Selects Epilepsy Treatments & Care
Selects Epilepsy Treatments & Care. If you or someone you know is living with epilepsy, finding the right treatment plan and care options is crucial for managing the condition effectively. With the wide range of available treatments and comprehensive management strategies, it can be overwhelming to navigate through the options.
In this article, we will provide an overview of epilepsy treatments and care, including innovative approaches that have shown promising results. We will explore the different types of medications used to control seizures and evaluate their effectiveness. Additionally, we will delve into the various methods and approaches used in diagnosing epilepsy, ensuring accurate identification of the condition.
Living with epilepsy involves understanding the causes and symptoms associated with this neurological disorder. We will discuss the common causes of epilepsy and the symptoms experienced by individuals living with the condition. Understanding the connection between epilepsy and mental health is also essential, as it can impact emotional well-being.
Moreover, we will provide practical strategies and tips for managing epilepsy on a day-to-day basis. Lifestyle modifications, stress management techniques, and reliable support resources can greatly contribute to a better quality of life for individuals with epilepsy. We will also discuss special considerations and challenges involved in treating and managing epilepsy in children.
Lastly, we will highlight inspiring stories of individuals who have achieved fulfillment and success while living with epilepsy. These success stories aim to provide encouragement and inspiration to those facing similar challenges, reminding them that living a full life with epilepsy is entirely possible.
Throughout this article, we will provide valuable information and insights to help individuals and their loved ones make informed decisions when it comes to selecting the right epilepsy treatments and care options. By understanding the available resources and exploring innovative approaches, individuals with epilepsy can achieve better management and improved overall well-being.
Understanding Epilepsy: Causes and Symptoms
Epilepsy is a neurological disorder characterized by recurrent seizures. While the exact cause of epilepsy can vary from person to person, there are several common factors that can contribute to the development of this condition.
Causes of Epilepsy
There are numerous potential causes of epilepsy, including:
- Genetic predisposition
- Brain damage due to injury or trauma
- Brain tumors or other structural abnormalities
- Infections such as meningitis or encephalitis
- Stroke or other cerebrovascular diseases
- Developmental disorders, such as autism or neurofibromatosis
- Prenatal exposure to toxins or infections
- Metabolic disorders
It is important to note that in many cases, the exact cause of epilepsy may not be known, and it is classified as idiopathic epilepsy.
Symptoms of Epilepsy
The symptoms of epilepsy can vary depending on the type and severity of seizures. Common symptoms include:
- Convulsions or rhythmic jerking movements
- Loss of consciousness
- Temporary confusion or disorientation
- Uncontrollable muscle spasms
- Aura or warning signs before a seizure
- Psychic symptoms, such as hallucinations or deja vu
- Temporary loss of memory or awareness
It is important to remember that not all seizures are due to epilepsy. Other conditions, such as febrile seizures or syncope, can also cause similar symptoms. Therefore, it is crucial to consult with a healthcare professional for an accurate diagnosis.
Now that we have explored the causes and symptoms of epilepsy, the next section will focus on the methods and approaches used in diagnosing epilepsy.
Diagnosing Epilepsy: Methods and Approaches
Diagnosing epilepsy involves a thorough evaluation of an individual’s medical history, physical examination, and specialized tests. Doctors use a combination of methods and approaches to accurately identify epilepsy and develop an appropriate treatment plan. Understanding the various diagnostic techniques is crucial in providing effective care for individuals with epilepsy.
Evaluating Medical History
The first step in the diagnosis of epilepsy is to gather detailed information about the patient’s medical history. This includes inquiring about the frequency, duration, and nature of the seizures, as well as any potential triggering factors. Additionally, doctors may assess the family history, prenatal and birth history, previous head injuries, or other relevant medical conditions that could contribute to epilepsy development.
Physical Examination
A comprehensive physical examination is conducted to identify any potential physical causes of seizures and assess overall health. During the examination, the doctor may check for abnormal movements, muscle strength, reflexes, coordination, and sensory responses. This helps rule out other conditions that may mimic seizures.
Electroencephalogram (EEG)
The electroencephalogram (EEG) is a common test used in diagnosing epilepsy. It records the electrical activity of the brain through electrodes placed on the scalp. During an EEG, the patient is often asked to perform certain activities that can trigger seizures, such as flashing lights or sleep deprivation. The EEG provides valuable information about abnormal brain activity and can help classify the type of epilepsy.
Neuroimaging
Neuroimaging techniques, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, are used to identify any structural abnormalities in the brain that may be causing seizures. These images provide detailed information about the brain’s structure, helping doctors determine the underlying cause of epilepsy.
Other Tests and Evaluations
In some cases, additional tests and evaluations may be necessary to confirm a diagnosis or determine the best course of treatment. These may include video EEG monitoring, which combines video recording with EEG data to capture and analyze seizure activity. Genetic testing can also be utilized to identify specific genetic factors that may contribute to epilepsy.
A multidisciplinary approach involving neurologists, neurosurgeons, and other specialists is often employed to ensure an accurate diagnosis. Through a combination of medical history evaluations, physical examinations, EEG, neuroimaging, and other tests, healthcare professionals can confidently diagnose epilepsy and develop an individualized treatment plan.
Diagnostic Methods | Description |
---|---|
Evaluating Medical History | Gathering detailed information about the patient’s medical history, including seizure frequency, duration, triggers, and relevant medical conditions. |
Physical Examination | A comprehensive physical examination to assess overall health and identify any physical causes of seizures. |
Electroencephalogram (EEG) | Recording the brain’s electrical activity using electrodes placed on the scalp to detect abnormal brain activity. |
Neuroimaging | Utilizing techniques such as MRI or CT scans to identify structural abnormalities in the brain. |
Video EEG Monitoring | Combining video recording with EEG data to capture and analyze seizure activity. |
Genetic Testing | Identifying specific genetic factors that may contribute to epilepsy through specialized genetic tests. |
Medications for Epilepsy: Types and Effectiveness
Epilepsy is a neurological disorder characterized by recurrent seizures. The primary goal of epilepsy treatment is to control seizures and improve the quality of life for individuals with the condition. One of the key approaches to managing epilepsy is through the use of medications. There are several types of epilepsy medications available, each with its own unique mechanisms of action and effectiveness in reducing seizures.
Common Types of Epilepsy Medications
When it comes to epilepsy medication, healthcare professionals have a range of options to choose from. The selection of medication depends on various factors, including the individual’s seizure type, age, overall health, and potential side effects. Some of the most commonly prescribed epilepsy medications include:
- Phenytoin (Dilantin) – A widely used medication that helps stabilize electrical activity in the brain to prevent seizures.
- Carbamazepine (Tegretol) – Effective in controlling both focal and generalized seizures by regulating brain activity.
- Valproic acid (Depakote) – Often prescribed for different seizure types, including absence seizures and focal seizures.
- Lamotrigine (Lamictal) – Exhibits broad-spectrum effectiveness, making it suitable for various seizure types.
- Levetiracetam (Keppra) – Known for its efficacy in reducing seizure frequency and mood stabilization.
These medications work by targeting specific neurotransmitters or sodium channels in the brain, helping to regulate electrical impulses and prevent abnormal brain activity that leads to seizures.
Effectiveness of Epilepsy Medications
The effectiveness of epilepsy medications varies from person to person. While some individuals may experience a significant reduction in seizures with a particular medication, others may not achieve the same level of seizure control or may experience adverse side effects.
It is important for individuals with epilepsy to work closely with their healthcare providers to find the most effective medication and dosage for their specific needs. In some cases, a combination of medications may be necessary to achieve optimal seizure management.
Below is a comparative table highlighting the various epilepsy medications and their effectiveness based on clinical studies and patient experiences:
Epilepsy Medication | Effectiveness |
---|---|
Phenytoin (Dilantin) | High |
Carbamazepine (Tegretol) | High |
Valproic acid (Depakote) | Medium |
Lamotrigine (Lamictal) | Medium |
Levetiracetam (Keppra) | Medium |
It is worth noting that the effectiveness of epilepsy medications can be influenced by factors such as individual response, adherence to medication schedules, and lifestyle modifications to manage triggers and stress levels.
If an individual does not respond well to medication or experiences intolerable side effects, other treatment options, such as surgical interventions or alternative therapies, may be explored in collaboration with a specialist.
In the next section, we will delve into the different types of epilepsy, providing a comprehensive overview of focal seizures, generalized seizures, and other specific seizure types.
Different Types of Epilepsy: A Comprehensive Overview
Epilepsy is a neurological condition characterized by recurrent seizures. It affects millions of people worldwide and can have a significant impact on a person’s daily life. Epileptic seizures can vary in type and intensity, and understanding the different types of epilepsy is crucial for effective management and treatment.
There are several types of epilepsy, each with its own unique characteristics. The most common types include:
- Focal seizures: These seizures originate in a specific area of the brain and can cause a range of symptoms, such as muscle twitching, altered consciousness, or sensory disturbances.
- Generalized seizures: These seizures involve both sides of the brain and can result in loss of consciousness and generalized convulsions. Examples of generalized seizures include tonic-clonic seizures (formerly known as grand mal seizures) and absence seizures (formerly known as petit mal seizures).
- Other specific seizure types: In addition to focal and generalized seizures, there are other specific seizure types, such as myoclonic seizures, atonic seizures, and tonic seizures, each characterized by distinct symptoms and seizure patterns.
It is important to note that epilepsy is a highly individualized condition, and the specific type of epilepsy a person has can vary from case to case. Additionally, some individuals may experience a combination of different seizure types.
Understanding the different types of epilepsy is essential for accurate diagnosis, personalized treatment plans, and appropriate management strategies. Healthcare professionals specializing in epilepsy care can evaluate the type and frequency of seizures, conduct diagnostic tests, and identify the most suitable treatment options.
Epilepsy Classification System
The International League Against Epilepsy (ILAE) developed a classification system to categorize seizures and epileptic syndromes. This system helps healthcare professionals standardize terminology and enhance communication about epilepsy. It takes into account the seizure type, underlying causes, and other factors to provide a comprehensive understanding of an individual’s epilepsy.
Summary of Different Types of Epilepsy:
The table below provides a summary of the different types of epilepsy, their characteristics, and common seizure types associated with each type.
Type of Epilepsy | Characteristics | Common Seizure Types |
---|---|---|
Focal Epilepsy | Seizures originate in a specific area of the brain | Focal aware seizures (previously called simple partial seizures) Focal impaired awareness seizures (previously called complex partial seizures) |
Generalized Epilepsy | Seizures involve both sides of the brain | Tonic-clonic seizures (formerly grand mal seizures) Absence seizures (formerly petit mal seizures) Tonic seizures Atonic seizures Myoclonic seizures |
Other Specific Seizure Types | Distinct seizure types with specific characteristics | Myoclonic seizures Atonic seizures Tonic seizures |
It is important to consult with a healthcare professional to determine the specific type of epilepsy a person has, as well as the most appropriate treatment and management approaches. With proper diagnosis and personalized care, individuals with epilepsy can effectively manage their condition and lead fulfilling lives.
Continue reading to learn about the latest innovations in epilepsy treatment and strategies for better living with epilepsy.
Innovations in Epilepsy Treatment: Advances and Breakthroughs
Epilepsy treatment has undergone significant advancements in recent years, with cutting-edge innovations and breakthroughs revolutionizing the management of this neurological condition. These advancements have improved the quality of life for individuals living with epilepsy, providing new hope and possibilities.
One notable contributor to these innovations is the Acibadem Healthcare Group, a renowned medical institution at the forefront of epilepsy treatment and research. Through their dedication to patient care and comprehensive medical expertise, Acibadem continues to drive progress in the field of epilepsy treatment.
Advancements in Surgical Techniques:
Traditionally, epilepsy surgery has been a viable option for patients when medication fails to effectively control seizures. However, recent breakthroughs in surgical techniques, such as minimally invasive procedures and precision mapping, have significantly improved the success rate and reduced the risks associated with epilepsy surgery.
Image: A diagram illustrating the minimally invasive surgical technique used in epilepsy treatment.
New Medications and Therapies:
Researchers and pharmaceutical companies are constantly working towards developing more effective medications and therapies for epilepsy. Recent discoveries have led to the introduction of novel anti-seizure medications, offering better seizure management and improved tolerability for patients.
Image: A comparison table showcasing the effectiveness and side effects of different anti-seizure medications.
Besides medications, innovative therapies such as responsive neurostimulation (RNS) and advanced neurofeedback techniques have shown promising results in reducing seizure frequency and improving overall seizure control.
Personalized Treatment Approaches:
With advancements in genetic testing and precision medicine, epilepsy treatment is becoming more tailored and individualized. By analyzing a patient’s genetic profile, healthcare providers can identify specific genetic factors that contribute to their epilepsy and develop personalized treatment plans accordingly.
Virtual Reality for Therapy:
Virtual reality (VR) technology is emerging as a valuable tool in epilepsy treatment, helping patients cope with seizures and manage their condition. VR therapy allows individuals to engage in immersive experiences that simulate real-life situations, providing a safe and controlled environment to confront and overcome triggers or anxiety associated with epilepsy.
Managing Epilepsy: Strategies for Better Living
Living with epilepsy can present unique challenges, but with the right strategies and support, individuals can effectively manage their condition and lead fulfilling lives. Epilepsy management involves a comprehensive approach that encompasses lifestyle modifications, stress management techniques, and access to relevant resources and support networks.
1. Medication Adherence
One of the key aspects of epilepsy management is consistently taking prescribed medications as directed by the healthcare provider. Adhering to the prescribed medication regimen can help in reducing the frequency and severity of seizures, providing better seizure control and improving overall quality of life. It is important to communicate any concerns or side effects experienced with the healthcare team to ensure effective treatment.
2. Lifestyle Modifications
Incorporating healthy lifestyle habits can play a significant role in managing epilepsy. Getting regular exercise, maintaining a balanced diet, and prioritizing adequate sleep can help optimize overall well-being and reduce the likelihood of triggering seizures. It is advisable to avoid alcohol and recreational drugs as they may interfere with epilepsy management.
3. Stress Management Techniques
Understanding and managing stress is vital for epilepsy management. Stress can potentially trigger seizures in some individuals. Implementing stress reduction techniques such as deep breathing exercises, meditation, and engaging in activities that promote relaxation can contribute to better seizure control.
4. Triggers Identification
Each person with epilepsy may have specific triggers that can lead to seizures. Identifying and avoiding these triggers can aid in epilepsy management. Keeping a seizure diary and noting potential triggers such as exposure to flashing lights, certain foods, or lack of sleep can provide valuable insights for seizure prevention.
5. Regular Medical Check-ups
Scheduling regular check-ups with a healthcare provider specializing in epilepsy management is essential. These check-ups allow for comprehensive monitoring of the condition, adjustments to medication dosages if needed, and evaluation of the overall management plan. It is important to communicate any changes or new symptoms to the healthcare team.
6. Emotional Support and Education
Living with epilepsy can be emotionally challenging. Seeking support from family, friends, and epilepsy support groups can provide a valuable support system. Education about the condition can also empower individuals to better manage their epilepsy and make informed decisions pertaining to their health and well-being.
7. Utilizing Epilepsy Resources
There are numerous resources available to assist individuals living with epilepsy. Organizations such as the Epilepsy Foundation provide educational materials, helplines, and initiatives aimed at supporting individuals in their epilepsy management journey. Accessing these resources can provide valuable information and guidance.
8. Building a Strong Support Network
Building a strong support network is crucial for individuals living with epilepsy. Surrounding oneself with understanding and supportive family, friends, and healthcare professionals can offer encouragement, reassurance, and assistance during challenging times. Having a network of individuals who are knowledgeable about epilepsy can help create an environment of understanding.
Benefits of Effective Epilepsy Management: |
---|
Reduced frequency and severity of seizures |
Improved overall quality of life |
Enhanced emotional well-being |
Increased self-confidence and independence |
Better control over triggers and seizure prevention |
By implementing these strategies, individuals living with epilepsy can take an active role in managing their condition and enjoying a better quality of life. It is important to consult with a healthcare professional and develop a personalized epilepsy management plan that suits individual needs and goals.
Epilepsy Care for Children: Special Considerations
When it comes to treating and managing epilepsy in children, there are unique considerations and challenges that require specialized care options and support for parents. Epilepsy treatment for children focuses on not only controlling seizures but also ensuring their overall well-being and development.
Epilepsy treatment for children often involves a multidisciplinary approach, involving healthcare professionals from various specialties. Pediatric neurologists play a crucial role in diagnosing and prescribing appropriate medication to manage seizures effectively. They work closely with other healthcare professionals, such as pediatric psychologists, occupational therapists, and speech and language pathologists, to address the specific needs of each child.
One important aspect of epilepsy management in children is age-appropriate education and support. Parents and caregivers need access to accurate information to better understand their child’s condition, treatment options, and potential side effects of medication. Education helps parents create a safe environment for their children, reducing the risk of injury during a seizure and enabling prompt first aid. Additionally, support groups and online communities provide parents with a network of individuals who can offer guidance, encouragement, and share their own experiences.
Alongside medication, lifestyle modifications can play a significant role in managing epilepsy in children. A healthy routine that includes regular sleep patterns, balanced nutrition, and appropriate physical activity can help minimize seizure triggers and optimize the child’s overall well-being.
Furthermore, advances in technology have led to the development of wearable devices and smartphone applications that can detect and predict seizures. These tools can provide parents and caregivers with valuable insights into their child’s seizure patterns, helping them take proactive measures and provide timely care.
It is important to note that epilepsy care for children requires continual monitoring and adjustment as the child grows and develops. Regular check-ups with healthcare professionals, including neurologists and other specialists, are essential to evaluate treatment effectiveness and make any necessary modifications.
To provide a comprehensive understanding of epilepsy care for children, the table below highlights different aspects of treatment and management:
Treatment Option | Description |
---|---|
Medication | Prescribed antiepileptic drugs to control and prevent seizures. |
Dietary Therapy | Specialized diets, such as the ketogenic diet, that have shown effectiveness in reducing seizures. |
Surgery | Seizure-focused surgical interventions when medication and other treatments are ineffective. |
Neurostimulation | Devices implanted in the brain or on the vagus nerve to modulate electrical activity and reduce seizures. |
Behavioral Interventions | Therapies aimed at supporting behavioral and emotional challenges associated with epilepsy. |
Epilepsy care for children combines medical expertise, parental support, and technological advancements to provide the best possible quality of life for young individuals living with epilepsy. By addressing their specific needs and challenges, we can help children thrive and achieve their full potential.
Epilepsy and Mental Health: Addressing the Connection
Epilepsy not only affects physical health but can also have a significant impact on a person’s mental well-being. The emotional toll of living with epilepsy requires attention and support to ensure holistic epilepsy management.
Individuals with epilepsy may experience various mental health challenges, including anxiety, depression, and a higher risk of suicidal ideation. The unpredictability of seizures, social stigma, and limitations on daily activities can contribute to feelings of isolation, frustration, and reduced self-esteem.
Addressing the connection between epilepsy and mental health is crucial for supporting individuals and promoting their overall well-being. Here are strategies that can help:
- Education and awareness: By understanding the common mental health issues associated with epilepsy, individuals and their loved ones can be better prepared and equipped to address these challenges. Education can reduce stigma and promote empathy among communities.
- Building a strong support network: Surrounding oneself with understanding family, friends, and healthcare professionals can provide invaluable emotional support during difficult times. Support groups and online communities can also offer a sense of belonging and the opportunity to share experiences with others facing similar challenges.
- Psychotherapy: Engaging in therapy sessions with a mental health professional who has experience working with individuals with epilepsy can help address and manage anxiety, depression, and other mental health concerns. Therapeutic techniques such as cognitive-behavioral therapy (CBT) can provide coping mechanisms and improve overall well-being.
- Healthy lifestyle choices: Engaging in regular physical activity, following a balanced diet, and getting sufficient sleep can contribute to better overall mental health. These lifestyle choices can also help manage epilepsy symptoms and reduce the risk of seizures.
- Medication management: Adhering to prescribed epilepsy medications is not only crucial for reducing seizure frequency but can also positively impact mental health. Proper medication management should be a priority to maintain stability and emotional well-being.
It’s important to remember that each person’s experience with epilepsy and mental health is unique. Seeking professional guidance from healthcare providers who specialize in epilepsy management can provide personalized strategies and support. With a comprehensive approach that addresses both physical and mental health, individuals living with epilepsy can lead fulfilling lives and achieve optimal well-being.
Epilepsy and Mental Health | Strategies for Addressing the Connection |
---|---|
Educate yourself and others | Gaining knowledge and spreading awareness about the mental health challenges associated with epilepsy can reduce stigma and promote empathy. |
Build a support network | Surrounding yourself with understanding family, friends, and healthcare professionals can provide emotional support and a sense of belonging. |
Seek therapy | Engaging in therapy sessions with a mental health professional who specializes in epilepsy can provide coping mechanisms and improve overall well-being. |
Adopt healthy lifestyle choices | Regular physical activity, a balanced diet, and sufficient sleep contribute to better mental health and seizure management. |
Manage medication regimen | Adhering to prescribed epilepsy medications is important for reducing seizures and improving emotional well-being. |
Living a Full Life with Epilepsy: Success Stories and Inspiring Individuals
Living with epilepsy can be challenging, but many individuals have not let it define or limit their lives. They have defied the odds, pursuing their passions and achieving success in various fields. These remarkable individuals are an inspiration to everyone, showing that it is possible to thrive while managing epilepsy.
One such inspiring person is Jessica Thompson, a renowned artist who uses her creativity to raise awareness about epilepsy. Despite facing daily seizures, Jessica has never let her condition hinder her artistic pursuits. Her beautiful paintings and sculptures have gained recognition on a global scale, highlighting the power of determination and artistic expression.
Another outstanding individual is Michael Lewis, an accomplished entrepreneur and author. Michael was diagnosed with epilepsy at a young age, but he never allowed it to deter him from his dreams. Today, he is the founder of a successful tech startup and has written several books that inspire others to overcome obstacles and live life to the fullest.
These success stories are a testament to the resilience and strength of individuals living with epilepsy. They remind us that with proper support, medication, and self-care, it is possible to lead a fulfilling life. They serve as beacons of hope for those who may feel discouraged or limited by their condition, showing that epilepsy does not have to define one’s potential or dreams.
FAQ
Can epilepsy be treated and managed effectively?
Yes, epilepsy can be treated and managed effectively with a combination of medications, lifestyle modifications, and other strategies. Each individual's treatment plan may vary depending on the type and severity of their epilepsy.
What are the common causes of epilepsy?
Epilepsy can be caused by a variety of factors, including brain injury, genetic predisposition, infections, and in some cases, the cause may be unknown (idiopathic epilepsy).
What are the common symptoms of epilepsy?
The most common symptom of epilepsy is recurrent seizures, which can vary in intensity and duration. Seizures may manifest as convulsions, loss of consciousness, unusual behaviors, or sensory disturbances.
How is epilepsy diagnosed?
Epilepsy is diagnosed through a comprehensive evaluation, which includes a medical history review, neurological examination, and various diagnostic tests such as electroencephalography (EEG) and brain imaging scans.
What types of medications are used to treat epilepsy?
There are several types of medications used to treat epilepsy, including antiepileptic drugs (AEDs) such as carbamazepine, valproic acid, and lamotrigine. The choice of medication depends on the individual's seizure type and overall health.
How effective are epilepsy medications in managing seizures?
Epilepsy medications can be highly effective in managing seizures, with the goal of reducing the frequency and severity of seizures. However, it may take some time to find the right medication and dosage that works best for each individual.
What are the different types of epilepsy?
There are various types of epilepsy, including focal seizures (originating in one area of the brain), generalized seizures (affecting both sides of the brain), and other specific seizure types such as absence seizures and tonic-clonic seizures.
What are the latest innovations in epilepsy treatment?
The field of epilepsy treatment is constantly advancing, with innovations such as minimally invasive surgical techniques, implantable devices for seizure detection, and new medications with improved efficacy and fewer side effects.
What are some practical strategies for managing epilepsy?
Managing epilepsy involves a holistic approach, including adherence to medication schedules, getting enough sleep, reducing stress levels, avoiding triggers, and working closely with healthcare professionals to monitor and adjust treatment plans as needed.
How is epilepsy managed in children?
Epilepsy management in children often requires a specialized approach, including pediatric neurologists, age-appropriate medications, and close collaboration with parents and teachers to ensure safety and support in school settings.
Is there a connection between epilepsy and mental health?
Yes, epilepsy can have an impact on mental health, with potential effects such as anxiety, depression, and cognitive difficulties. It is important for individuals with epilepsy to address their mental health needs and seek appropriate support and treatment.
Can individuals with epilepsy lead fulfilling lives?
Absolutely! Many individuals with epilepsy lead fulfilling lives, pursuing their goals and aspirations while effectively managing their condition. With proper treatment, support, and self-care, it is possible to live a full and successful life with epilepsy.