Epilepsy (Seizure Disorder): Symptoms, Causes, Diagnosis & Treatment

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Epilepsy (Seizure Disorder): Symptoms, Causes, Diagnosis & Treatment

Epilepsy is an assortment of different types of seizures and syndrome mechanisms that share sudden, excessive, and synchronous discharge of cerebral neurons, in common. This abnormal electrical activity may result in loss of consciousness, abnormal movements, atypical behavior, or distorted perceptions that are of limited duration but reoccur if untreated.

The site of origin of the abnormal neuronal activity determines the symptoms that are produced. For example, if the motor cortex is involved, the patient may experience abnormal movements or a generalized convulsion, whereas seizures originating in the parietal or occipital lobe may include visual, auditory, or olfactory hallucinations.

Epilepsy is characterized by recurrent seizures. Most of the cases of epilepsy are idiopathic, some may be secondary to trauma or surgery on the head, intracranial tumor, tuberculoma, cysticercosis, cerebral ischemia etc. Drug or vagal nerve stimulator therapy is the most widely effective mode for the treatment of patients with epilepsy. It is expected that seizures can be controlled completely in approximately 70 to 80 percent of patients with one medication.

This disorder affects approximately 3 percent of individuals by the time they are 80 years old, and about 10 percent of the population will have at least one seizure in their lifetime.

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How Does Epilepsy Affect Your Body?

Epilepsy is a brain disorder, because of which its main effect is seen in the central nervous system causing symptoms like nausea, sweating, loss of consciousness, and lack of awareness. Epileptic seizures also cause trouble with breathing; sometimes patients choke because of troubled breathing. A tonic seizure will also cause the person’s muscles to lock up in a rigid position during the seizure, while someone who suffers from an atonic seizure will have the opposite problem. This seizure disorder, however, does not directly affect the reproductive system; it can affect those who are pregnant. Women who have epilepsy and are also pregnant tend to have a higher number of seizures during pregnancy.

What Are The Causes of Epilepsy?

Many times epilepsy has no common cause of occurring, while sometimes the following causes are responsible for it:

  • Genetic – Epilepsy which is categorized by the type of seizure one experiences, or the part of the brain that is affected, runs in families.
  • Genes – There are certain genes which may make a person more sensitive to environmental conditions that trigger seizures.
  • Head trauma – Head trauma as a result of a car accident or other traumatic injury can also cause seizures.
  • Rain abnormalities – Brain tumors or strokes, can cause epilepsy as these conditions or abnormalities damage the brain.
  • Infectious diseases – Meningitis, AIDS and viral encephalitis can cause epilepsy.
  • Prenatal injury – When in the womb, babies are sensitive to brain damage that could be caused by several factors and can result in epilepsy or cerebral palsy.
  • Developmental disorders – Epilepsy is sometimes associated with developmental disorders like autism and neurofibromatosis.
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What Are The Risk Factors of Epilepsy?

  • Age – Epilepsy is most common in children and older adults. However, it can occur at any age.
  • Family history – Family history of epilepsy may increase the risk of developing a seizure disorder.
  • Head injuries – Head injuries possess a risk of epilepsy.
  • Stroke and other vascular diseases – These can lead to brain damage that may trigger seizures.
  • Dementia – Dementia increases the risk of epilepsy in older adults.
  • Brain infections – Infections like meningitis can cause inflammation in the brain or spinal cord, which can increase the risk.
  • Seizures in childhood – High fever earlier in childhood can sometimes be associated with seizures. The risk of seizures increases if the child experienced a long seizure in the past, has a nervous system condition or a family history of epilepsy.
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What Are The Symptoms of Epilepsy?

Symptoms may vary depending on the type of seizure, whereas sometimes people tend to have the same type of seizure each time. Thus, the symptoms will be similar from episode to episode.

Generally, seizures are classified as either focal or generalized, based on how the abnormal brain activity begins:

  • Focal seizures without loss of consciousness – These seizures include symptoms like altered emotions or change in the way things look, smell, feel, taste or sound, involuntary jerking of a body part and spontaneous sensory symptoms such as tingling, dizziness and flashing lights.
  • Focal seizures with impaired awareness – These seizures cause symptoms like change or loss of consciousness or awareness, staring into space and not responding normally to the surrounding environment or performing repetitive movements.
  • Absence seizures – These often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking.
  • Tonic seizures – This type of seizure causes stiffening of muscles and affects the muscles in back, arms and legs.
  • Atonic seizures – Atonic seizures cause a loss of muscle control, which may cause a sudden collapse or fall down.
  • Clonic seizures – These seizures cause repeated or rhythmic, jerking muscle movements.
  • Myoclonic seizures – These seizures are characterized by sudden brief jerks or twitches of arms and legs.
  • Tonic-clonic seizures – They cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or tongue biting.
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How is Epilepsy Diagnosed?

  • Neurological exam – This examination is conducted to test behavior, motor abilities, mental function and other areas which help in determining the type of epilepsy one may have.
  • Blood tests – A blood test is done to check for signs of infections, genetic conditions or any other conditions that may be associated with seizures.
  • Electroencephalogram (EEG) – In this test, electrodes are attached to the scalp with a paste-like substance and records the electrical activity of the brain. A doctor may monitor the patient on video while conducting an EEG, to record any seizures that are experienced by the latter. Recording the seizures may help in determining the kind of seizures one may have and also helps to rule out other conditions.
  • High-density EEG – High-density EEG helps in determining which area of the brain is affected by seizures.
  • Computerized tomography (CT) scan – A CT scan uses X-rays to obtain cross-sectional images of the brain and can reveal abnormalities that might be causing seizures, such as tumors, bleeding, and cysts.
  • Magnetic resonance imaging (MRI) – An MRI uses powerful magnets and radio waves to create a detailed view of the brain which helps in detecting lesions or abnormalities in the brain that could be responsible for causing seizures.
  • Functional MRI (fMRI) – A functional MRI measures the changes in blood flow that occur when specific parts of the brain are working to identify the exact locations of critical functions so that the surgeon can avoid injuring those places while operating.
  • Positron emission tomography (PET) – It uses a small amount of low-dose radioactive material that’s injected into a vein to help visualize active areas of the brain and detect abnormalities.
  • Statistical parametric mapping (SPM) – SPM is a method of comparing areas of the brain that have increased metabolism (during seizures) to the normal state of the brain, which can give an idea of where seizures begin.
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How to Prevent And Control Epilepsy?

  • Ride safely – Use safety belts and motorcycle helmets to reduce motor vehicle and traffic injuries.
  • Step carefully – Older adults and children have an increased chance of brain injuries from falls.
  • Exercise regularly and eat healthy – To prevent the chances of stroke.
  • Avoid alcohol and smoking cigarettes.

Treatment of Epilepsy – Allopathic Treatment

When medications fail to provide adequate control over seizures, epilepsy surgery is recommended, in which a surgeon removes the area of the brain that causes seizures.

It may take time before the best drug and dosage is determined for an epileptic patient. The following medications are used to treat the symptoms:

  • Carbamazepine (Carbatrol or Tegretol) – For partial, generalized tonic-clonic and mixed seizures.
  • Diazepam (Valium ), lorazepam (Ativan) and similar tranquilizers such as clonazepam (Klonopin) – Effective in the short-term treatment of all seizures, particularly status epilepticus.
  • Eslicarbazepine (Aptiom) – Once-a-day medication used alone or in combination with other anti-seizure drugs to treat partial-onset seizures.
  • Ethosuximide (Zarontin) – Used to treat absence seizures.
  • Felbamate (Felbatol) – Treats partial seizures alone; used rarely and only when no other medications have been effective.
  • Lamotrigine (Lamictal) – Treats partial, generalized and mixed seizures.
  • Levetiracetam (Keppra) – Treats partial seizures, primary generalized seizures, and myoclonic (shock-like jerks of muscle) seizures.
  • Perampanel (Fycompa) – Used to treat partial onset seizures and primary generalized tonic-clonic seizures.
  • Pregabalin (Lyrica) – Treats partial seizures, but is used more often to treat neuropathic pain.
  • Topiramate (Topamax) – A combination drug used to treat partial or generalized tonic-clonic seizures.
  • Phenobarbitol – It is the oldest epilepsy medicine and is used to treat most forms of seizures. It is known for its effectiveness.
  • Phenytoin (Dilantin) – Controls partial seizures and generalized tonic-clonic seizures.
  • Valproate, valproic acid (Depakene, Depakote) – Used to treat partial, absence, and generalized tonic-clonic seizures.
  • Zonisamide (Zonegran) – Used with other drugs to treat partial, generalized and myoclonic seizures.
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Treatment of Epilepsy – Homeopathic Treatment

  • Cicuta – It is very effective when used to treat cases of epilepsy where convulsions are marked by violent, body distortions.
  • Artemisia Vulgaris – It is used to treat cases of Petit Mal Epilepsy, which are characterized by staring into space, leaning forward or backward and stopping a sentence abruptly.
  • Stramonium – It is used to treat convulsions triggered by exposure to bright lights or shiny objects.
  • Cuprum Met – This is used to treat seizures that are preceded by experiencing an aura in the knees.
  • Bufo Rana – It treats attacks that occur during sleep. Such epileptic attacks are accompanied by experiencing an aura in the genital regions and is especially helpful for women who experience seizures during menstruation.
  • Hyoscyamus – Some epileptic fits are followed by a deep sleep which can be treated with Hyoscyamus.
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Epilepsy – Lifestyle Tips

  • Take your medication as prescribed regularly.
  • Sleep for the recommended duration as lack of sleep can trigger seizures.
  • Wear a medical alert bracelet.
  • Exercise and drink water regularly.
  • Avoid consumption of alcohol and don’t smoke.
  • Follow a healthy nutritional diet.

What Are The Recommended Exercises For a Person With Epilepsy?

The following exercises are recommended for a person with Epilepsy:

  • Walking
  • Running
  • Swimming
  • Cycling

Epilepsy & Pregnancy – Things to Know

  • Epilepsy during pregnancy is quite challenging because a number of commonly used anticonvulsants are known teratogens, which pose a risk to the fetus, especially when consumed during the first trimester.
  • Seizures in pregnancy are also quite dangerous to the fetus so there is a delicate risk-benefit assessment that physicians must evaluate.
  • Anticonvulsant medications increase liver metabolism and may impact folic acid metabolism. Folic acid is necessary to lower the risk of neural tube defects associated with low folic acid.

Common Complications Related to Epilepsy

  • Falling; can injure head or break a bone
  • Drowning while swimming or bathing
  • Car accidents, either due to loss of awareness or control
  • Pregnancy complications
  • Depression, anxiety and suicidal thoughts and behavior
  • Status epilepticus; occurs if in a state of continuous seizure lasting more than five minutes
  • Sudden unexpected death in epilepsy

FAQs

Q. What do I do if someone is having a seizure?

A. Stay calm and keep the person safe until they are fully aware. You can also note the time duration of the seizure.

Q. How does someone get epilepsy?

A. Epilepsy is not contagious. Most of the times, the reason is unknown and thus is called idiopathic epilepsy. However, in some cases, factors like genetics can play a part.

Q. What is an aura?

A. An aura is a partial seizure that happens before a generalized seizure. Usually, people who have auras do not lose consciousness.

Q. What’s the difference between seizures and epilepsy?

A. A seizure is a brief disruption in normal brain activity that interferes with brain function, while epilepsy is a brain disorder associated with an increased susceptibility to seizures.

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