Published on Mar 21, 2018 and last reviewed on Apr 01, 2020 - 5 min read
We all are familiar with the term epilepsy, and always associate it with fits or seizures. But, there is more to it. So, what is it precisely? Read on to know.
Epilepsy is a group of neurological disorders in which there are abnormal electrical activities in the brain causing a brief disruption in the communication system of the brain cells. Epilepsy has trademark symptoms of seizures. A seizure is a sudden rise in the electrical activity of the brain. It can involve a part of the brain or the entire brain.
It results in episodes of unusual behavior, loss of awareness, and can affect both males and females of any age. The symptoms can vary, as some people just stare blankly for some time and others have jerky arms or legs twitches. For it to be diagnosed as epilepsy, you have to have at least two unprovoked seizures. Medications (mostly lifelong) or surgery are used in the management of most cases of epilepsy. In children, epilepsy may go away as they age.
1) Partial seizures: Otherwise called focal seizures. In this type, the electrical activity takes place in a localized area of the brain. This could be -
Simple partial seizures - It is now called focal seizures without loss of consciousness. Here, the patient is conscious during the seizure episode.
Complex partial seizures - It is now called focal seizure with impaired awareness. Here, the patient becomes unconscious during the episode.
A doctor needs to thoroughly diagnose partial seizures, as they are commonly confused with narcolepsy, migraine, or other mental disorders.
2) Generalized seizures: Where the abnormal electrical activity takes place in the entire brain. Further types include -
Tonic-clonic - Previously it was called grand mal seizures. They result in loss of consciousness, body shaking, muscle stiffening, and loss of bladder control.
Tonic seizures - It results in muscle stiffening and commonly affects the muscles of the back, arms, and legs.
Clonic seizures - They cause rhythmic and jerking movements.
Atonic seizures - Also called drop seizures, as it results in loss of muscle control, which causes a sudden fall.
Absence seizures - Previously it was called petit mal seizures. This often occurs in children. It is characterized by a brief loss of awareness and staring blankly.
Myoclonic seizures - This causes brief twitches in the arms and legs.
In the following situation, make sure you get immediate medical help:
If the seizures last for more than 5 minutes.
If breathing does not return to normal after a seizure.
If the person is still unconscious.
If a second seizure occurs immediately.
If you are pregnant.
If you are diabetic.
In case of an injury during the seizure.
If this was your first seizure.
In more than 50 % of cases, the cause of epilepsy cannot be determined. Various causes can lead to seizures and some of the possible causes are:
Brain scarring after an injury.
Very high fever.
Traumatic brain injury.
Stroke and other vascular diseases.
Injury to developing brain in the fetus or brain malformation.
Reduced oxygen supply at birth.
Maternal drug use.
Reduced oxygen supply to the brain.
Other neurological conditions.
Infectious diseases (AIDS).
Brain infections (meningitis or encephalitis).
Symptoms can differ from one person to another. For this reason, the list has varying possibilities of symptoms that can exist alone or together. They can include the following. Convulsions.
Twitching of limbs.
Involuntary, repetitive movements.
Short fainting spell.
Taste and smell disturbance.
Confusion after the episode.
Knowing your trigger will help in the prevention of episodes. It could be one or a combination of the following.
Lack of sleep.
Specific food items.
The doctor will need your medical history and the list of symptoms that you are experiencing. Then the doctor will try to diagnose epilepsy and rule out all other possible conditions by the following tests:
Neurological examination - to test motor and mental functions.
Blood tests - to rule out infectious diseases, and to check blood sugar levels. They might also check the liver and kidney functions.
Electroencephalogram (EEG) - Here, electrodes are used to record the electrical activity of the brain.
CT (computerized tomography) scan or MRI (magnetic resonance imaging) - Here, detailed images of the brain are obtained. It is used to diagnose conditions like tumors and cysts.
Neuropsychological tests - Your thinking, memory and speech skills are assessed in this test, which helps the doctor determine the areas of your brain that are affected.
Statistical parametric mapping (SPM) - It is used to identify areas of the brain with increased metabolism during seizures.
Some of the commonly used treatment options include:
Anticonvulsant or anti-epileptic medications - It helps reduce the number of seizures. The drugs used are Levetiracetam, Lamotrigine, and Valproic acid.
Vagus nerve stimulator - The vagus nerve is stimulated using a surgically placed device.
Ketogenic diet - Most people are benefited from the ketogenic diet, which is a high fat, low carbohydrate diet.
Brain surgery - If the patient does not respond to medications, the area of the brain responsible for seizure activity is altered or removed.
The consequences of seizures are more dangerous and difficult to treat than the disease itself. It includes:
Injury due to fall.
Drowning if there is a seizure while swimming.
Road accidents due to loss of control when driving.
Side effects of anti-epileptic medications on mental health.
Seizures during pregnancy can adversely affect the health of the mother and her baby.
Brain damage due to repeated abnormal electrical activities.
Minor risk of death due to heart or airway complications.
Status epilepticus - It is when a continuous seizure activity lasts for more than 5 minutes. Status epilepticus increases the risk of permanent brain damage and death.
SUDEP - Sudden Unexpected Death in Epilepsy.
If this is the first episode of seizure, it is imperative to get to an ER as quickly as possible. If you have been previously diagnosed with epilepsy, an increase in the frequency of seizures or a change in symptoms is an indicator that it is time to visit your neurologist for a follow-up and update in medication or dosage.
Query: Hi doctor, My 18 months old kid is having a problem of a blood clot in the central vein of the brain and also having meningitis fever. Here, the doctors are using Heparin IV, syrup Epival, tablet Debritone, Panadol syrup and some other medications. But, my son is continuously going to bad condition... Read Full »
Query: Hello doctor, I have been suffering from a wide array of mental symptoms for around nine years. Some years ago, I went to see a neurologist. He took an EEG, and found "epileptiform activity", I think in temporal lobes. So he said I have epilepsy and prescribed Valproate. He said my depersonalisation... Read Full »
Query: Hello doctor, I am writing to get a second opinion for my relative. He is a 19 year old male. He had a seizure last year and the second seizure was on last week. His EEG was normal and also had an MRI. The doctors said that he has chronic sinusitis with thickened mucosa and they started giving him... Read Full »
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