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Neurology - Epilepsy

Overview

What is Epilepsy?

Epilepsy, a neurological condition that affects the brain's electrical system leads to a tendency for recurrent, unprovoked seizures. The brain is a highly organised electrical circuit that sends tiny, steady impulses that control everything we do. This rhythm gets interrupted by sudden bursts of uncoordinated electrical activity for someone with epilepsy, much like a power surge or a circuit breaker tripping. This disruption is what produces a seizure.

A single seizure, perhaps triggered by a high fever or a head injury, does not mean a person has epilepsy. Epilepsy in the UAE, as across the world, is diagnosed when someone has two or more unprovoked seizures. It is a spectrum disorder, affecting everyone differently. Manifesting differently for everyone, some people may have very subtle moments of staring, while others experience dramatic convulsions. The first step towards getting the right support for epilepsy treatment is understanding.

Types of Epilepsy and Seizures

Based on where the abnormal electrical activity starts in the brain, seizures are broadly divided into two main types.

Focal seizures begin in just one area on one side of the brain. Unusual sensations might be felt, such as a strange taste or a rising feeling in the stomach. Some patients might smack their lips, pick at their clothes, or feel a sudden wave of intense emotion like fear or joy. Some people remain fully aware during a focal seizure. Others become confused or lose awareness.

Generalised seizures involve both sides of the brain from the very start. “Tonic-clonic' seizure fall under this category. This happens when a person loses consciousness, becomes stiff, and then jerks rhythmically. An 'absence' seizure on the other hand looks different, like a brief staring spell, often mistaken for daydreaming. Sudden, brief jerks of the arms or legs are caused by a 'myoclonic' seizure.

 

Knowing when to seek help is vital. A single seizure or even a suspected seizure of any kind should always prompt a medical review, to understand its cause. After two or more unprovoked seizures occurring more than twenty-four hours apart, a consultation is warranted as this is a key indicator of epilepsy itself. Even a first seizure warrants an expert evaluation, especially if initial tests suggest a higher risk of another one occurring.

Seizures are not always obvious. Any unexplained 'spells' could be a subtle seizure. They can appear in ways like repeated staring into space, sudden episodes of confusion or memory lapses, odd jerks of a limb or strange sensations like a rising feeling in the stomach should be investigated. A change in the pattern or frequency of their seizures, or difficulty controlling them with current medication, is a clear signal to see a specialist for those already diagnosed with epilepsy. This is particularly important when looking for epilepsy in Dubai, Abu Dhabi, Sharjah, Ajman, Ras Al Khaimah, and Al Ain in the UAE, with the region's expert centres offering advanced diagnostic and treatment options not available everywhere.

 

A detailed conversation with a neurologist who will need a precise description of the 'spells', such as what happens before, during and after marks the beginning of a medical investigation. A witness account from a friend or family member is often invaluable since many people have no memory of their seizure. Doctors will also ask about the patient's medical history. This includes any past head injuries, infections and whether anyone in the family has epilepsy.

The most common test is an electroencephalogram, or EEG. This painless test uses small sensors on the scalp to record the brain's electrical activity and can detect abnormal 'waves' that point towards a tendency for seizures. Sometimes a routine EEG is normal, so the doctor may recommend a longer, prolonged EEG or one done after sleep deprivation. 

An MRI scan is the most common brain imaging used for diagnosis. This helps create detailed pictures of the brain's structure to look for a potential cause, such as a small scar or an area of abnormal development. Blood tests are used to help rule out other temporary causes, like a metabolic imbalance or infection. Confirming a diagnosis of epilepsy, identifying the specific seizure type and understanding its likely cause are the goals.

 

  • Generalised Epilepsies 

  • Juvenile Myoclonic Epilepsy

  • Tonic-Clonic Seizures

  • Focal Epilepsies (including Temporal Lobe Epilepsy)

  • Epilepsy with Absence Seizures

  • Myoclonic and Atonic Seizures

  • Drug-Resistant Epilepsy

  • Epilepsy Associated with Brain Tumours or Stroke

  • First Seizure Clinics and Risk Assessment

  • Status Epilepticus (Prolonged or Repeated Seizures)

 

The least invasive, most effective options are our first approaches at NMC. The cornerstone of epilepsy treatment is anti-seizure medication for most with the right drug carefully selected for each seizure type. This usually starts at a low dose. It’s then adjusted as needed to balance seizure control with potential side effects.

Advanced alternatives are offered if medication is not enough. Dietary therapy such as the ketogenic diet has proven remarkably effective for some forms of epilepsy, for suitable candidates, especially in children. Neurostimulation may be appropriate for those with drug-resistant epilepsy. This is where a small device like a vagus nerve stimulator (VNS) is implanted to help regulate abnormal brain activity. From first diagnosis to complex management, the NMC network is equipped to provide comprehensive care for epilepsy in the UAE. This happens within a coordinated, compassionate team.

 

Consultant neurologists with a focused, advanced interest in epilepsy lead our teams. Supported by specialist nurses, neurophysiologists, together they perform and interpret EEGs and neuroradiologists. They bring a wealth of experience to the NMC network with all our specialists having trained at leading international centres.

A diagnosis of epilepsy can be frightening and full of uncertainty and our consultants are known for their unparalleled bedside manner. They are patient, respond to questions, from driving regulations to genetic risks. The team across Dubai, Abu Dhabi, Sharjah, Ajman, Ras Al Khaimah, and Al Ain in the UAE provides the same high standard of expert, empathetic care whether a patient needs expert epilepsy treatment or a second opinion for a difficult-to-control condition.

 

FAQs

Find the Answer to Your Medical Questions

Frequently Asked Questions

Not for everyone. Many people are able to achieve complete seizure freedom with medication. They also may eventually stop treatment under medical guidance. It is a chronic condition for others and can be managed very effectively, allowing a full and active life.
Designed for safety, driving regulations are strict. A person is generally required to be completely seizure-free for a period in the UAE. This is determined by the neurologist and licensing authority (often one year or more) before being permitted to drive. Specific legal requirements are guided by specialists, depending on the patient.
Some can cause side effects such as fatigue, dizziness, weight changes or mood effects. It is the same for all powerful medications. Many people however, have no significant issues. The neurologist will work to find the drug and dose that controls seizures with the fewest side effects for each patient. Medication should never be stopped or changed without a doctor's advice.
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