Epilepsy

What Is Epilepsy?

Epilepsy is a brain condition that causes repeated, unprovoked seizures. A seizure is a sudden change in brain electrical activity that temporarily affects how the brain works. This can cause changes in movement, sensation, awareness, or behaviour.

Having a single seizure does not mean you have epilepsy. Epilepsy is diagnosed when a person has had two or more unprovoked seizures, or when a neurologist determines there is a high risk of further seizures based on testing such as an EEG or MRI.

Epilepsy can start at any age, but it most commonly begins in childhood or after the age of 60. It is not a mental illness and it is not contagious.

Types of Seizures

Seizures are classified into two main groups based on where in the brain the abnormal activity begins.

Focal Seizures (Partial Seizures)

Focal seizures start in one area of the brain. They are the most common seizure type in adults.

• Focal aware seizures — you remain conscious but may experience unusual feelings, movements, or sensations (previously called simple partial seizures)
• Focal impaired awareness seizures — your awareness is affected and you may not remember the seizure afterwards (previously called complex partial seizures)
• Focal to bilateral tonic-clonic seizures — a focal seizure that spreads to involve both sides of the brain, causing convulsions

Generalised Seizures

Generalised seizures involve both sides of the brain from the start.

• Absence seizures — brief episodes of staring or blanking out, common in children
• Tonic-clonic seizures — the body stiffens (tonic phase) then jerks rhythmically (clonic phase), often with loss of consciousness
• Myoclonic seizures — sudden, brief muscle jerks, usually in the arms or upper body
• Atonic seizures — sudden loss of muscle tone causing a drop or fall
• Tonic seizures — the body suddenly stiffens without jerking

What Causes Epilepsy?

In about half of all cases, no specific cause can be identified. This is called idiopathic or unknown epilepsy. Known causes include:

• Genetic factors — epilepsy can run in families, and certain gene changes increase seizure risk
• Brain injury — from head trauma, stroke, infection (such as meningitis or encephalitis), or brain tumours
• Developmental conditions — including cerebral palsy and autism spectrum disorder
• Prenatal injury — brain damage before birth from infection, poor nutrition, or oxygen deprivation
• Vascular conditions — stroke is a leading cause of epilepsy in people over 60

How Is Epilepsy Diagnosed?

Diagnosing epilepsy involves a careful process that includes your medical history, a neurological examination, and diagnostic testing. At CURA Medical Specialists, our neurologists use several key investigations:

EEG (Electroencephalogram)

An EEG records the electrical activity of your brain and is the most important test for epilepsy diagnosis. We offer three types of EEG at our Drummoyne clinic:

1. Routine EEG — a 20 to 40 minute recording in our clinic, usually the first test performed
2. Ambulatory EEG — a portable 3-day recording you wear at home, ideal for capturing seizures that happen infrequently
3. Sleep-deprived EEG — performed after staying awake overnight, which increases the chance of detecting abnormal brain activity

Brain Imaging

Your neurologist may request an MRI scan of your brain to look for structural causes of seizures, such as scarring, tumours, or vascular malformations.

Blood Tests

Blood tests help rule out other conditions that can cause seizures, such as electrolyte imbalances, infections, or metabolic disorders.

Epilepsy Treatment Options

The goal of epilepsy treatment is to stop seizures with as few side effects as possible. Most people with epilepsy can achieve good seizure control with medication.

Anti-Seizure Medications

Anti-seizure medications (previously called anti-epileptic drugs or AEDs) are the first-line treatment. Your neurologist will choose a medication based on your seizure type, age, other medical conditions, and potential side effects. Common medications prescribed in Australia include:

• Sodium valproate (Epilim)
• Levetiracetam (Keppra)
• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)
• Topiramate (Topamax)

Many of these medications are subsidised under the Pharmaceutical Benefits Scheme (PBS). Your neurologist will discuss the most suitable option for you.

Important: If you are pregnant or planning pregnancy, talk to your neurologist before making any changes to your medication. Some anti-seizure medications carry risks during pregnancy and require careful management.

When Medication Does Not Work

About one in three people with epilepsy continue to have seizures despite medication. This is called drug-resistant or refractory epilepsy. Additional options may include:

• Combination medication therapy
• Referral to a comprehensive epilepsy centre for surgical assessment
• Vagus nerve stimulation (VNS)
• Dietary therapies such as the ketogenic diet

Epilepsy and Driving in Australia

Driving rules for people with epilepsy in Australia are set by the Austroads national guidelines, which are applied by each state and territory licensing authority. These rules exist to keep you and other road users safe.

Private Vehicle Licence

To hold a private vehicle licence, you generally must be seizure-free for a minimum period. The standard requirements are:

• Seizure-free for at least 12 months for an unconditional licence
• In some cases, a conditional licence may be granted after a shorter seizure-free period, subject to your neurologist’s assessment and regular review
• Any change in medication must be discussed with your neurologist, as dose changes can temporarily affect your driving eligibility

Commercial Vehicle Licence

Requirements for commercial vehicle licences (trucks, buses, taxis) are stricter:

• Generally requires a seizure-free period of at least 10 years
• Must be off all anti-seizure medication for at least 5 years
• Requires specialist neurological assessment and clearance

Your Responsibilities

• You are legally required to report your epilepsy to your state or territory licensing authority
• Your neurologist can provide a medical fitness to drive assessment and the required paperwork
• If you have a seizure, you must stop driving and notify your licensing authority
• Penalties apply for driving against medical advice or without reporting your condition

At CURA Medical Specialists, our neurologists regularly complete Austroads fitness to drive assessments and can guide you through the process.

Living with Epilepsy in Australia

Seizure First Aid

Knowing what to do when someone has a seizure is important. The Epilepsy Foundation recommends:

1. Stay calm and stay with the person
2. Time the seizure — call 000 if it lasts longer than 5 minutes
3. Protect them from injury — move hard or sharp objects away
4. Place them on their side (recovery position) once the jerking stops
5. Do not put anything in their mouth
6. Stay with them until they are fully recovered

Work and Employment

Most people with epilepsy can work in a wide range of jobs. Under Australian anti-discrimination law, employers cannot discriminate against you because of epilepsy. Some roles with safety requirements (such as operating heavy machinery or working at heights) may need a medical assessment.

Medicare and NDIS Support

Neurologist consultations and EEG testing at CURA Medical Specialists are eligible for Medicare rebates when you have a GP referral. If your epilepsy significantly affects your daily life, you may also be eligible for support through the National Disability Insurance Scheme (NDIS).

Mental Health

Depression and anxiety are more common in people with epilepsy. If you are struggling with your mood or emotional wellbeing, let your neurologist know. Treatment is available and can make a real difference.

When Should You See a Neurologist About Epilepsy?

You should see a neurologist if you:

• Have had a seizure for the first time
• Have recurring seizures or episodes of unexplained loss of awareness
• Are taking anti-seizure medication but still having seizures
• Want a review of your current epilepsy treatment
• Need a fitness to drive assessment
• Are planning pregnancy and take anti-seizure medication
• Have been told you have abnormal EEG results

Frequently Asked Questions About Epilepsy

Can epilepsy be cured?

Some people outgrow epilepsy, particularly if it starts in childhood. For others, medication can control seizures effectively, and in some cases medication can eventually be stopped under neurological supervision. Epilepsy surgery can be curative for certain types of focal epilepsy.

Is epilepsy hereditary?

Epilepsy can have a genetic component. If a close family member has epilepsy, your risk is slightly higher than the general population, but most people with a family history of epilepsy will not develop the condition.

Can you die from epilepsy?

Most seizures are not life-threatening. However, there is a rare condition called Sudden Unexpected Death in Epilepsy (SUDEP). The best way to reduce this risk is to take your medication as prescribed and maintain good seizure control. Talk to your neurologist about SUDEP if you have concerns.

How long do you have to be seizure-free to drive in Australia?

Under Austroads guidelines, you generally need to be seizure-free for at least 12 months for a private vehicle licence. Commercial vehicle requirements are stricter. Your neurologist can assess your individual situation and complete the required medical paperwork.

What should I do if I see someone having a seizure?

Stay calm, protect them from injury, time the seizure, and place them on their side once jerking stops. Do not restrain them or put anything in their mouth. Call 000 if the seizure lasts longer than 5 minutes or if it is their first seizure.

Does Medicare cover epilepsy treatment?

Yes. Neurologist consultations and EEG testing are eligible for Medicare rebates with a GP referral. Most anti-seizure medications are subsidised through the Pharmaceutical Benefits Scheme (PBS).

Book an Epilepsy Consultation at CURA Medical Specialists

Our specialist neurologists in Drummoyne, Sydney provide comprehensive epilepsy diagnosis, treatment, and ongoing management. We offer routine, ambulatory, and sleep-deprived EEG testing on site, and can complete Austroads fitness to drive assessments.

Ask your GP for a referral to CURA Medical Specialists, then book your appointment online through HealthEngine or call our clinic directly.