Vision and Eye Changes with Epilepsy | National Epilepsy Month

November is National Epilepsy Month. It is a time to bring awareness to this disorder, which affects 50 million people worldwide, according to the World Health Organization.

Epilepsy can lead to muscle jerking and altered levels of consciousness. It can also cause ophthalmologic signs. Continue reading below to learn more about this disorder. 
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​What is Epilepsy? 

Epilepsy is a neurological condition that involves recurrent seizures. It occurs due to abnormal brain activity. It’s thought that chemical changes in the brain cause a sudden surge in electrical activity, which leads to seizures. The condition can affect both children and adults.

Usually, seizures are categorized by whether one or both cerebral hemispheres are affected. Seizures also originate from different parts of the brain. They range in severity and frequency.

Seizures can manifest themselves in different ways. When we think of a seizure, we picture jerking muscle movements. But other types of seizures can also occur that can cause a variety of symptoms, such as:

• Confusion
• Fear
• Staring
• Loss of awareness

The cause of epilepsy is not always known. Genetics may play a role since some forms of epilepsy appear to run in families. Epilepsy can also develop after a disruption to the brain from a tumor, head injury, or a stroke. According to the Mayo Clinic, in about half the people with epilepsy, there is not a clear cause. 
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​Possible Eye and Vision Changes

Seizures due to epilepsy do not usually lead to permanent vision issues. But epilepsy may involve several vision and eye changes during a seizure.

Epilepsy affects various lobes of the brain that control different movements and behaviors. Depending on the area of the brain involved, ophthalmologic signs may include:

• Rapid eye blinking
• Staring
• Eye deviation
• Visual field loss
• Visual hallucinations

Occipital seizures are likely to cause visual disturbances.  According to research in the peer-reviewed journal Brain, occipital epilepsy is considered uncommon, although it might be under-recognized. It is estimated to affect up to 2.6 percent of people with epilepsy.

This type of epilepsy originates from the occipital lobe. Some of the possible external eye manifestations include forced closure of the eyelids, a rapid flickering of the eyes, and jerks of the eyelids. 
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​How is Epilepsy Treated? 

There is currently no cure for epilepsy, but treatment options are available that can control seizures and improve quality of life. Typically, there is not a one size fits all treatment for epilepsy. Different strategies may work for some and not for others. Below are epilepsy treatment options.

Medication: Medication is often the first-line therapy in treating epilepsy. Certain types of seizures tend to respond better to medication than others. There are also many kinds of drugs used to treat different types of seizures. Since there are so many medication options, it might take a little trial and error before the right treatment is found.

Dietary therapy: Dietary changes are effective for some people with certain types of seizures, such as refractory seizures. Nutritional therapy is often used in combination with medication. Although there are different types of dietary changes, the ketogenic diet is one of the most common diets used. The diet is low-carbohydrate and high in fat.  

Devices: Different devices are also an option for treating epilepsy. Device therapy involves using a device that sends an electrical signal to the nervous system and prevents seizures. 

Surgery: According to the Epilepsy Foundation, it is estimated that about 30 to 40 percent of people have drug-resistant epilepsy, which means it is not controlled with medication. When medication and other treatment options do not work, surgery may be recommended. There are several types of surgical options depending on the area of the brain involved, including minimally invasive and invasive procedures. For example, a procedure called a focal resection removes a section of the brain that is causing seizures.
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If you have any questions about eye changes and epilepsy, we are happy to help. Also, if you would like to schedule an appointment, please call our office at 508-746-8600.