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Everything You Should Know About Epilepsy

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Everything You Should  Know About Epilepsy

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Epilepsy is a common neurological problem that causes unprovoked, recurrent seizures. The below article details this condition.

Medically reviewed by

Dr. Sneha Kannan

Published At October 19, 2019
Reviewed AtAugust 18, 2023

What Is Epilepsy?

Epilepsy is a common neurological disease in which brain activity becomes abnormal, causing unprovoked, recurrent seizures. A seizure is a sudden disturbance of electrical activity in the brain. There are two primary types of seizures, which are:

  • Generalized Seizures - These affect the entire brain.

  • Focal Seizures - These types of seizures affect just one part of the brain. It might be difficult to recognize a mild seizure. It can last a couple of moments, during which you lose consciousness. Stronger seizures can cause fits and uncontrollable muscle twitches and can last a couple of moments to a few minutes. Some people lose consciousness during a stronger seizure. However, most people do not have any memory of it occurring.

What Causes Epilepsy?

Epilepsy is not contagious. Although numerous underlying disease mechanisms can result in epilepsy, it still has no identifiable cause in about 50 % of all cases. In the other half, epilepsy may be traced to various factors, such as:

  • High fever.

  • Very low blood sugar.

  • Alcohol withdrawal.

  • A severe head injury.

  • Prenatal injury.

  • Infections.

  • Congenital abnormalities or genetic conditions.

  • Stroke.

Who Can Get Epilepsy?

Epilepsy is a common neurological issue that affects 65 million people far and wide. Anybody can develop epilepsy, but it is more common in young children and older adults. Men are more likely to get epilepsy than women. In addition, children and adolescents are more prone to develop epilepsy of unknown or genetic origin.

What Are the Symptoms of Epilepsy?

Because epilepsy is mainly caused by abnormal activity in the brain, seizures can affect any process the brain coordinates. The signs and symptoms of seizures may include:

  • Temporary confusion.

  • Stiff muscles.

  • A staring spell.

  • Loss of consciousness or awareness.

  • Uncontrollable jerk of the arms and legs.

  • Psychological symptoms like fear, anxiety, or deja vu.

However, symptoms differ from individual to individual and per the type of seizure. Doctors generally categorize seizures as either focal or generalized, depending on where and how the abnormal brain activity starts.

  • Focal (partial) Seizures - A basic partial seizure does not include a loss of consciousness. The symptoms include:

    • Alterations of taste, smell, sight, hearing, or touch.

    • Dizziness.

    • Tingling and twitching of limbs.

    • Focal seizure symptoms may be confused with other neurological disorders, like migraine, narcolepsy, or mental illness. Therefore, a detailed examination and testing are required to differentiate epilepsy from other conditions.

  • Complex Partial Seizures - These include loss of consciousness along with:

    • Staring blankly.

    • Lethargy.

    • Performing repetitive movements.

How Is Epilepsy Diagnosed?

The doctor may suggest some diagnostic tests depending on the medical history and symptoms. For example, the doctor may order several tests to diagnose epilepsy and discover the cause of seizures. The evaluation may include:

  • Neurological Examination: The doctor may test the individual's behavior, mental function, motor abilities, and other areas to diagnose the medical condition and determine the type of epilepsy one may have.

  • Blood Tests: The doctor may consider taking a blood sample to check for signs of infections, genetic conditions, or other conditions associated with seizures.

The doctor may suggest tests to detect brain abnormalities, such as:

  • EEG (Electroencephalogram): This is the most common test to diagnose epilepsy. It is a noninvasive, painless test in which electrodes are attached to the scalp using a paste-like substance or cap. These electrodes record the brain's electrical activity. If someone has epilepsy, there will be changes in the normal pattern of brain waves, even when not having a seizure.

Some imaging tests can uncover tumors and other abnormalities that can cause seizures. These tests may include:

  • Computed tomography (CT) scan.

  • Magnetic resonance imaging (MRI).

  • Positron emission tomography (PET).

  • Single-photon discharge computerized tomography.

How Is Epilepsy Treated?

Most people can manage epilepsy. The treatment plan is based on the severity of symptoms, your health, and how well you react to the therapy.

Some treatment options include:

Medications:

  • Antiepileptic Drugs: These medications can reduce your number of seizures. In some people, they help eliminate seizures. For the medications to be effective, take them as prescribed by the doctor. Many children with epilepsy who experience epilepsy symptoms can eventually quit medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. The doctor may advise about the right time to stop taking medications. More than 20 different types of antiepileptic medications are available. The medication the doctor chooses to treat epilepsy depends on the type of seizures one has and other factors like age and other health conditions. However, these medications may have some side effects, including fatigue, dizziness, weight gain, loss of bone density, skin rashes, loss of coordination, and speech problems.

  • Other Therapies: Apart from medications and surgery, there are a few potential therapies that can be an alternative for treating epilepsy:
  • Vagus Nerve Stimulator: In this, a battery-powered device called a vagus nerve stimulator is implanted underneath the skin of the chest. This device transmits bursts of electrical energy through the vagus nerve and to the brain. It is unclear how this device inhibits seizures, but it can reduce seizures by 20 % to 40 %.

  • Ketogenic Diet: In a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. Studies suggested some children with epilepsy have been able to reduce their seizures by following a ketogenic diet.

  • Deep Brain Stimulation: It is often recommended for people whose seizures do not get better with medication. In this treatment, surgeons implant electrodes into a specific part of the brain (thalamus). The electrodes are connected to a generator implanted underneath the chest. This generator transmits electrical pulses to the brain at timed intervals and may reduce seizures.

Surgery: If medication cannot reduce the number of seizures, brain surgery is another option. Surgery may be helpful to people who respond poorly to drug treatments.

How Can Epilepsy Be Prevented?

About 25 % of epilepsy cases are preventable. The following things can be helpful:

  • Preventing trauma or head injury is the best way to prevent post-traumatic epilepsy.

  • Using medications and other methods to lower the body temperature of a feverish child can lessen the chance of febrile seizures.

  • Adequate perinatal care can decrease new epilepsy cases caused by birth injury.

  • Epilepsy associated with stroke is focused on reducing cardiovascular risk factors, e.g., steps to control high blood pressure, obesity, diabetes, and avoiding tobacco and excessive alcohol use.

  • Central nervous system infections are common reasons for epilepsy in tropical areas. Therefore, eliminating parasites in these environments and educating on avoiding infections can effectively reduce epilepsy worldwide, such as cases due to neurocysticercosis.

Conclusion:

Epilepsy is a chronic condition that can negatively affect many parts of life. However, the exact of epilepsy is still unclear. But epilepsy may be traced to certain factors, such as high fever, very low blood sugar, and alcohol withdrawal. Treatment includes medications or surgery that can control seizures for most people with epilepsy. Understanding the condition can help one take better control of it.

Frequently Asked Questions

1.

Can One Live a Normal Life With Epilepsy?

Epilepsy treatment has advanced in recent years. As a result, more effective medications, diagnostic tests, and treatment options are available to make lives easier for those with epilepsy. Most epileptic patients can lead a normal life with the proper diagnosis and treatment. However, if a person has had epilepsy for a long duration and is difficult to control, daily life activities may become difficult for them, and they may need assistance.

2.

Can People With Epilepsy Drive?

Driving is not recommended for persons with epilepsy during their initial years of treatment and those with uncontrolled epilepsy. The driving agencies must be kept informed regarding epilepsy conditions. However, most people with epilepsy can drive if they meet the driving rules (for their seizure type). Driving itself does not cause epileptic seizures.

3.

How to Live With Epilepsy?

A person with epilepsy can live an everyday life if they take the necessary measures to manage epilepsy. These include:
- Taking their medications regularly.
- Talking with their healthcare providers if they have any questions.
- Recognizing seizure triggers, such as bright lights, and avoiding them.
- Maintaining a record of their seizures and consulting their healthcare provider if they notice increased frequency.
- Getting enough rest and sleep.
- Relaxing to lower stress.

4.

What Are Some Interesting Facts About Epilepsy?

Some interesting facts about epilepsy are:
- Epilepsy is not contagious and thus cannot be transmitted from one person to another like an infection.
- Epilepsy is more common than people believe. One in ten will have a seizure (unprovoked) during their lifetime.
- Anyone (of all ages) can develop an epileptic seizure.
- There are many forms of epilepsy.
- Disturbances in brain electrical signals cause epilepsy.

5.

What Activities Should Epileptics Avoid?

People with epilepsy must avoid activities that trigger epileptic seizures. Those with uncontrolled epilepsy should avoid:
- Driving.
- Sports.
- Dangerous activities such as sky diving, mountain climbing, and hand gliding.
Strenuous activities requiring lots of energy or full concentration can lead to loss of consciousness, resulting in injury or death.

6.

What Can Worsen Epilepsy?

Epilepsy can worsen due to the following:
- Missed medication or dose.
- Lack of sleep or rest.
- Strenuous activities.
- Stress and anxiety.
- Co-morbid conditions such as diabetes or heart disease.
- Alcohol intake or illicit drug use.
- Hormone changes and menstruation.
- Infections (common cold or the flu).
- Triggering factors such as bright lights.
- Herbal medications.

7.

Does Epilepsy Get Worse With Age?

The clinical features, the brain's electrical activities, and the prognosis of epilepsy are dependent on age (childhood or elderly). Epilepsy incidence increases over the age of 60 due to the presence of other conditions, such as stroke or dementia. If a person were diagnosed during childhood, it might become easier to control with time. However, it can worsen for some people with age.

8.

How Many Hours of Sleep Does an Epileptic Person Need?

Epileptic people must get sufficient sleep and rest to prevent the worsening of epilepsy. Epileptic adults must ensure that they get seven to eight hours of sleep at night. In case a person who is epileptic goes to bed late, they should compensate by waking up late to prevent sleep deprivation and to feel refreshed.

9.

Do People With Epilepsy Have a Good Memory?

 
Epileptic seizures of any type can affect a person's memory during or after the seizure. Those with frequent seizures might have a memory problem, especially those with generalized seizures. Epilepsy can make it difficult to store memories, and such people may be more prone to forget things quickly.

10.

Does Epilepsy Count as Brain Damage?

Most epileptic seizures do not damage the brain. However, prolonged uncontrolled seizures can cause brain damage. If a seizure attack lasts longer than five minutes, or more than one seizure occurs within a short duration of five minutes, and the person does not regain normal consciousness, it is probably status epilepticus, a medical emergency that can lead to permanent brain damage, disability, and death.

11.

Does Epilepsy Qualify as a Disability?

Epilepsy is a potentially disabling condition that can be socially isolating. The epileptic person and their family get affected socioeconomically, psychologically, and physically (the epileptic person). Epilepsy qualifies as a disability as people with uncontrolled epilepsy find it challenging to work for an extended period of time and lack a normal life and thus should be granted benefits.
Dr. Jena Pratap Chandra
Dr. Jena Pratap Chandra

Family Physician

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