What is Epilepsy?

Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.

The seizures in epilepsy may be related to a brain injury or a family tendency, but often the cause is completely unknown. The word "epilepsy" does not indicate anything about the cause of the person's seizures or their severity.

Epilepsy is the fourth most common neurological disorder and affects people of all ages.

What Are Seizures and Epilepsy?

Epilepsy is a medical condition where a person has recurring unprovoked behaviour or convulsive movements of either a part or whole of the body without their voluntary control on the activity

Nerve cells communicate with each other through electrical impulses. During a seizure, these impulses become overactive or occur at the same time, which leads to irregular brain activity. This can cause changes in behaviour and body functioning.

Having a single seizure does not mean that a person has epilepsy. Many people have a single isolated seizure and don’t go on to develop epilepsy.

Seizures are short episodes when a person does not function normally because of abnormal electrical discharges in the brain.

What Causes Epilepsy?

Epilepsy do not have a single cause. In fact, in many people with epilepsy, no cause is ever found.

Some known causes include:
  • Developmental abnormalities in the brain
  • Infections like cysticercosis ( intestinal tape worm ), tuberculosis, meningitis and encephalitis ( brain fever) and abscesses ( pus formation ) which leave a scar in the brain
  • Lack of adequate supply of oxygen to the brain like after birth, cardiac arrest, asphyxiation (drowning in water ) and other situations
  • Disturbance in adequate blood circulation to the brain (Stroke and other vascular problems)
  • Tumors of the brain
  • Injuries to brain
  • Genetic and metabolic Causes

How to recognise epilepsy or seizure ?

The most visible sign of epilepsy is a seizure. Seizures usually last from seconds to several minutes. There are many types of seizures. Some are severe. Some are subtle. People having a seizure might not be able to respond to others. They may not remember the seizure. Sometimes a seizure will be widespread, causing symptoms throughout the body.

Some of the symptoms and behaviours that can occur during a seizure include:
  • Convulsions (uncontrollable muscle stiffening and shaking)
  • Brief staring spells
  • Repetitive, automatic behaviour, such as chewing movements
  • Decreased awareness of what is going on.

Whom to consult?

Neurologists are medical doctors who specialize in disorders of the brain and nerves. They are the specialists who most often diagnose and treat people with epilepsy.

What should I do when I see a person with ongoing seizure activity?

  • Do not panick
  • realise this is a transient disturbance which will subside on its own
  • try to keep a rolled hand kercheif in the mouth of the victim between tongue and teeth so that he doesn’t bite the tongue.
  • allow adequate ventilation around the victim
  • unbutton shirts and trousers
  • remove sharp objects away from the scene as he may injure himself
  • do not give any iron objects to the victim’s hands as they may injure themselves.
  • take him to the doctor
  • if possible record a video of the event as it will help your doctor to identify the type of epilepsy the victim has .

How Is Epilepsy Diagnosed?

Neurologist diagnoses epilepsy , classifies the type of epilepsy that an individual has.
  • usually epilepsy is confirmed with
  • the detailed history of events that preceded or followed and that happened during the episode both from the patient as well as form others who were around
  • a detailed family history
  • thorough clinical examination
  • Electroencephalography (EEG), which records brain wave patterns
  • Magnetic resonance imaging (MRI) of the brain
  • Blood tests

What Are the Treatment Options?

The most common treatment to prevent seizures is the daily use of medications. Nearly 70 percent of people with epilepsy can have good control of their seizures using medications. Most people whose seizures are controlled with drugs have few restrictions on their activities. Many medications are available. Some of them work better for one type of epilepsy than another. Talk to your neurologist about the choice of medication, how often it is taken, and any side effects. Side effects may vary from one drug to another and from one person to another. Your neurologist will make sure that the prescribed drug is the best medication for you. In some cases medication does not work. Then surgery or vagus nerve stimulation may be an option. In vagus nerve stimulation, a device similar to a pacemaker is implanted under the skin on the chest. It reduces seizures by delivering electrical signals to the brain via the vagus nerve in the neck.

Epilepsy surgery usually involves identifying and removing the seizure focus. It can be very effective and even curative for some people, even when medications have failed. It is not a “last resort.” Talk with your neurologist about the best treatment for your seizures.

Living with Epilepsy

Epilepsy is different for everyone. Some people have seizures that are easily controlled; their epilepsy doesn’t have much effect on their daily lives. Others may find that their seizures will have a bigger impact on their lives; they may affect the way they work, socialize, or complete daily activities.

To help control your seizures:
  • Take your medication as prescribed
  • Maintain regular sleep patterns
  • Avoid excessive alcohol use or use of illegal drugs
  • Work to reduce and manage stress
  • Talk to your neurologist about any changes in symptoms or new symptoms
  • Exercise to maintain your overall health

Driving and Safety

In many states, laws require people to report any medical condition that may affect their ability to maintain control of a vehicle. In some states, physicians must report people with such conditions. Sometimes, a physician’s approval is needed to be able to drive again. Talk to your neurologist about this issue and your overall safety. People with epilepsy also need to avoid sports or activities that could be hazardous if they were to lose consciousness or become unable to control their movements. Working at a height should also be avoided, along with swimming or bathing alone.

Women and Epilepsy

Women with epilepsy should talk to their neurologist before becoming pregnant. Most pregnancies in women with epilepsy have a happy outcome and a healthy baby. But both seizures and the drugs that treat seizures can be harmful to the developing baby. Women need to be under close medical care to make sure the epilepsy is under the best control possible.