What is Epilepsy?

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What is the meaning of Epilepsy?

Epilepsy is a type of neurological disorder that causes recurrent seizures in a person. These seizures occur because of a sudden abnormal electrical activity in the brain that causes a temporary disturbance in the messaging systems between the brain cells.

Primary symptoms usually include seizures and may cause loss of awareness. Epilepsy seizures have a range of severity depending on the underlying disorder that triggers Epilepsy. 

Epilepsy can occur at any age, may be present in people over 60 years of age or in young children. This is a condition that stays lifelong and may get better with age. Over 65 million people in the world suffer from Epilepsy, men suffer slightly more than women. 

First line of treatment includes anti-seizure medications. If medicines are not effective, patients may be advised Surgery. Different types of seizures can occur in a person depending on which area of the brain is affected.

Let us discuss about Epilepsy through this article-

• What are the types of Epilepsy/ Epileptic Seizures ?
• What are the causes of Epilepsy? 
• What are the triggers of Epilepsy? 
• What are the symptoms of Epilepsy? 
• How to diagnose Epilepsy and plan the treatment for Epilepsy?
• What are the treatments for Epilepsy? 
• What are the complications of Epilepsy?
• How to live with Epilepsy?
• Frequently asked questions ( FAQ’s ) about Epilepsy

What are the types of Epilepsy/ Epileptic Seizures?

Epileptic seizures are divided into two main categories. 

Partial seizure: A partial seizure occurs when epileptic activity or sudden abnormal electrical impulse generation takes place in one part of a person’s brain. These seizures are also known as focal seizures. There are two types of partial seizure: 

• • Simple partial seizure: The patient remains conscious during this type of seizure. In most cases, the patient is also aware of his surroundings, even when the seizure is in progress. 
  • Complex partial seizure: This seizure impairs the patient’s consciousness. The patient usually does not remember the seizure. If they do, their memory will be vague. 

Generalized seizure: A generalized seizure occurs when epileptic activity or sudden abnormal electrical impulse generation occurs involving the whole brain. The patient will lose consciousness while the seizure is in progress. 

• • Tonic-clonic seizures (previously known as Grand mal seizures or Grand mal epilepsy): Probably the best-known type of generalized seizures. It causes loss of consciousness, body stiffness, and tremors.  
  • Absence seizures: Previously called Petit mal seizures or Petit mal epilepsy, these involve short lapses of consciousness wherein the person appears to be staring off into space. Absence seizures often respond well to treatment. 
  • Tonic seizures: The muscles become stiff, and the person may fall. 
  • Atonic seizures: Loss of muscle tone causes the person to fall abruptly. 
  • Clonic seizures: It is associated with rhythmic, jerking movements of the face or neck or arms. 

Secondary generalized seizure- A secondary generalized seizure occurs when epileptic activity begins as a partial seizure, but then spreads to the whole brain. As this seizure progresses, the patient loses consciousness. 

• • Status Epilepticus: A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to consciousness between the episodes. 

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What are the Causes of Epilepsy? 

Epilepsy can occur due to the following causes- 

• Epileptic seizures can be genetic- Almost 1 in every 3 people with epilepsy have a family history of the disease. 
• After head injury scarring of the brain tissue ( Post- traumatic epilepsy)
• Prenatal head injury  (head injury before birth in the child)
• Head trauma or injury, such as a vehicle accident
• Brain stroke (This is major cause of Epilepsy in patients above 35 years of age)
• Brain tumor or cyst
• Lack of oxygen in the brain during birth of the child.
• Development disorders or neurological diseases present since birth
• Dementia or alzheimer’s disease
• Maternal use of drugs
• Excessive Alcohol or drug abuse
• Infectious diseases like AIDS, meningitis that spreads to the brain tissues.
• Vascular diseases

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What are the triggers of Epilepsy?  

The following can trigger epilepsy or seizure attack-

• Excessive caffeine
• Excessive Alcohol
• Drugs
• Certain medications
• Skipping meals, overeating, or improper eating habits
• Specific dietary substances
• Stress
• Illness such as fever, etc 
• Bright flashy lights
• Lack of sleep
• Very low blood sugars

Seizures can occur either due to any one of these triggers or can occur due to a combination of these triggers. A record of the triggers and pattern of seizures must be recorded and maintained by the patient for further analysis. 

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What are the symptoms of Epilepsy? 

The main symptom of epilepsy is recurrent seizures. If a person experiences one or more of the following symptoms, they should consult a doctor. 

Symptoms of seizure or Epilepsy can vary from person to person. It also depends on the type of Epileptic Seizure a person is having. Some of these symptoms are as follows-

Simple partial seizures: There is no loss of consciousness. It has the following symptoms-

• Dizziness
• Tingling sensation in the body 

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• Changes in taste, smell, and vision 

Complex partial seizures: This involves loss of consciousness or awareness. Its symptoms are as follows-

• No response of the patient
• The patient keeps staring into the space
• Perform repetitive movements like clapping, rubbing hands, etc.

Generalized seizures: – It involves all areas of the brain. There are six types of generalized seizures, and they all have different symptoms. 

• In tonic-clonic seizures, there is stiffness in the body, loss of bladder control, shaking, biting the tongue, loss of consciousness, etc. 
• In atonic seizures, the person is unable to control his muscles and falls. 
• In tonic seizures, there is muscle stiffness.
• In clonic seizures, recurrent tremors occur in facial, neck, and arm muscles. 
• In myoclonic seizures, there are symptoms of tingling in the patient’s hands and legs. 
• In absence seizures, the person keeps repeating the same task, like eye blinking or lip-smacking.

Status epilepticus: Muscle spasms, confusion, falling, loss of bladder or bowel control, clenching of teeth, unusual behaviour, irregular breathing.

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How to diagnose Epilepsy and plan the treatment for Epilepsy?

Doctor does a complete physical examination and takes a detailed medical history to find the underlying cause of the Epilepsy, which may be a serious medical issue.

Following tests and investigations are done to diagnose Epilepsy-

1. Blood tests- Complete blood count ( CBC ), Liver and Kidney function tests, Blood glucose levels, etc. are asked by the doctor.
2. EEG (Electroencephalogram)- This is the most important test for the diagnosis of Epilepsy. It is a painless test where electrodes are attached to the scalp that record the electrical activity of the brain. This gives the doctor the information about the changed brain wave patterns  which are common in patients of Epilepsy.
3. Other Imaging tests- CT scans, MRI scans, PET ( positron emission tomography ), etc are the tests that are done to identify the site of any brain tumors or other abnormalities in the brain. 

Seizure journal- One must maintain a seizure journal and bring the journal to the treating doctor in every checkup or visit, for determining the medicines to be prescribed or to analyse whether the medicines are effective in the treatment. Seizure journal helps the doctor to plan other treatment options for the patient. 

Seizure journal  must be used to note the following points after the epileptic seizure-

• day and time of the seizure attack
• activity that caused seizure
• the surrounding factors at the time of seizure
• the stress factors that may have lead to seizure
• any unusual smell or sound or view that may have lead to seizure attack
• the food item after which seizure occurred
• time duration between last meal and seizure attack
• number of sleep hours the night before the seizure activity
• level of physical tiredness or fatigue at the time of seizure attack

What are the treatments for Epilepsy? 

There is currently no cure for most types of epileptic seizures. In most of the patients, epileptic seizures are managed well. Treatment plan depends upon factors like type and severity of the seizures, general health and age of the patient. 

Some of the treatment options are- 

Anti- epileptic ( anti-seizure/ anti- convulsant ) medications- These medicines help to reduce the frequency of seizure attacks or eliminate them completely in a few cases. Patients must strictly abide by the prescription and dosage of the medication as given by doctors. 

Medications are the first line of treatment for the symptoms in Epilepsy, but they can’t cure it completely. 

Commonly used drugs for the treatment of epilepsy include benzodiazepines, sodium valproate, carbamazepine, lamotrigine, levetiracetam, etc. 

1. Vagus nerve stimulator- In this procedure, a device is placed under the skin of the chest by minor surgical incision. This device then electrically stimulates the nerves of the neck that run up to the brain and help to stop seizures.
2. Diet modifications- Doctors may advise the patient to take a Ketogenic diet which has high fat and low carbohydrates. This is shown to be effective in some patients who did not respond well to the medications.
3. Brain surgery- This is considered as the option when medicines are not working well to control seizure activity. The most common type of brain surgery done for epileptic patients is resection ( eg- temporal lobectomy , where a part of the temporal lobe is removed to stop seizure attacks). Another procedure called multiple subpial transection is done where a nerve pathway is interrupted , thus stopping the seizure activity. 

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The doctor aims to reduce the rate and severity of seizures, while also avoiding side effects at the same time so that the patient can lead a normal, active and productive life. 

What are the complications of Epilepsy?

Some of the serious complications of Epilepsy are-

• Road traffic accident, incase a seizure attack occurs while driving
• Risk of permanent brain damage
• Brain death or coma, in case of seizure attack lasting for more than 5 minutes ( status epilepticus)
• Loss of consciousness between two seizure attacks
• Sudden unexplained death ( less than 1 percent occurrence )

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How to live with Epilepsy?

Patients with epilepsy must follow the following coping steps, apart from regular doctor visits and following the treatment plan.

• Maintain a seizure journal to identify the trigger factors and to avoid them.
• Educate the people around you about the disease, steps to follow in case of acute seizure attack.
• Helpline numbers of hospitals should always be readily available.
• The medical bracelet can be worn by the patient to alert people nearby in case the patient is having a seizure attack and can’t speak
• Join support groups and clubs in case of people with seizure disorders
• Patients who also have Depression or Anxiety must take medical help.
• Patients must sleep properly and follow a healthy diet and exercise routines. 

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Frequently asked questions ( FAQ’s ) about Epilepsy

What is the success rate of surgery in Epilepsy patients?

81 percent of the patients show no signs of seizures, 6 months after the surgery. 72 percent of patients show no seizure activity, 10 years after the surgery.

Is there a permanent cure for Epilepsy?

There is no cure for Epilepsy. However early diagnosis and treatment plan helps to manage the symptoms effectively. Seizure attacks can be managed with medicines. Patients unresponsive to the medicines are advised surgery after detailed medical history and physical examination.

What are the side effects of medications of Epilepsy?

Side effects like- tiredness, dizziness, skin reactions or rashes, lack of coordination and loss of balance, memory related problems, etc. may occur in patients taking medications for Epilepsy.

What are the complications of brain surgery in Epilepsy patients?

Allergic reaction to anesthesia, bleeding, infection at the site of surgery, cognitive changes in the brain functioning patterns, etc are some of the complications that may occur after the brain surgery.

We hope we were able to answer all your questions about Epilepsy through this article.

For more information and treatment of Epilepsy,  you may contact a Neurologist.

We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you the best advice and treatment plan.

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