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EPILEPSy

What is Epilepsy?

  • Definition of epilepsy:

A disease of the brain that can cause a person to become repeatedly unconscious / unresponsive to external stimuli. (Sometimes with violent movements that he/she cannot control)

  • what is seizure :

A seizure is a single occurrence of abnormal unconscious / unresponsive episode.

  • Types of epilepsy:

There are many types of seizures.  A person with epilepsy can have more than one type of seizure.

Major Types of Seizures

  • Seizures are classified into two groups.

    1. Generalized seizures affect both sides of the brain.
    • Absence seizures usually seen in children. It is also called as petit mal seizures, can cause rapid blinking or a few seconds of staring into space.
    • Tonic- clonic seizures, also called grand mal seizures, can make a person
      • Cry out.
      • Lose consciousness.
      • Fall to the ground.
      • Have muscle jerks or spasms.

    The person may feel tired after a tonic-clonic seizure.

    1. Focal seizures are located in just one area of the brain. These seizures are also called partial seizures.
    • Simple focal seizuresaffect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell.
    • Complex focal seizurescan make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes.
    • Secondary generalized seizuresbegin in one part of the brain, but then spread to both sides of the brain.

    Seizures may last as long as a few minutes. Any seizure persisting more than 15 min is called as status epileptics. And it requires urgent medical attention in hospital.

How to define an episode of seizure or epilepsy: The signs of a seizure depend on the type of seizure.

Sometimes it is hard to tell when a person is having a seizure.

A person having a seizure may seem confused or look like they are staring at something that isn’t there.

 Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.

These words are used to describe generalized seizures:

  • Tonic: Muscles in the body become stiff.
  • Atonic: Muscles in the body relax.
  • Myoclonic: Short jerking in parts of the body.
  • Clonic: Periods of shaking or jerking parts on the body.

When to reach to medical attention to neurologist:

  • The person has never had a seizure before.
  • The person has difficulty breathing or waking after the seizure.
  • The seizure lasts longer than 5 minutes.
  • The person has another seizure soon after the first one.
  • The person is hurt during the seizure.
  • The seizure happens in water.
  • The person has a health condition like diabetes, heart disease, or is pregnant.

First Aid in emergency:

These are general steps to help someone who is having any type seizure:

  • Stay with the person until the seizure ends and he or she is fully awake. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
  • Comfort the person and speak calmly.
  • Check to see if the person is wearing a medical bracelet or other emergency information.
  • Ease the person to the floor.
  • Turn the person gently onto one side. This will help the person breathe.
  • Clear the area around the person of anything hard or sharp. This can prevent injury.
  • Put something soft and flat, like a folded jacket, under his or her head.
  • Remove eyeglasses.
  • Loosen ties or anything around the neck that may make it hard to breathe.
  • Time the seizure.

Never do any of the following things

  • Do not hold the person down or try to stop his or her movements.
  • Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
  • Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.
  • Do not offer the person water or food until he or she is fully alert.

Instruction to patients on treatment:

  1. Patient should always keep the stock of medicines and carry them with us when we go outstation.
  2. Patient should have regular follow up with doctors for medical guidelines and detection of side effects of the medicines if there are any.
  3. Patient should live normal and maintain regular life style i.e. to have regular hours of sleep and have regular time for meals.
  4. Any epilepsy patient on treatment should never fast.
  5. Patient should not feel inferior and depressed but learn to live with it and learn to cope with the stresses if there are any.
  6. Patient should try themselves to be as independent as possible in all aspects and not use “Epilepsy” as an excuse for sympathy for others.
  7. REGULARITY of the treatment is the KEY to better control of seizures and ultimately better quality of life.
  8. It is good to keep record of all attacks and daily medicine intake in an organised format.
  1. The organised approach would serve three purposes.
  2. We can tell our doctor confidently about our regularity and frequency of the attacks.
  3. Doctor can understand our illness better and that will help him to adjust our dosage schedule properly.
  • Side effects of the medicines if any can be deteceted earlier from our notes.

Some Frequently asked question:

Which tests are performed usually on epilepsy patient:

  1. CBC LFT RFT to look for any adverse side effects of any antiepileptic drug.
  2. EEG to see electrical activity of brain on regular basis/ emergency basis.
  3. MRI Brain to look for the cause of seizure like tumor / scar/ previous stroke.

Can we do Surgery for epilepsy patients? And who does this surgery?

Yes. Trained neurosurgeon can do this surgery.

In very less percentage of patients have any mass/ tumor/ developmental defect that can treated with surgery.

Oblique view of male head showing electrode placement on the scalp for an EEG

Investigations:

An electroencephalogram (EEG) is a test that detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp. Your brain cells communicate via electrical impulses and are active all the time, even when you’re asleep. This activity shows up as wavy lines on an EEG recording.

An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in diagnosing other brain disorders.

 

 

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