Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent seizures. A seizure occurs due to a transient abnormal electrical activity in the brain leading to convulsions or loss of consciousness, lack of awareness, abnormal sensation or behavior etc. Seizures usually last for a few seconds, or a minute or two. Patient may have headcahe or vomiting followed by sleep.

Majority of people have only one type of seizure, however few have more than one type of seizure.

The common types of Seizures are:

• Generalized Tonic-Clonic Seizure– where the person has loss of consciousness, up rolling of eyes with generalized stiffening of the body followed by clonic movements of the limbs, frothing from the mouth, tongue bite, laboured respiration lasting few seconds to minutes followed by deep sleep like state occasionally there maybe passage of stool or urine.
• Partial onset seizures– where abnormal sensation or movement starts from one part of the body tending to spread to other side with preservation of consciousness initially
• Myoclonic Jerks– Patient may have sudden jerking of one of the limbs, only upper limbs or even the whole body. Commonly such jerks may occur on awakening from sleep
• Absence Seizures– Usually occurs in children. The child is unresponsive for a few seconds only, just staring. There maybe repetitive fluttering of the eyes occasionally. Later the child resumes his/her activity as if nothing has happened.

At times the patient may have a number of seizures without regaining consciousness then in that case it is a medical emergency, for if the seizures are not controlled then it can lead to brain damage and other complications

There are around 10-12 million Indians with epilepsy and around two third do not receive proper treatment. Epilepsy can begin at any age but occurs more often in children and the elderly. The common causes are brain infections, neurocysticercosis, head injuries, stroke, dementia, tumor, hereditary, etc. But in more than 50% of cases of epilepsy, the cause cannot be identified.

How to diagnose Epilepsy:

Having an eyewitness account of the seizure phenomena makes the diagnosis of epilepsy. The investigation that facilitates the diagnosis of epilepsy is an ECG, MRI of the brain helps you to know the cause of epilepsy. It is advisable to video the seizure since everybody has a mobile with them, to show the seizure phenomena.

Treatment

Around 70 to 75 percent of patients of epilepsy can be controlled with the antiepileptic drugs. In more than 50 percent the antiepileptic drug can be gradually tapered off. However there is no cure for epilepsy but only control. There are several drugs for seizure control, that are relatively safe.

Around 25 to 30 percent may have poor control of seizures, they may benefit from:

• Surgical removal of the portion of the brain responsible for seizures
• Vagus nerve stimulation
• Ketogenic diet

Along with regular intake of medication one has to lead a disciplined life with adequate sleep

If there is any other associated illness then other medication can be taken alongside with the antiepileptic medication.

What to do if one has a Seizure:

• Turn the person on the side in a safe place to prevent any fall
• Loosen the clothes, do not restrain the body movements.
• Do not force anything in the mouth like spoon, finger etc
• Do not make the person drink anything immediately
• If the patient regains consciousness let the patient lie comfortably in the bed
• If the person does not regain consciousness then he/she should be taken to the hospital for further treatment

Epilepsy is a treatable disorder of the brain. It is not a infectious disease. There are large number of antiepileptic drugs. Early treatment results in good outcome. Patients with epilepsy should not drive, climb heights or swim. They can be fully educated, gainfully employed and lead a normal life.