Epilepsy & First Seizure

Epilepsy is one of the most common neurological conditions and is defined by a tendency to recurrent, unprovoked seizures. It is caused by transient, excessive electrical activity in the brain.

A first, isolated seizure does not always mean epilepsy. The aim of the initial assessment is to distinguish provoked from unprovoked seizures, identify the seizure type and estimate the risk of a new seizure.

Seizures present differently depending on the area of the brain involved. A seizure is often followed by transient confusion, fatigue, muscle ache or headache.

Epilepsy may be due to a structural cause (e.g. after stroke, head injury or infection), to genetic or metabolic factors, while in many cases the cause remains unknown. Certain factors can trigger a seizure in susceptible people:

Work-up includes a detailed history, neurological examination, an EEG and, where needed, a brain MRI.

The EEG records the brain's electrical activity and can reveal epileptiform discharges that guide diagnosis. As head of an EEG Laboratory, Dr. Apostolakopoulou also interprets complex recordings, including long-term Video-EEG.

Treatment is individualised according to seizure type, age, history and lifestyle. It includes the selection and titration of anti-seizure medication and counselling on everyday safety (driving, work, sleep).

In selected cases of drug-resistant epilepsy, adjustment of a Vagus Nerve Stimulator (VNS) is performed in collaboration with a neurosurgeon.