangerous. But Dr. Bateman says her aim is to help patients completely eliminate seizures. 

"You can live a fully independent life with epilepsy," she says. "One to two seizures a year should not simply be accepted as good control—we should help patients strive for being seizure-free with minimal treatment side effects." 

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