What is Epilepsy?
Epilepsy is a relatively common neurological disorder that causes people to have recurrent seizures. Seizures occur when there is abnormal electrical activity within the brain, triggered by nerve cells or neurons in the brain sending out the wrong signals. Many people are not clear on the difference between seizures and epilepsy.
Seizures (also known as fits or convulsions) are a symptom of epilepsy where as Epilepsy is a neurological disorder in which the brain is predisposed to sudden alterations in electrical activity, triggering a seizure. The occurrence of one seizure does not necessarily mean you have epilepsy.
If the seizure was the result of a once off head injury for example then it may never occur again and the person will not be diagnosed as having epilepsy. However all first time seizures require a thorough medical evaluation to determine the cause and the probability of it developing into epilepsy or not.
How do you recognize a Seizure?
As mentioned a seizure happens when there is brief surge of electrical activity in a part or all of the brain. They can last anywhere from a few seconds to a few minutes and can have many different symptoms ranging from an obvious convulsion and loss of consciousness to minor twitching movements of a small part of the body or even just blank staring.
Depending on the area of the brain involved and the symptoms displayed seizures are divided into a number of different classes.
The first major classification depends on whether the abnormal activity in the brain is in one area only, causing partial or focal seizures, or whether it involves the whole brain causing a generalized seizure.
These are the main types of seizures and how you can recognize them:
Partial Seizures:
Simple partial seizures – you may experience alterations in emotions or the way things look, feel, taste or smell without any loss of consciousness
Complex partial seizures – your level of consciousness or awareness is altered, together with staring and abnormal non-purposeful movements such as lip smacking, hand rubbing or repetitive swallowing.
Generalized seizures:
Absence seizures – commonly known as petit mal seizures they are characterized by brief lapses of awareness, staring and sometimes subtle body movements.
Myoclonic seizures – sudden, forceful jerks of the arms and legs
Atonic seizures – cause you to suddenly fall down or collapse and are commonly known as drop attacks.
Tonic-clonic seizure – this type of seizure is the most intense and is also known as a grand mal seizure. These seizures cause what most people recognize as a convulsion: loss of consciousness, body stiffening, shaking or jerking, sometimes accompanied by tongue biting or loss of bladder control.
A localized abnormal electrical impulse in the brain, causing a partial seizure, can spread to the rest of brain converting the partial seizure into a generalized seizure, a process known as secondary generalization.
If a person has two or more seizures they are usually considered to be epileptic. While seizures vary enormously between different people and even in the individual most epileptics tend to have the same type of seizure each time.
What Causes Epilepsy?
In about half of all affected people epilepsy has no identifiable cause. Although there is a small genetic component to epilepsy allowing epilepsy to sometimes ‘run’ in families’ genetic inheritance places a very small role in this condition.
In the rest of people Epilepsy can often be traced back to an incident that involved some form of brain trauma or deprivation of oxygen to the brain. This could be due factors such as the following:
* Brain injury or trauma in an accident or fall
* Deprivation of oxygen such as a difficult birth or a near drowning
* Illness or disease such as a stroke causing a lack of oxygen to the brain
* Brain damage due to an infective process, swelling or in rare cases due to a tumor.
There are however certain risk factors that can increase your chances of developing epilepsy:
* Because brain injuries are so commonly a cause of epilepsy not wearing your seatbelt in the car or partaking in dangerous activities or sports without a helmet can all place you at increased risk.
* Strokes another important factor and being overweight smoking, having high cholesterol, drinking alcohol in excess etc can all increase your risk.
* Brain infections such as meningitis or encephalitis also increase your risk of developing epilepsy.
* Prolonged febrile convulsions (seizures due to a high fever) during childhood may increase your risk
* You may be at increased risk of developing epilepsy if you have a family history of it.
Diagnosing Epilepsy
Your doctor will take a detailed history of your seizures, and may perform certain tests, to try and determine if your seizure was the result of a once off incident or if it may be epilepsy.
In order to be diagnosed with epilepsy you have to have suffered from recurrent, unprovoked seizures and, in conjunction with your medical history, your doctor may perform the following tests to confirm the diagnosis:
* EEG – Electroencephalogram. This measures electrical activity in the brain and abnormal ‘electrical spikes’ can indicate epilepsy
* Brain MRI or CT scan – can be useful when looking for a cause within the brain such as a stroke, tumor or abnormal brain anatomy
Because epilepsy, although a condition itself, can also be a symptom of or occur in association with many other medical conditions your doctor may also perform other tests as part of the medical evaluation if he suspects an underlying condition.
Help for Epilepsy
The aim of treatment in epilepsy is to keep the patient seizure free and side effect free; however this is not always an easy goal to achieve. There are many different anti-epileptic drugs that work in different ways and have different side effects. In addition different prescription medications will work better for certain conditions and what works for one person may not work for another.
This usually results in a rather ‘hit and miss’ technique of trying to find a medication that works for each person and may involve a number of different dosages, drugs or combinations of drugs being tried. Unfortunately this can still leave you experiencing not only your seizures but also a variety of different side effects.
It is very important that you speak to your doctor and find out all that you can about your condition and the medication prescribed – remember there is no such thing as a stupid question! If your doctor is finding it difficult to find a treatment regime that controls your seizures you may be referred to a specialist, either a neurologist or an epileptologist, who would suggest further alternatives.
There are a number of other treatment modalities that are sometimes used in unusual cases and these include surgical procedures, neural stimulation and special diets.
More Information on Epilepsy
What must you do if you witness someone having a Seizure?
Most people feel thoroughly ill-equipped when faced with a person experiencing a seizure. Here are some simple, common sense tips that will help you to deal with the situation:
First and foremost – stay calm!
One of the primary goals is to prevent the person having the seizure from hurting him or herself so remove any objects nearby that may cause harm such as tables with sharp corners. You can also place something soft under the head.
Move the patient into the recovery position by laying them on their left side.
Pay attention to the length of the seizure and the symptoms displayed.
Don’t restrain the person and try to hold them down
Don’t put anything in the patient’s mouth – not only are you in danger of being bitten but, contrary to popular folklore, you cannot swallow your tongue during a seizure!
Do not give the patient any water, food or oral medication until he or she is fully alert.
If the seizure lasts longer than 5 minutes or there are repeat seizures contact your emergency medical service
Be sensitive to the person’s dignity and try to keep onlookers away
Source: Native R
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