Chủ Nhật, 12 tháng 1, 2014

Epilepsy

Epilepsy Epilepsy is a neurological disorder that causes a seizure due to abnormal nerve cell activity in the brain. The individual will experience peculiar sensations and abnormal symptoms during seizure and sometime he/she may lose consciousness. The symptoms of epilepsy vary from one person to the other. Epilepsy is a common disorder around the world and 1 out of 100 people may have a seizure at some point of his life. This disorder can be controlled by proper medications. Seizure is caused due to abnormal electrical activity in the brain is a clear symptom of epilepsy. Epilepsy is a group of disorders marked by recurrent seizures.


Symptoms :


Symptoms of seizure disorder vary from one individual to the other. Some of the signs of seizure are jerky movements of arms and legs (uncontrollable), confusion of thoughts, staring spell, loss of consciousness (temporary), and strange psychic symptoms. Epileptic seizures will have the same symptoms all the time unlike induced or psychological fit.


Types :


Non epileptic seizure will have the same symptoms of seizures but it is caused by psychological problems like emotional issues or stress. It can be managed by psychiatric drugs. Provoked seizure is a single episode of seizure induced by trauma or low blood sugar or low sodium or high fever or alcohol usage. Some children will have febrile seizures which they would overcome as they grow. In medical terms seizures are either classified as generalized or focal.


Focal seizures occur due to abnormal activity at some point of the brain and hence they are called as focused seizures. It can be simple focal seizure (marked by changing emotions and sensory perceptions) and dyscognitive focal seizure which is marked by loss of consciousness for some time. Generalized seizures is one in which all areas of the brain are affected.


Based on the symptoms they produce, generalized seizures are divided into 6 types :



  • Absence seizure in which there is no jerk movement but the person will stare or blink for few seconds.

  • Tonic seizure is one that causes muscle stiffness affecting the muscles of arms, legs and your back.

  • Clonic seizure is characterized by jerking movements of the muscle of the face, arms, legs and neck.

  • Myoclonic seizure is marked by sudden twitches of arms and legs.

  • Atonic seizure makes the person to fall down due to loss of muscle control.

  • Tonic- Clonic seizure is known as grand mal seizure which is marked by stiffening of body muscles, shaking of body, loss of consciousness and loss of bladder control.


Causes :


Epilepsy or seizure occurs due to abnormal electrical activity in the brain. When the electric signals transmitted by the brain become erratic they create a typical “electrical storm” leading to seizure. Several factors can trigger epilepsy and for many people it can occur due to combination of one or more factors. Genetics can play a vital role in causing epilepsy since the seizure disorder run in families in many cases.


Trauma or injury on the head in childhood can cause seizure. Any type of brain injury or brain tumors can trigger epilepsy. Stroke is one of the major causes for epilepsy in adults. Certain infectious diseases like AIDS or meningitis may cause seizure. Any type of prenatal injury caused to the baby can damage its brain leading to epilepsy. Certain kinds of developmental disorders like autism may induce epilepsy. Certain diseases like dementia can trigger epilepsy in older adults.


Complications :


Having an episode of seizure is not dangerous on its own, but it can cause serious injury if you are driving. You may fall down breaking a bone or cause head injury. People with epilepsy are likely to get drowned while swimming and hence they should avoid swimming alone.


Pregnant women with seizure episode can cause danger to the baby which can develop defects due to the heavy medications. Many people with seizure have increased risk of developing psychological problems like depression or anxiety. Finally in rare cases epilepsy can cause sudden death termed as SUDEP (sudden unexplained death in epilepsy).


Diagnoses :


The doctor will check the symptoms to find out the type of epilepsy you have. He may conduct neurological examination for testing the motor abilities and your mental function. EEG is the major test used for detecting epilepsy which records the sudden outburst of electrical activity in the brain. For some people CT or MRI scan is taken for detecting any abnormalities in the brain. In some cases, SPECT or PET scans are taken for ruling out any anomaly in the brain.


Treatment :


Most of the epilepsy can be managed by medications. Anti epileptic drugs are highly useful in managing the intensity of seizure episodes. If you are not having a single episode for more than 2 years, you can discontinue the medication for the rest of the life. Finding the right set of medications is a complex task. The doctor has to analyze the age of the person, his health condition, and type of seizure before prescribing the drug.


Some of the side effects of anti epileptic medications are dizziness, fatigue, weight gain, rash, reduced bone density, memory and cognitive problems, slurred speech and poor concentration. But not all the people who are taking medications will have the negative effects. Make sure that you are taking the exact medications as prescribed by your doctor and don’t stop the medication suddenly. In case of any emotional changes or new feelings of depression, you need to visit your doctor. This drug can create abnormal mood changes in many people.


Surgery is done only when the root cause of epilepsy is tumor or any infection in the brain. If the origin of seizure is from that part of the brain that is meant for speech, hearing and other motor functions then you may be kept awake for half of surgery so that your surgeon will closely monitor any changes. Sometimes you have to continue taking drugs even after surgery.


Alternative Treatment :


Vagus nerve stimulation : In this method, a small device will be implanted in the chest area which sends electrical energy to counteract with the sudden electrical waves sent from the brain.


Ketogenic Diet : A diet rich in fats is recommended which in turn breaks down the fat for generating energy which in turn will reduce the intensity of seizure.


Lifestyle Changes :


Without consulting your doctor, do not self medicate for treating seizure. You should sleep well and eat a healthy balanced diet. Wear a bracelet or medical card to know that you are prone to seizure so that you can be taken to the clinic in case of emergency.


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