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Epilepsy – Causes, Symptoms, Seizures, Types and Treatment
Epilepsy – Causes, Symptoms, Seizures, Types and Treatment

Epilepsy – Causes, Symptoms, Seizures, Types and Treatment

Epilepsy have been known to man for many centuries. Epilepsy is a very common problem. Although this term is not new to many people but at the same time there are many misconceptions prevalent in the society about this disease.

Way back before the time of Hippocrates. So, way before Jesus Christ or before the common age people used to think that epilepsy was caused by the moon. That it was caused by the evil spirits. They thought people with epilepsy are crazy. A lot of misconception still persist today. Many people still believe that epileptic fits are because of the evil possession and then they prefer seeing a faith healer for this illness rather than a doctor.

In this article I have explained what epilepsy is, how it is caused, its symptoms, its types and how it can be controlled.

WHAT IS EPILEPSY?

Epilepsy is a lifelong condition and it can develop over any age. People over 65 are almost as likely to develop epilepsy as a child under 10. Epilepsy is a condition where people have recurring and unpredictable seizures. Epilepsy is a condition which occurs due to excessive and uncontrolled neuronal activity in brain. Now the result of the excessive neuronal discharge in any specific area or the whole cerebral cortex leads to seizure. Let’s understand it with an example.

You might have seen the TV shows and movies right where someone falls to the ground and starts convulsing. Yet needless to say this definitely isn’t everyone’s experience with epilepsy. This is just one of the types of seizure and there are 60 different other type of seizures. Some involve fainting and convulsing but others just cause short periods of rapid blinking and staring into the space. Some involve strange sensations like tingling or ringing sound in the ear or odd behavior.

EPILEPTIC SEIZURES

WHAT IS A SEIZURE?

The brain is made up of billions of cells called neurons. Neurons release electrical impulses. These electrical impulses send messages that tell different parts of the body what to do and how to carry out functions. But this signal has to be working together like traffic lights some go red; some go yellow and some go green. So that cars can move smoothly and can’t crash. This synchronization of neurons is maintained by the main excitatory neurotransmitter Glutamate and main inhibitory neuro transmitter GABA. When some of the neurons are out of sync with one another they may cause seizures. Now imagine what would happen if traffic lights were all out of whack, like they all turned green at once. Can you imagine the chaos it would cause? That’s what seizures does to our body.

During seizures neurons fires too rapidly and randomly sends many messages at the same time. This overwhelms the brain. I hope you understood what is seizure. Seizures are broadly classified into two categories depending upon the region of the brain that is affected.

1. PARTIAL SEIZURE / FOCAL SEIZURE

When the affected area is limited to one hemisphere (one half of the brain) or sometimes even a smaller area like a single lobe we call it Focal seizure or Partial seizure. The symptoms of focal seizure depend upon the site of the brain is involved.

a. MOTOR CORTEX AREA

Some symptoms include –

  • Muscle jerking in one area of the body.
  • Turning of head to the one side.

b. VISUAL CORTEX AREA

Some symptoms include –

  • Flashes of light which are only perceived by the patient.

c. AUDITORY CORTEX AREA

Some symptoms include –

  • Patient perceives a ringing sound in the ear.

d. SENSORY AREA

Some symptoms include –

  • Sensations or false touched

It can also be differentiated into two types depending upon the consciousness but the symptoms experienced would depend upon the area affected as mentioned above.

a. SIMPLE PARTIAL SEIZURE

  • In this seizure the person is awake and alert and will usually know that something is happening and will remember the seizure afterwards.

b. COMPLEX PARTIAL SEIZURE

  • In this seizure the person experiences impaired consciousness.
  • Which means losing consciousness completely, loss of awareness and responsiveness, so they might not remember what exactly happened during a seizure.

2. GENERALIZED SEIZURES

In this condition both the hemispheres are affected. It usually starts at one place in the brain and then due to widespread neuronal networks, they spread to whole of the cerebral cortex. One of the important structures that helps in the spread is the corpus callosum (corpus callosum connects both the hemisphere). The main characteristic of generalized seizure is their spread and not confined to a specific area. It is again sub categorized into –

a. TONIC SEIZURE

Here the muscles all of a sudden become stiff and flexed, which can cause the person to fall often backwards. The muscle gets contracted without any relaxation. It leads to loss of consciousness in the patient and it usually lasts for 10-20 seconds.

Some symptoms include –

  • Increase blood pressure – due to increase sympathetic activity
  • Tongue bites – due to contraction of jaw muscles
  • Cyanosis
  • Ictal cry – it’s a typical sound produced due to tonic contractions of the muscles of larynx and muscles of expiration. This is a rare condition observed among patients.

b. CLONIC SEIZURE

Here the patient has violent muscle contraction also known as convulsions. Convulsions are not caused only due to epileptic seizures but can also be caused due to many other reasons like in electric shock, trauma etc. When the convulsions are non-epileptic people usually use the word fits.

Here the continues discharge from the brain gets interrupted by small durations of relaxation. Hence spasms and jerking are observed which is vigorous muscle movements. It lasts for 2-3 minutes.

c. TONIC – CLONIC SEIZURE

It happens in almost 10% of the patient with epilepsy. Tonic – Clonic seizures never go unnoticed. Like their name describes this type of seizure includes tonic and clonic phase.

They first experience tonic phase (Tonic seizure) which would last for 10-20 seconds and then it transforms into the clonic phase (Clonic seizure) which last for only 1 minute and then it transforms into the post-ictal phase.

Post – ictal phase is characterized by confusion, unresponsiveness and muscular flaccidity. The patient usually remains in this phase for 1-2 hours after which he will gradually transform into normal state. This is usually the type of seizure people visualize when they think of epilepsy. Essentially the child will become suddenly unconscious and will then begin to experience a series of muscle contractions that involve the entire body. This phase it can begin with a fall or sudden cry or breathing difficulty. It is possible that the person accumulates saliva or loses urine or stool during this phase.

d. ABSENCE SEIZURE

Most common type of seizure in the children and it is caused due to genetic abnormality in the children. The person experiences a sudden and brief loss of consciousness without any muscle tone. It usually lasts for only few seconds. No post-ictal confusion. They lose consciousness and regain consciousness. Generally, the only outward sign being that the person looks like the paced out. For example, if the person is walking, he will suddenly stand still.

e. ATONIC SEIZURE

Here the muscles of the patient suddenly relax and becomes floppy which can cause patient to fall forwards. It occurs suddenly and hence prevention is difficult.

f. MYOCLONIC SEIZURE

Myoclonic seizure consists of a sudden onset of brief and uncontrollable jerks of a muscle or muscle group. Here the patient experiences short muscle twitches, sometimes just a single twitch but sometimes many in a short amount of time. It is usually nonviolent and the person doesn’t lose consciousness. Usually these tend to happen in the morning but can also occur during sleep and last for only few seconds.

Anyone can have a seizure. Researches shows that 1 out of every 10 people will experience a seizure in their lifetime. That doesn’t mean that the person will be diagnose with Epilepsy.

WHAT CAUSES EPILEPSY?

First of all, epilepsy is not a mental or psychiatric disorder. It is not caused because of stress or failures in life.

1. VASCULAR CAUSES

Associated with blood supply of the brain this include Stroke, bleeding, AV malformations etc.

2. INFECTIONS

Infections which causes epilepsy are meningitis, Brain Abscesses, AIDS

3. TRAUMA

Leading cause in both young and old patients like due to road accident, penetrating injuries

4. HEREDITORY

Infections which causes epilepsy are meningitis, Brain Abscesses, AIDS

5. NEOPLASM

Due to tumors

6. AUTOIMMUNE DISEASE

CNS , Alzheimer’s disease, Vasculitis, SLE

7. METABOLIC DISORDERS

Increase level of glucose, Hyponatremia

8. DRUGS

Common drugs which causes epilepsy is alcohol, cocaine and phencyclidine

9. IDIOPATHIC

Some epilepsy doesn’t have any cause

SYMPTOMS

Symptoms depends upon the seizure experienced by the patient. Some symptoms have already been mentioned above depending upon the seizure. I will list down few more symptoms

Some symptoms include –

  • Loss of awareness
  • Unusual behavior / sensations
  • Uncontrollable movements
  • Loss of consciousness

TREATMENT OF EPILEPSY

Well there is no complete cure for epilepsy it’s a lifelong disease but that doesn’t mean it is a life sentence. 70% of people with epilepsy can have a good control over their seizure with proper medications taken.

Mostly treatment is possible through antiepileptic drugs. These medications are to be taken for a long time period regularly. Duration of the therapy is between 4-5 years or may be 10 years or even longer. The most effective way of treating epilepsy is timely and regular administration of these drugs. An important point to remember is that good control over seizures that doesn’t mean one can stop the drugs because these seizures can reoccur if medications are stopped.

If you have two or more seizures that appear out of the blue and occur more than 24 hours apart you may be diagnosed with epilepsy. But things like excess alcohol consumption, sleep deprivation, concussions or new medications can also cause seizures that aren’t at all related to epilepsy. If you think you have epilepsy then talk to a doctor about getting it diagnose with the help of CT scan, MRI, ECG etc.

Epilepsy should be normal

Some people with epilepsy still face the stigma and discrimination built on negative misconceptions. The key message is that epilepsy is an illness of the brain. It is not something to be ashamed of. This is not due to evil possession or any supernatural phenomenon. It is an illness just like common cold or pneumonia etc. It is completely treatable and with the currently available therapeutic options living a normal life with epilepsy is absolutely possible.

So, if someone has similar symptom, then he or she should see a doctor and get treatment. They should behave and feel like a normal part of society. In reality these epileptic patients if properly treated can become an important part of our society and serve humanity just like Theodore Roosevelt the 26th president of US. He was an epileptic patient too.

For more such information check out my website medicoved.com

Author : Easminara shaikh

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