American Academy of Neurology Response to Prince's Struggle With Epilepsy: Q & A with Daniel B. Hoch, PhD, MD

Prince reveals his struggle with epilepsy on the Tavis Smiley show: singer says he developed flashy persona to compensate for illness. The American Academy of Neurology's Daniel B. Hoch, PhD, MD, presents some questions and answers to help our readers understand more about epilepsy.

1) What is epilepsy, what is a seizure, and how are seizures different from epilepsy?

Epilepsy is the name given to a condition in which seizures can occur on their own without a clear trigger. Seizures that are not spontaneous usually take place only when the immediate cause is present, such as a poison, illness, or problem with metabolism. A seizure is a symptom of abnormal function of the brain cells in which the normal activity of neighboring cells becomes synchronized repeatedly, probably due to the effects of the electrical and chemical signals that allow the cells to "talk" with each other.

The symptoms of a seizure can be very different from person to person, or even seizure to seizure. Some people lose consciousness and fall down with movements of the entire body. Once called "grand mal", most doctors now call these "generalized seizures" since large parts of the brain are affected by the seizure activity.

Some seizures are more subtle, however, and produce only some involuntary movement of a limb, tingling, confusion or repetitive behavior. Consciousness and memory are not always impaired. There can be an "aura" that warns the person that a seizure is starting. These subjective experiences can be a funny feeling, emotion, memory, or even a hallucination. Almost any kind of mental experience is possible depending on where in the brain the seizure starts.

2) What does Prince mean that he was born epileptic?

Some people are born with epilepsy. This low threshold to have seizures can be due to an inherited condition or due to abnormal development of the nervous system. Also, some kinds of injury to the fetus during development or to the infant at birth can also predispose someone to seizures. In that case someone could be described as being born with epilepsy.

3) Prince says he had epilepsy as a child. Does it go away?

Some types of epilepsy seem to cause seizures only during the first 20 years or so of life. Those seizures can start at almost any time in childhood, but tend to stop occurring in the late teenage years or early 20's. The seizures may stop happening because of changes in the chemistry and electrical connectivity of the brain as it ages.

4) Prince says his parents didn't know how to handle it. How should they have handled it?

Epilepsy is a very complicated illness that can interfere with life in a number of ways. Since the seizures only happen intermittently and unpredictably, they are very disruptive. The behavior that happens with a seizure can be varied and unusual, making it hard for those who observe them to know how to respond or what to do. For patients and their families, the disorder can be difficult to accept, and seek help. Even when a doctor or nurse is involved, the seizures may not always stop with treatment—especially the first one that is tried—and a specialist may be needed.

If parents think that their child is having seizures, or if teachers have witnessed unexplainable symptoms, especially changes in awareness or memory, they should get medical advice. It may or may not be necessary to see a neurologist. If the symptoms continue in spite of medication or other interventions, then a neurologist is almost certainly needed for advice. In addition, in some communities there may be support groups and other services that can help patients and their families deal with the impact seizures may have on school, and on quality of life in general. Education of teachers and even family and friends can be helpful.

5) Prince says he was teased as a child, and he was splashy and noisy as a kid in order to cope. Are people with epilepsy different in some way?

People with epilepsy are often completely normal between their seizures. This makes it very difficult for the individual and their friends to understand the seizures and the illness. In response, as with any disability, a person may experiment with various ways of covering up the epilepsy. Having a chronic illness, especially one that has been so misunderstood over thousands of years, is very difficult, and individual coping mechanisms are needed. While a large number of famous people throughout history are said to have had epilepsy, there is little proof of it in most cases (you can learn more about this at Epilepsy.com). However, many incredible and talented people have almost certainly had epilepsy and were successful in spite of it, actor Danny Glover, and former California Representative and author of the Americans with Disabilities Act, Tony Coelho. Likewise, Prince's extraordinary talent and artistic contributions further exemplify that this illness does not need to limit someone's life.