Epilepsy

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What is Epilepsy?

Epilepsy is a neurological disorder that results in recurring seizures. The seizures are due to abnormal electrical activity in the brain, which differentiates this disease from other seizure disorders. The area of the brain affected can vary, leading to different types of epilepsy.

 

The condition is relatively common, with approximately one in every 100 to 200 people diagnosed in this country. It is usually diagnosed after a person has had at least two seizures or a single seizure and other risk factors that point toward the condition. In some cases, children who are diagnosed with epilepsy eventually outgrow the condition. 

Why does Epilepsy Occur?

In about half of all cases, the cause of epilepsy is not known. The rest may be attributed to factors such as:

 

-  Genetics – Certain types of epilepsy appear to run in families, suggesting that genetics may play a role

-  Medical Disorders – A stroke can cause damage to the brain can result in epilepsy, especially in older patients.

-  Head Trauma – A severe blow to the head can result in epilepsy.

-  Diseases – Some diseases like meningitis can also result in epilepsy.

 

In many cases, epilepsy does not occur directly after an injury or illness. Instead, symptoms may appear months later, making it difficult at times to find a link between the two.  

What are Epilepsy Symptoms?

The main symptoms of epilepsy are seizures. However, these seizures can take on a variety of faces, depending on the type of epilepsy the patient has. Most patients will always have the same type of seizure over and over again. Some of the most common characteristics of epileptic seizures include:

 

·         Staring into space

·         Confusion that eventually clears

·         Uncontrollable movements in the limbs

 

Some patients also lose consciousness, particularly in the event of generalized seizures. Other epilepsy symptoms vary based on the type of seizures that occur. 

Types of Epilepsy Seizures

Epilepsy seizures are typically categorized as either partial or generalized. The distinction is based on whether the entire brain or just a portion of it is involved in the abnormal activity. Some patients will have partial seizures at first and then experience generalized seizures as the condition progresses. 

Partial Seizures

Partial seizures, also known as focal seizures, originate in a single area of the brain. Because only one part of the brain is involved in the episode, a localized area of the body is affected. For example, if the affected area of the brain controls hand movements, the patient may see involuntary movements in the hand during a seizure.

 

In some cases, partial seizures can become complex, which means the person's state of consciousness is altered. When this occurs, the patient may appear confused or dazed. Other symptoms include repetitive movements that seem to have no purpose, such as rubbing hands together or walking around in circles.  

Generalized Seizures

Generalized seizures involve the entire brain and may include a complete loss of consciousness. There are six types of generalized seizures related to epilepsy:

 

Atonic – These seizures are characterized by a loss of muscle tone that usually results in a fall.

Myclonic – This type of seizure consists of jerking motions that the patient cannot control.

Absence – As the name suggests, absences seizures have few symptoms other than a short loss of consciousness.

Clonic – These seizures are characterized by short, repetitive jerks and motions.

Tonic – Tonic seizures involve involuntary stiffening of the muscles.

Grand Mal – This is the most dramatic type of seizure that involves a loss of consciousness followed by a series of violent jerking. At the end of the seizure, the patient may fall into a deep sleep.

People with epilepsy are advised to see their doctor with the first seizure and with subsequent seizures if they last more than five minutes, a second seizure immediately follows or the patient has other health conditions like pregnancy or diabetes. 

How is Epilepsy Diagnosed?

Epilepsy may be suspected after a patient has had two seizures. The tests for diagnosing epilepsy can vary, and may initially consist of blood tests and a general exam of your motor abilities. Other tests might include a speech or IQ test that monitors brain functioning. Medical tests consist of an EEG, which records the electrical activity in your brain and a CT scan, which can reveal abnormalities in the brain.

 

An MRI may also be prescribed if the doctor wants to see a more detailed x-ray of your brain. Two other tests, a PET scan and a SPECT use small amounts of radioactive material to pinpoint the precise location in the brain where the malfunction is occurring. By determining specifically where the problem lies in the brain, doctors can come up with the most effective treatment plan. 

What are the Most Effective Epilepsy Treatments?

There are a number of options in epilepsy treatments. Most doctors will begin with the least invasive approach and then progress to other treatments according to a patient's needs.  

Medication

The most common method of treating this condition is with epilepsy medication. Many epilepsy patients can live without frequent symptoms by finding the right anti-seizure medication. However, it is often a process of trial and error to find the best epilepsy medication and dosing amount for each individual. In a few cases, epilepsy medication will not prove helpful in controlling seizures.

 

However, many patients find that after two or more years of taking medication regularly, they can live seizure-free without the need for scheduled doses. This is particularly true with children who are diagnosed with epilepsy. The main concern is to find the right medication for each individual situation. With more than 20 possibilities to choose from, there is a good chance that you and your doctor can work together to find an effective solution for your condition.

 

To ensure success with your medication, make sure you take the proper doses exactly as prescribed. You should ask your doctor before changing your dosage amount or stopping the medication completely. Some anti-seizure medications carry the risk of possible side effects. While most of these are relatively mild, it is important to let your doctor know right away if you notice changes to your mood or behavior or experience a rash. 

Surgery

When medication doesn't do the trick, surgery is another option. Surgery is often considered when the condition originates in a small, localized area of the brain. It is also important that the affected area does not impact important functions like speech or hearing. In these cases, the doctor can remove a small portion of the brain that is responsible for the seizures. If the area cannot be removed completely, the doctor can also make a series of cuts in the area to prevent seizures from spreading. After surgery, many patients are able to cut the dosing on their medications or stop taking them altogether. 

Alternative Therapies

Some epileptic patients also find that alternative therapies help control symptoms. This might include a ketogenic diet that is high in fat and low in carbohydrates. A ketogenic diet may be especially helpful for children diagnosed with epilepsy. Getting plenty of sleep is another important factor, since sleep deprivation is a known trigger for seizures.

 

Epilepsy is a serious condition, but there are solutions available. If you have experienced a seizure of any kind, it is important to see a doctor as soon as possible. While he may not pursue an epilepsy diagnosis until a second seizure occurs, he will be able to monitor your condition in the meantime. Once your doctor diagnoses epilepsy, the two of you can work together to find the most effective epilepsy treatments for your individual needs.

 

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