Introduction And Treatment Of Epilepsy

Epilepsy :

Epilepsy is a condition that affects the brain and is identified by recurrent seizures.
More than 600,000 people in the UK suffer from epilepsy. About one in every 100 people develops this disorder.

Symptoms of Epilepsy :
The main symptoms of epilepsy are recurrent seizures. There are different types of seizures, depending on which part of the brain it affects.

Brain cells, called neurons, send electrical signals. They communicate with each other in the brain through chemical messaging. During a seizure, there is an abnormal burst of neurons firing electrical impulses. It can cause the mind and body to make strange movements.
The severity of seizures can vary from person to person. Some people experience strange states without losing consciousness, or go into a “trance”-like state for a few seconds or minutes. While some people faint and experience tetanus (uncontrollable shaking of the body).

Some people may only have one seizure. If they are not at high risk of having further seizures, they are not considered to have a seizure.

Types of Tours :
Epilepsy patients can experience any type of seizure, although most people have a consistent pattern of symptoms. Seizures can happen while you are asleep or awake.
The type of seizure depends on which part of the brain it affects, there are two types:

  •         Focal (or partial) seizures – where only a small part of the brain is affected
  •         Generalized seizures – where most or all of the brain is affected

Some seizures do not fit into these categories and are known as unclassified seizures.

 Focal Seizure :
There are two main types of focal seizures.

  1.            Focal Aware Seizures
  2.            Focal Impaired Awareness Seizures

Generalized Seizure :

There are 6 main types of generalized seizures.

  •         Absences
  •         Myoclonic Seizures
  •         Clonic Seizures
  •         Atonic Seizures
  •         Tonic Seizures
  •         Tonic-clonic seizures

ยท        Myoclonic-tonic-clonic seizures and myoclonic-atonic seizures are a combination of the generalized seizures described above.

Status epilepticus :
 Status epilepticus is the name used for a seizure lasting more than 5 minutes, or a series of consecutive seizures where the person does not regain consciousness between seizures. This is a medical emergency and requires treatment as soon as possible.
If you care for someone who has epilepsy, you may be trained to treat tetanus. If you suspect tetanus, it is important to call 999 for an ambulance immediately.

If you have been trained to treat this condition, you will usually be instructed to use one of the following methods:

  •          A medicine called buccal midazolam, which comes in liquid form and is given as a drip on the inside of a person’s cheek or nose (this is the most common quick treatment).
  •          A drug called diazepam is injected into the person’s abdomen (less commonly used).
    If you have tried one of these treatments and the seizures continue, call 999 for an ambulance.
  •      If you have tried one of these treatments and the seizures continue, call 999 for an ambulance.

Causes of Epilepsy :
In some cases of epilepsy, the cause is not known.
If there is an identifiable cause, it is usually related to the effect of a condition on the brain.
The brain is a delicate assembly of nerve cells, electrical impulses and chemicals called neurotransmitters. Any damage has the potential to affect brain function and cause seizures.
Epilepsy types can be classified according to their causes, which can be:

  •           Genetic
  •       Structural
  •           Infectious
  •           Stoffwechsel (Metabolic)
  •           Immune system
  •           Unknown

Motives of the Seizure :
Many people with epilepsy, seizures can occur for no apparent reason. However, certain conditions or the use of certain substances can sometimes precede a seizure. These include:

  •         stress
  •         Lack of sleep
  •         Withdrawal from alcohol following heavy drinking
  •         Some medications
  •         Illegal drugs
  •         Your menstrual cycle or period
  •         Flashing lights (this is an uncommon trigger that affects less than 5% of       epilepsy patients, and is known as photosensitive epilepsy)

Keeping a seizure diary can be helpful in identifying what triggers your seizures. Each time you have a seizure, record it and note what you were doing. Over time, you may notice some avoidable things that trigger your symptoms.

Treatment of Epilepsy :
A large number of epilepsy patients can be successfully treated with anti-seizure medication (ASMs). These medications do not completely cure epilepsy, but can prevent seizures from occurring.
There are many different types of anti-seizure medications. These drugs work by changing the levels of chemicals that transmit electrical impulses in the brain. This reduces the chances of a seizure.
The type of anti-seizure medicine prescribed for you will depend on several factors, such as:

  •          The type of visits you make your age
  •          Is there a concern that a certain anti-seizure medication will interact with other medications (such as the contraceptive pill)
  •         Do you plan to have a child?

 Examples of commonly used anti-seizure medications include sodium valproate, carbamazepine, lamotrigine, and levetiracetam.

Use of anti-seizure medications

Brain surgery :
If seizures are not controlled after using anti-seizure medications, your doctor may recommend an alternative method.
Brain surgery is usually only performed when:

  •        Seizures begin in a specific part of the brain that can be safely removed
  •         All other treatments have failed

Alternative Procedure :

Your doctor may recommend an alternative procedure if:

  •         Your seizures are still poorly controlled after trying treatment with anti-seizure medications
  •         Brain surgery is not suitable for you.

        This can be Vagus Nerve Stimulation (VNS).

Vagus Nerve Stimulation (VNS) :
Vagus nerve stimulation is a procedure in which a small surgical instrument is inserted into the chest wall on the upper left side of the chest. The device sends electrical signals to the vagus nerve, which affects the brain and can help reduce seizures.

Ketogenic Diet :
A ketogenic diet is a diet that is typically very low in carbohydrates and high in fat. This type of diet forces the body to produce substances called ketones, which the body can use as fuel. Ketones can help reduce seizures.

Living With Epilepsy :

Regular exercise and a healthy diet are recommended for everyone. They can help prevent many diseases, including heart disease and many types of cancer.

To provide your body with the nutrients it needs, try to eat a balanced diet that includes all the food groups. Regular exercise can increase your bone strength, reduce stress and reduce fatigue.

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