What is epilepsy?Epilepsy is a fairly common neurological disorder, especially prevalent in the developing countries. In this disease, the transmissions of the electrical signals of the brain are disrupted and this leads to episodes of symptoms known as seizure. Although it is assumed that epilepsy would cause episodes of uncontrolled, involuntary movements or unconsciousness, the symptoms widely vary among the patients.
The seizures are actually signs of abnormal or excessive neuronal activity in the brain. The seizures cause subtle, yet quite visible sensations, emotions and behavior. While some people may stare blankly for some time others may have full fledges convulsions.
Symptoms
Since the cause of epilepsy is abnormal functioning of the brain cells, the symptoms may include any behavior that has a relation with the brain. The common symptoms may include a staring spell, temporary confusion, complete loss of consciousness or uncontrollable jerking movements of the arms and legs.
According to the generation of the seizures, doctors classify these into two types. The one that originates in one part of the brain are called partial seizures. Others which are produced due to abnormal functioning of the whole brain are termed as generalized seizures.
Major Types and Symptoms of Partial Seizures
Simple partial seizures: These seizures can alter the way things look, taste, smell, feel or sound. Usually, simple partial seizure doesn’t include the loss of consciousness.
Complex partial seizures: Complex partial seizure is related to loss of consciousness. Due to this, the patient loses awareness for some time. This type of seizures results in staring and non-purposeful movements.
Major Types and Symptoms of Generalized Seizures
Absence seizures: Absence seizures include staring, subtle body movement and brief lapses of awareness.
Tonic-clonic seizures: This is the most intense of all types of seizures. Tonic-clonic seizures are characterized by loss of consciousness and body stiffening and shaking. These may also include tongue biting or loss of bladder control.
Myoclonic seizures: Sudden jerks of arms and legs are the main results of this type.
Atonic seizures: The results of this type of seizures include sudden collapse or fall down. Atonic seizures are also known as drop attacks.
Causes
In most of the cases of epilepsy, the exact reason behind the disease remains unknown. However, there are some factors which may contribute to the onset of the disease. It is believed that lower oxygen supply to the baby during birth may be reason of epilepsy. Some genetic factors which results in injury to the brain such as tuberous sclerosis can also trigger epilepsy attacks. Head injuries during childbirth or from accidents during youth may also lead to epilepsy. A fairly common reason behind epilepsy is brain tumors. It has been observed that tumors can contribute to abnormal functioning of the associated brain cells, leading to seizures. Diseases that infect the brain, such as meningitis or encephalitis may also lead to epilepsy. Strokes and other diseases that may hurt the brain can also lead to epilepsy. Increased or abnormal quantities of substances such as sodium and blood sugar may also lead to epilepsy.
Types
Epilepsy can be broadly divided into idiopathic and symptomatic types. While idiopathic epilepsy has a genetic factor, the causes for symptomatic epilepsy are unknown. Depending upon the types of seizures, epilepsy can be divided into four major segments as follows;
Idiopathic generalized epilepsy: Common types of seizures include myoclonic, absence and tonic-clonic.
Idiopathic partial epilepsy: This type of epilepsy begins at childhood. The common seizures include simple partial motor seizures and generalized seizures.
Symptomatic generalized epilepsy: This type includes the seizures such as generalized tonic-clonic, tonic myoclonic, tonic atonic and absence seizures.
Symptomatic partial epilepsy: This type of epilepsy is caused by localized abnormality of the brain, such as strokes, tumors and trauma etc. This type of surgery may be completely treated with surgery.
Diagnosis
Often, epilepsy may be misdiagnosed as there are various other disorders which show similar symptoms. The most common procedures to detect epilepsy include the following;
Electroencephalography (EEG): It basically tests the electrical signals of the brain. 32 electrodes are fitted on the patient’s scalp to test the electrical activity. The test takes one to two hours and the results are more effective when the patient is sleeping.
Inpatient Video EEG monitoring: This test is usually performed to detect the source of seizures. An uncertain result may be used to rule out epilepsy. Continuous monitoring may be helpful in determining previously undiagnosed seizures.
Magnetic resonance imaging (MRI): MRI is an essential tool in detecting lesions in the brain and finding the cause of the disease. It is also used to identify potential patients for surgery. It is also helpful in detecting minor asymmetries in any part of the brain, the potential locations for start of the seizures.
Positron Emission Tomography: PET is very helpful in detecting the points where seizure begins for patients with partial seizure.
SISCOM: Subtraction Ictal SPECT Co-registered to MRI (SISCOM) is a relatively newer way of testing and is used to find the seizure spots. A radioactive tracer is used to detect the location and functioning of seizure in this testing procedure.
Neuropsychological testing: Neuropsychological test is used to judge the memory and cognitive behavior of the patient. A common and fairly renowned example would be the IQ testing. These tests can be helpful in determining dysfunctional areas of the brain.
Treatment
Non surgical treatments: There are many medications now available for epilepsy. Although there is no cure, the prognosis is quite inspiring and it has been found that 80% of patients can control their conditions with the medicines. The main medication for epilepsy and the most favorite are the anti epileptic drugs (AED). Many variants of AED are available in the market. However, many side effects have been found, such as nausea, osteoporosis and the like. Tagretol, depakote and Topamax are quite popular medicines. Apart from these, Zarontin, Felbatol, Gabitril, Keppra and Lamictal are also used for different types of seizures.
Sometimes, surgery becomes obvious for patients who do not respond well to medicines. The surgery is aimed at providing relief from seizures and decreasing the abnormal functioning cells. There are two types of epilepsy surgery. One is for removing the part of brain where the seizure starts and the other is to interfere with the nerve pathways through which the seizures spread. Surgery is performed only if the area where the seizure starts is identifiable.
Atonic seizures: The results of this type of seizures include sudden collapse or fall down. Atonic seizures are also known as drop attacks.
Causes
In most of the cases of epilepsy, the exact reason behind the disease remains unknown. However, there are some factors which may contribute to the onset of the disease. It is believed that lower oxygen supply to the baby during birth may be reason of epilepsy. Some genetic factors which results in injury to the brain such as tuberous sclerosis can also trigger epilepsy attacks. Head injuries during childbirth or from accidents during youth may also lead to epilepsy. A fairly common reason behind epilepsy is brain tumors. It has been observed that tumors can contribute to abnormal functioning of the associated brain cells, leading to seizures. Diseases that infect the brain, such as meningitis or encephalitis may also lead to epilepsy. Strokes and other diseases that may hurt the brain can also lead to epilepsy. Increased or abnormal quantities of substances such as sodium and blood sugar may also lead to epilepsy.
Types
Epilepsy can be broadly divided into idiopathic and symptomatic types. While idiopathic epilepsy has a genetic factor, the causes for symptomatic epilepsy are unknown. Depending upon the types of seizures, epilepsy can be divided into four major segments as follows;
Idiopathic generalized epilepsy: Common types of seizures include myoclonic, absence and tonic-clonic.
Idiopathic partial epilepsy: This type of epilepsy begins at childhood. The common seizures include simple partial motor seizures and generalized seizures.
Symptomatic generalized epilepsy: This type includes the seizures such as generalized tonic-clonic, tonic myoclonic, tonic atonic and absence seizures.
Symptomatic partial epilepsy: This type of epilepsy is caused by localized abnormality of the brain, such as strokes, tumors and trauma etc. This type of surgery may be completely treated with surgery.
Diagnosis
Often, epilepsy may be misdiagnosed as there are various other disorders which show similar symptoms. The most common procedures to detect epilepsy include the following;
Electroencephalography (EEG): It basically tests the electrical signals of the brain. 32 electrodes are fitted on the patient’s scalp to test the electrical activity. The test takes one to two hours and the results are more effective when the patient is sleeping.
Inpatient Video EEG monitoring: This test is usually performed to detect the source of seizures. An uncertain result may be used to rule out epilepsy. Continuous monitoring may be helpful in determining previously undiagnosed seizures.
Magnetic resonance imaging (MRI): MRI is an essential tool in detecting lesions in the brain and finding the cause of the disease. It is also used to identify potential patients for surgery. It is also helpful in detecting minor asymmetries in any part of the brain, the potential locations for start of the seizures.
Positron Emission Tomography: PET is very helpful in detecting the points where seizure begins for patients with partial seizure.
SISCOM: Subtraction Ictal SPECT Co-registered to MRI (SISCOM) is a relatively newer way of testing and is used to find the seizure spots. A radioactive tracer is used to detect the location and functioning of seizure in this testing procedure.
Neuropsychological testing: Neuropsychological test is used to judge the memory and cognitive behavior of the patient. A common and fairly renowned example would be the IQ testing. These tests can be helpful in determining dysfunctional areas of the brain.
Treatment
Non surgical treatments: There are many medications now available for epilepsy. Although there is no cure, the prognosis is quite inspiring and it has been found that 80% of patients can control their conditions with the medicines. The main medication for epilepsy and the most favorite are the anti epileptic drugs (AED). Many variants of AED are available in the market. However, many side effects have been found, such as nausea, osteoporosis and the like. Tagretol, depakote and Topamax are quite popular medicines. Apart from these, Zarontin, Felbatol, Gabitril, Keppra and Lamictal are also used for different types of seizures.
Sometimes, surgery becomes obvious for patients who do not respond well to medicines. The surgery is aimed at providing relief from seizures and decreasing the abnormal functioning cells. There are two types of epilepsy surgery. One is for removing the part of brain where the seizure starts and the other is to interfere with the nerve pathways through which the seizures spread. Surgery is performed only if the area where the seizure starts is identifiable.
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Very informative, overall. Although, I am disappointed that you did not mention other natural ways of treatment.
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