Overview
Epilepsy is a disorder of central nervous system and is characterized by abnormal brain activity causing seizures. In some cases, it may cause episodes of unusual behavior, or loss of awareness of surroundings. It can occur to any one at any point of time and at any age. Male or female, children, adult and old are equally affected by epilepsy.
Risk factors of epilepsy
There are some factors that can increase the chances of a person to suffer from epilepsy. These include:
- Family history of epilepsy
- Head injuries
- Brain damage due to stroke and other blood vessel diseases
- Dementia increases epilepsy risk in older adults
- Brain infections such as meningitis.
Causes of epilepsy
n more than half of the cases of epilepsy, its cause is not known. The left ones can have seizures due to following factors:
- Family history of seizures
- Injury to brain
- Brain conditions like brain tumors or strokes
- Infectious diseases like meningitis, viral encephalitis, AIDS etc.
- Injury to baby before or during birth
Developmental disorders like neurofibromatosis, autism etc.
Symptoms of epilepsy
The symptoms of epilepsy vary widely as some people may just stare blankly without any activity during epilepsy attack while others may twitch limbs for few seconds or minutes. So, in general, an epilepsy attack causes following symptoms in the patient:
- Uncontrolled twitching or jerking of the arms and legs (seizure)
- Temporary episode of extreme confusion
- A simple spell of blank staring by the person
- Loss of consciousness or awareness of the surrounding
- Sometimes fear, extreme sweating and anxiety.
This is what patient complains of, but doctors classify the symptoms of seizures into following types:
- Radiation Therapy: It is performed by two different methods called Internal Radiation Therapy, where the radiation seeds are placed surgically inside body and they target the tumor and helps in breakdown and External Radiation Therapy, where the high-energy radiation beams are focused on the targeted tumor from outside the body by a machine which is responsible for its breakdown.
- Chemotherapy:It is responsible for a tumor cell to shrink and helps in destroying completely. Chemotherapy is performed during radiation therapy which results in dead tumor cells. Chemotherapy is often used on malignant tumors and is not performed on benign tumors.
- Laser Interstitial Thermal Therapy: It is a minimally invasive treatment where heat is transmitted from inside out through a burr hole made in the skull.
Focal seizures
These are the seizures that occur due to abnormal activity in specific area of brain and are of following categories:
- Focal seizures without unconsciousness:This type of focal seizure is responsible for jerking of body parts, altered emotions, change in perception of smell, look, taste, feel and sound. They don’t cause a loss of consciousness but are generally associated with dizziness, episode of flashing lights and tingling sensations in body.
- Focal seizures with impaired consciousness:This type of focal seizure is responsible for loss of awareness or consciousness with no response to surrounding activities. In some cases, person just keeps on staring into space blankly or perform one activity repetitively like rubbing of hands, swallowing or walking in circles.
As these symptoms occur in other disorders too, these may be confused with some neurological disorders, like mental illness, depression or migraine.
Generalized seizures
Other than focal seizures, there are seizures that may involve whole of the brain. These are called generalized seizures and are of following types:
- Absence seizures: These mostly occur in children with a brief loss of awareness or child just staring into the space with or without some body movement like blinking eye or smacking lip smacking.
- Tonic seizures: These seizures usually cause stiffening of arm, leg or back muscles resulting in falling of the person on the ground.
- Atonic seizures: These seizures cause loss of muscle control, resulting in collapse or fall.
- Clonic seizures: These seizures are characterized by repeated jerking movements and usually face, neck and arms.
- Myoclonic seizures: These are sudden jerks for a brief period.
- Tonic-clonic seizures:These seizures cause stiffening and shaking of body, biting of tongue and sometimes loss of consciousness and/or loss of bladder control.
Emergency symptoms of epilepsy
Immediate medical intervention is required if you or any of your known experiences following:
- Seizure for more than five minutes
- Breathing difficulty
- Consciousness not returning even after the seizure stopped.
- Immediate second seizure occurs.
- High fever.
- Injury during the seizure.
Diagnosis of epilepsy
Getting just one seizure is not a diagnosis of epilepsy as at least two episodes of unprovoked seizures are required to consider an epilepsy diagnosis. Further there are various tests that are required to confirm epilepsy diagnosis, like:
- A neurological exam to test the behavior of the patient, his motor abilities, mental function etc.
- Blood test to find out any signs of infections, brain disorders or genetic conditions etc.
- Electroencephalogram (EEG) to record the electrical activity of the brain.
- High-density EEG to precisely determine affected areas of brain.
- CT scan brain to find out abnormalities in brain like cysts, tumor, bleeding etc. that might be causing seizures.
- MRI to detect lesions or abnormalities in brain that might be causing seizures.
- PET scan to visualize active areas of the brain and detect abnormalities.
Treatment of epilepsy
It is very important to find out the cause and type of seizure for effective treatment. Once the this is confirmed, doctor starts treatment with anti-epileptic medication. The medication is generally stopped after uneventful two or more years depending upon patient condition and recovery. Patient is advised to regularly follow up with the doctor to keep a check on the condition and medications.
In some rare cases, medications fail to provide relief to the patient. In such cases, surgery is indicated to remove the part of the brain that is causing the seizures.
- A neurological exam to test the behavior of the patient, his motor abilities, mental function etc.
- Blood test to find out any signs of infections, brain disorders or genetic conditions etc.
- Electroencephalogram (EEG) to record the electrical activity of the brain.
- High-density EEG to precisely determine affected areas of brain.
- CT scan brain to find out abnormalities in brain like cysts, tumor, bleeding etc. that might be causing seizures.
- MRI to detect lesions or abnormalities in brain that might be causing seizures.
- PET scan to visualize active areas of the brain and detect abnormalities.
Surgery is indicated in following situations:
Along with the results of these tests, doctor also uses a combination of analysis techniques like Statistical parametric mapping (SPM), Curry analysis, Magnetoencephalography (MEG) etc. to pinpoint the starting point of seizures in brain.
- If seizures originate from a small and well-defined area of the brain
- The area has no role in important functions like language, speech, movement, hearing etc.
Surgery is indicated in following situations:
- Vagus nerve stimulation: This involves implantation of a device called vagus nerve stimulator beneath the chest skin with its wires connected to the vagus nerve in the neck. This device is powered by battery and works by sending electrical energy to the brain through the vagus nerve. Although it’s not clear how device stops the seizures, but it is found to reduce seizures by 20 to 40 percent.
- Deep brain stimulation: This involves implantation of electrodes into thalamus part of the brain. A generator is implanted into the chest or skull and wires of electrodes are connected to it. It works by sending electrical impulses to the brain to reduce seizures.
Post-epilepsy care
Uncontrolled epilepsy can cause widespread and long-lasting problems including depression, anxiety etc. that require constant care and support:
- Psychological support: Depression and anxiety of about epilepsy uncertainty may disturb the patient a lot. So psychological support is very important to boost the morale of the patient and increase his faith in medicine
- Education: It is important for the patient to educate himself as well as his friends and family about epilepsy for better management of emergency.
- Independence: Don’t let epilepsy uncertainty take up your choices. Just live freely and do not let stress or anxiety bother you. These may also help in reducing seizure frequency.
- Physiotherapy: Physiotherapy is required to improve the muscle strength and overcome any walking or movement disabilities if caused.
What to do if you find someone having epilepsy seizure?
Epilepsy seizure are uncontrolled activities that cannot be controlled or stopped and usually stop on their own. During the seizure stay calm, don’t try to restrain the patient and make sure there is no object near to the patient that can harm him. Also get aside and let the space be free for air circulation. Apart from these follow the following recommendations:
- Observe the person so that you can give details to doctor later about the kind and duration of seizure
- Loosen tight clothes, especially neckwear
- Place something soft under the head of the patient
- Roll the patient carefully towards one side
Why NICE ?
- We are associated with the best hospitals globally having the emergency infrastructure, fully equipped with the latest technologies and techniques to overcome from every emergency condition.
- Our team of doctors are highly experienced in ‘Emergency Patient Management’ and work together to save the patient.
- Consultation from doctors through e-mail, phone, and video calling.
- Rehabilitation programs are organized to assist complex surgery patients.
- Complete support and assistance being given before and after treatment.
- Cost of treatment is quite less as compared to other service providers.
- We are always ready to offer our helping hand and our services are available 24/7.
