Epilepsy

Until recent years and even till now, epilepsy has been considered the work of supernatural forces beyond human understanding or control.

With the characteristic uncontrollable shaking of hands and legs, many people believe that epilepsy was a punishment of some wrong-doing and look on to such fits with pity. However, medicine has proven shown epilepsy to be a treatable and manageable disease.

Epilepsy is a neurological disorder affecting the central nervous system which causes the sufferer to experience seizures that vary from person to person.

Seizures occur when there are abnormal levels of electrical stimuli in the brain which causes imbalance in the motor, sensory and mental functions.

Epilepsy occurs both in the old and young and in males and females across all races, although it is slightly higher in men than in women.

Epilepsy is diagnosed in a person when unprovoked seizures occur more than twice that were not caused by easily reversible conditions such as head trauma, alcohol withdrawal, low blood sugar, sleep deprivation, and high fever.

Seizures may vary from person to person. Some people with epilepsy may simply stare into space for a few seconds during a seizure, while others repeatedly jerk their arms or legs.

Having a single seizure does not exactly mean you have epilepsy.

Types & Symptoms of Epilepsy

The two major types of seizures are

Generalized seizure

This involves all areas of the brain. Generalized seizures are sometimes referred to as grand mal seizures. Types of generalized seizures include

  • Absent seizures which causes a blank stare. This type of seizure can also cause repetitive movements like lip smacking, finger tapping or blinking. There’s also usually a short loss of awareness.
  • Tonic seizures which cause muscle stiffness.
  • Atonic seizures  which can lead to loss of muscle control and can make you fall down suddenly.
  • Repeated, jerky muscle movements of the face, neck, and arms are charateristics of clonic seizures
  • Myoclonic seizures causes random and quick twitching of the arms and legs.
  • Tonic-clonic seizures also known as  “grand mal seizures.” Symptoms include: stiffening of the body shaking, loss of bladder or bowel control, biting of the tongue, loss of consciousness

Following a seizure, you may not remember having one, or you might feel slightly

To the casual observer, the person experiencing such a seizure may cry out or make some noise, stiffen for some seconds, then have jerky movements of the arms and legs.

Often the rhythmic movements slow before stopping with eyes are usually open. The person may not appear to be breathing but is often breathing deeply after an episode.

The return to consciousness is gradual and usually occurs within a few moments. People are often briefly confused after an episode of a generalized seizure.

Partial or focal seizures

Only an area of the brain is involved, so only part of the body is affected. Depending on the area of the brain having abnormal electrical activity, symptoms may vary.

  • If the part of the brain that controls the movement of the hand is involved, for example, then perhaps only the hand may show rhythmic movements or jerking.
  • If other areas of the brain are involved, symptoms may include strange behaviours or small repetitive movements such as picking at clothes or lip smacking.
  • Sometimes a person with partial seizure appears dazed or confused. This may represent a partial complex seizure.  During a partial complex seizure, the person may stare into space and not respond normally to their environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.

Possible Causes and Risk Factors of Epilepsy

  • Premature birth or low birth weight
  • Birth trauma such as lack of oxygen
  • Abnormal brain structures at birth
  • Bleeding into the brain
  • Oxygen deprivation or serious brain injury
  • Tumor in the brain
  • Brain infections such as meningitis
  • Stroke resulting from blockage of arteries
  • Cerebral palsy
  • Alcohol withdrawal
  • Abuse of drugs and chemicals such as paint thinner
  • Mental disabilities
  • Family history of epilepsy or fever-related seizures
  • Age
  • Dementia

Diagnoses

If suspect you have a seizure, it is best you seek the doctor’s attention immediately. Symptoms of seizures can have severe consequences.

Your medical history and symptoms will help your doctor decide which tests will be helpful. You will probably have a neurological examination to test your motor and mental functioning.

In order to diagnose epilepsy, other conditions that cause seizures should be ruled out. Your doctor will probably order a complete blood count and chemistry of the blood.

Blood tests may be used to look for:

Electroencephalogram (EEC) is a common test used in diagnosing epilepsy. First, electrodes are attached to your scalp with a paste.

It’s a noninvasive, painless test. You may be asked to perform a specific task. In some cases, the test is performed during sleep.

The electrodes will record the electrical activity of your brain. Whether you’re having a seizure or not, changes in normal brain wave patterns are common in epilepsy.

Other tests that can be carried out include:

  • Magnetic Resonance Imaging (MRI)
  • Inpatient Video-EEG monitoring in Adult
  • Pediatric Epilepsy monitoring Units (EMU)
  • Positron emission tomography (PET)
  • Single-photon emission computed tomography (SPECT)
  • Intracarotid amobarbital/methohexital (Wada test)
  • Stereoelectroencephalograph

It is important that the type of epilepsy and the type of seizures both are diagnosed properly.

Treatment

Treatments include:

  • Medicines called anti-epileptic drugs – these are the main treatment
  • Surgery to remove the part of the brain that’s causing the seizures
  • A procedure to put a small electrical device inside the body that can help control seizures
  • A special diet (ketogenic diet) that helps in controlling seizures

Living with Epilepsy

Epilepsy is a lifelong disease therefore there would be lifestyle changes when someone is diagnosed with the disease.

Care of an epileptic at home varies with the frequency and type of seizures. It is important to take anti-convulsant medication regularly to prevent seizures.

When a seizure occurs, an observer can take the following  precautions to avoid injuries:

  • Cushion the person’s head.
  • Remove any tight neckwear.
  • Turn the person on his or her side.
  • Do not hold the person down or restrain the person.
  • Do not place anything in the mouth or try to pry their teeth apart. The person is not in danger of swallowing his or her tongue.
  • Take the individual to the hospital after the seizure has passed