Last updated date: 12-May-2023
Originally Written in English
Epilepsy is a neurological condition whereby brain activity gets abnormal. This results in seizures or episodes of irregular behavior, feelings, and occasionally loss of awareness. Epilepsy can strike anyone at any time. Males and females of various races, ethnicities, and ages are all susceptible to epilepsy.
Most people with epilepsy can manage their seizures using medication or, in certain cases, surgery. Other people need to be treated for seizures for the rest of their lives, while others' seizures go away with time. Also, some children with epilepsy tend to outgrow the disease over time.
Signs and Symptoms of Epilepsy
Epilepsy signs occur due to unusual activity of the brain. As a result, seizures can disrupt any process that the brain manages. The following are some of the signs and symptoms of a seizure:
- Temporary perplexity
- A bout of staring
- Jerking motions of the arms and legs that are uncontrollable
- Consciousness or awareness loss
- Psychic symptoms, including fear, worry, or a sense of déjà vu
The symptoms tend to vary based on the type of epilepsy and seizure. A person who has epilepsy will, in most situations, experience the same sort of seizure every time. Therefore the symptoms will be consistent from episode to episode.
Doctors and neurologists can classify seizures into the following, depending on how the aberrant brain activity starts. They include;
- Focal or partial seizures
Focal (partial) seizures occur if the seizures emerge due to an aberrant activity in only one section of the brain. Such seizures can be divided into two groups, including;
Focal seizures without any consciousness loss: These seizures, also known as simple partial seizures, do not result in a loss of consciousness. Instead, they can affect emotions as well as the appearance, smell, feel, taste, and sound of things. Involuntary jerking of a part of the body like the arm or leg, as well as sudden sensory symptoms, including dizziness, tingling, or flashing lights, may occur.
Focal seizures accompanied by impaired consciousness: These seizures include an alteration or consciousness loss. You may look into space and fail to respond usually to the surroundings during a complex partial seizure. You may also do repeated activities like hand rubbing, swallowing, chewing, or moving in circles.
- Generalized seizures
Generalized seizures are seizures that appear to affect all parts of the brain. There are different forms of generalized seizures, including;
- Absence seizure
- Tonic seizures
- Atonic seizures
- Clonic seizures
- Myoclonic seizures
- Tonic-clonic seizures
Causes of Epilepsy
In nearly half of those who suffer from epilepsy disease, there is no known etiology. The condition in the other half can be attributed to a number of factors, including:
- Genetics: Certain forms of epilepsy classified according to the type of seizure or the portion of the brain affected are heritable. There may be a hereditary component in these occurrences.
- Conditions affecting the brain: Epilepsy can occur due to brain disorders that lead to brain damage, including brain tumors and strokes. Stroke is the most common cause of epilepsy among people over the age of 35.
- Trauma to the head: Epilepsy can be caused by head trauma from a vehicle accident or any other traumatic injury.
- Infectious illnesses: Epilepsy can be caused by infectious disorders like AIDS, meningitis, and viral encephalitis.
- Development problems: Epilepsy and developmental issues, including autism and neurofibromatosis, are sometimes linked.
- Prenatal injury: Babies are vulnerable to brain injury before birth. This can be caused by a variety of circumstances like the mother's infection, poor nutrition, and oxygen deficiency.
The neurologist will examine your symptoms as well as medical history during epilepsy diagnosis. To diagnose epilepsy and identify the source of seizures, he or she may conduct various tests as well. These diagnostic tests can include;
- A neurological examination: To diagnose the disease and identify the type of epilepsy you have, the doctor may evaluate your behavior, mental function, motor ability, among others.
- Blood tests: The physician may order a blood sample to look for infections signs, genetic disorders, or other illnesses which might be linked to seizures.
Apart from these, the neurologist may also recommend other tests and procedures to diagnose brain abnormalities:
- Electroencephalogram (EEG): ECG is typically the most common test for an epilepsy diagnosis. During the test, the physician will attach electrodes to the scalp using a cap or paste-like material. The electrodes will then take a record of the brain’s electric activity.
- EEG with a high density: Your doctor may suggest a high-density EEG exam. It involves placing electrodes closer together than traditional EEG, roughly half a centimeter distant. A high-density EEG could enable your doctor to pinpoint the parts of the brain the seizures affect.
- Magnetic resonance imaging (MRI): This imaging test creates a precise image of the brain using strong magnets and radio waves. The physician might diagnose brain lesions or other possible abnormalities that are causing seizures.
- A computerized tomography (CT) scan: This type of imaging employs x-rays to create cross-sectional pictures of the brain. A CT scan can detect brain abnormalities like tumors, hemorrhages, or cysts that could be causing the seizures.
- Positron emission tomography (PET): Neurologists can use this test to check the active parts of the brain and identify abnormalities. This is done by injecting a small quantity of lower-dose radioactive substance into a vein.
- Single-photon emission computerized tomography (SPECT): This test is utilized mostly if an MRI and EEG fail to determine the area in the brain where the seizures are coming from.
Epilepsy is a condition that the majority of people can effectively manage. The intensity of your symptoms, your overall health, or how well you react to treatment will factor into your treatment strategy.
The following are some of the epilepsy treatment options;
Anti-seizure drugs are usually the first-line treatment for epilepsy conditions. These medications aid in the reduction of seizure severity and frequency. However, they cannot halt a progressing seizure, and they can't heal epilepsy.
The stomach plays the role of absorbing the drug. After that, it gets to the brain via the bloodstream. From there, it works by reducing the electrical activity that causes seizures by altering the neurotransmitters. Lastly, the anti-seizure drugs pass through the gastrointestinal tract and exit the body via the urine.
There are numerous anti-seizure medications available. According to the type of seizure you experience, the doctor may recommend a single medicine or a combination of certain drugs.
The most common epilepsy medicines are;
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
- Levetiracetam (Keppra)
- Topiramate (Topamax)
- Valproic acid (Depakote)
If the use of medication fails to reduce the number of seizures, epilepsy surgery might be a better option. Resection is the most common surgical procedure, which entails eliminating the portion of the brain that causes seizures.
Temporal lobectomy is the most common technique for removing the temporal lobe. This can, in some situations, put an end to seizure activity.
You may remain awake in some situations during the procedure. This is to allow the medical providers to speak with you and avoid the removal of a section of your brain regulating critical processes, including vision, speech, hearing, and motion.
If the affected part of the brain is excessively large or vital to remove, the neurologist can recommend multiple subpial transection or disconnection. To break off the neural pathway, the surgeon can create incisions in the brain. As a result of this, seizures won’t spread to other parts of the brain. Some individuals are able to reduce or even stop taking antiseizure drugs after surgery.
Any surgical procedure carries risks, such as a severe anesthetic reaction, infection, and bleeding. When the brain is operated on, it is not uncommon for cognitive alterations to occur. So before making a final decision, discuss the benefits and drawbacks of the various procedures with the surgeon. Also, get a second opinion if necessary.
Apart from using drugs and surgical procedures, the doctor can recommend the following therapies to treat epilepsy;
- A vagus nerve stimulator: This is a piece of equipment that is surgically implanted beneath the skin of the chest to trigger the nerve running through the neck electrically. This may aid in the prevention of seizures.
- Ketogenic diet: This high-fat, low-carbohydrate diet helps more than half of those who fail to react to epilepsy medicine.
- Deep brain stimulation: This involves the implantation of electrodes into a certain area of the brain, usually the thalamus. Next, the electrodes are attached to a generator that is implanted in the chest or skull. They emit electrical pulses to the brain, hence reducing seizures.
Epilepsy is a common brain disorder that causes regular seizures. Seizures are brief bursts of electric activity within the brain that disrupt its normal functioning. They can manifest themselves in a variety of ways.
Furthermore, epilepsy can strike at any age, although it most commonly affects children or persons over the age of 60. It's usually permanent, but it can improve gradually with time. Medications, surgery, and other therapies can effectively help manage epilepsy.