Even before her first grand mal seizure that day in August 2002, Kerstin Highlands knew something was wrong.

The muscle spasms she'd been having for months in her arm had reappeared and become more intense, but that didn't dissuade Ms. Highlands, who was 14 at the time, from going to the mall with friends.

"I didn't know what to do about my arm, so I just went," said Ms. Highlands, now 20 and a junior at Westmoreland County Community College. "Luckily, when I fell backward, there just happened to be a critical care nurse behind me and she caught my head with her ankle."

Ms. Highlands, of Hempfield, was diagnosed with epilepsy soon after, and her doctor told her that the spasms in her arm had been a form of seizure called a myoclonic seizure.

With this new knowledge, her family concluded that she also had been having mild seizures called absence seizures -- characterized by staring spells and memory loss -- since middle school.

Since she started taking medication in 2003, Ms. Highlands has had no more seizures. In November, she won the Expressions of Courage art contest sponsored by Ortho-McNeil Neurologics, a pharmaceutical company.

Her drawing, titled "Falling Flowers of Courage," was chosen from hundreds of other submissions created by artists who have epilepsy.

Peggy Beem, associate director of the Epilepsy Foundation of Western/Central Pennsylvania, said that like Ms. Highlands, many of those with the condition are not diagnosed until they experience a major seizure.

"It's a common story," she said. "Epilepsy varies widely in the way it's expressed and isn't well understood by most people, so even doctors may miss the symptoms at first."

Although her organization is called the Epilepsy Foundation, Ms. Beem stressed that the group offers support and services for anyone in Western and Central Pennsylvania who has a seizure disorder. That's a more general term that is used interchangeably with the term epilepsy.

The Epilepsy Foundation offers educational programs for the public as well as for those with epilepsy and their families, and it helps advocate for those who have experienced discrimination because of their condition. The Western/Central branch also offers a nationally recognized summer camp for kids with epilepsy called Camp Frog.

Epilepsy is more common than many people realize, Ms. Beem said. A neurological condition in which the brain suffers from bursts of electrical activity, epilepsy is estimated to affect 1 percent to 3 percent of Americans, or about 200,000 people in Pennsylvania.

Although epilepsy is perceived as a condition of the young, Ms. Beem said almost half of the people she sees with seizure disorders are 65 or older and many returning veterans also suffer from the disorders because of head injuries received in battle.

Like Ms. Highlands, many individuals with epilepsy can control their seizures with the help of medication, but Ms. Beem noted that about half cannot find a drug that works for them and so they may have a seizure at any time.

"Epilepsy has been around for thousands of years, but we still need more funding for research," she said. "We're hoping for a cure some day."

With help from her doctors and education from the Epilepsy Foundation, Ms. Highlands has learned that moderating her lifestyle is just as important as her medication in controlling her symptoms.

"For some people, their trigger is alcohol or bright lights, but for me it's more stress and lack of sleep," she said. "I've noticed that during tests in school, when I've been tired and stressed out, my arm will start to jerk."

Since she lives at home, her parents, Karen and Earl Highlands, can remind her to get her eight hours' rest and take time to relax. But Ms. Highlands hopes to live on her own after graduating with a degree in Web design. She knows that will require her to be even more responsible, she said.

"Sometimes it's tough. I want to go out with my friends, but I have to know when to say when," she said. "I always need to think before I act."

Learning that she had epilepsy as a teenager was scary, she said, but she considers herself lucky. Not only has she found a medication she can tolerate that controls her seizures, she has a condition that can be treated.

"There are so many people who have it worse. I could have had something fatal," she said. "It was good just to get a diagnosis and learn what epilepsy is."

Ms. Beem said that people's perception of epilepsy as mysterious or debilitating can be dispelled through education and awareness.

"You may not know it, but you already know people with epilepsy. Your neighbor, friend or co-worker," she said.

"It's their living a successful and independent life that has made their condition invisible."