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Epilepsy is a disorder that occurs in the central nervous system. This is considered a neurological disorder, in which nerve cell activity the brain becomes disrupted. This disruption causes seizures or periods of unusual behavior. A person may also feel abnormal sensations and sometimes loose consciousness.
Symptoms of a seizure can vary quite significantly. Some individuals with epilepsy may stare blankly for a few seconds during the time a seizure is under way. Other people may have their arms and/or legs jerk repeatedly.
Nearly 1 in 6 individuals in the United suffers from a seizure disorder. Almost ten percent of individuals may have a single unprovoked seizure. Although, having a single seizure does not indicate that you have epilepsy. At least two unprovoked seizures are typically required for an epilepsy diagnosis.
With mild seizures, treatment may be required due to the risk and danger these seizures were to occur during an activity such as driving or swimming. Treatment with medications or surgery may sometimes control seizures for around 80 of people suffering from epilepsy. Some children with epilepsy may outgrow the condition over time as they age.
Since abnormal activity within the brain cells causes epilepsy, seizures are an output of the activity. Signs and symptoms of seizures may include the following:
- A period when a person stares
- Loss of consciousness or awareness
- Temporary confusion
- Jerking movement of the arms and legs that are uncontrollable.
- Psychic symptoms
Symptoms can vary depending on the type of seizure someone has. In the majority of the circumstances, a person with epilepsy will tend to have the same type of seizure for each episode, so that the symptoms will be similar every time.
Doctors commonly classify seizures as either generalized or focal, based on how the abnormal brain activity starts.
When a seizure appears to result from abnormal activity in just one area of your brain, they are called focal (partial) seniors; These seizures fall into two categories.
Focal seizures without loss of consciousness (simple partial seizures). The seizures do not cause loss of consciousness. However, they may change emotions or modify the way things taste, feel, look, sound and smell. They may also cause in involuntary movements such as jerking of the leg and arm, and spontaneous sensory symptoms such as flashing lights, dizziness, and tingling
Focal dyscognitive seizures (complex partial seizures) These seizures involve a change of loss of consciousness or awareness. With a complex partial seizure, a person may stare into space and not respond to the environment, or do repetitive movements, such as hand rubbing, walking in circles and chewing,
Symptoms of focal seizure may not be apparent, when comparing to neurological disorders, such as narcolepsy, mental illness or migraine headaches. A comprehensive examination and test will be needed to identify, epilepsy from other disturbances.
Seizures that occur in all areas of the brain are referred to generalized seizures. Six types of generalized seizures are:
Absence seizures, which use to be called absence seizures, previously known as petit mal seizures, usually absence seizures occur in children and are characterized by staring into space or subtle body movements such as lip smacking and eye blinking. These seizures may occur in batches and cause a brief loss of awareness.
Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures commonly affect muscles in your back, arms, and legs and may cause you to fall to the ground.
Atonic seizures, are also know as drop seizure, they can cause loss of muscle control which causes a person to collapse suddenly or fall.
Clonic seizures, Clonic seizures are related to rhythmic or continual, jerking of muscle movements. These types of seizures commonly affect the face, neck and arms.
Myoclonic seizures usually appear as suspend brief jerks or twitches of your legs and arms.
Tonic-clonic seizures, called grand mal seizures in the past, are known as the most dramatic types of epileptic seizures, and can cause a sudden loss of consciousness, body stiffening and shaking, and may sometimes loss of bladder control or biting of biting your tongue.
When should you see the doctor
You should get immediate medical help if any of the followings occurs:
- The seizure last more than five minutes
- You have a very high fever
- You are pregnant
- You’ve injured yourself during the seizure
- You have diabetes
- You are experiencing heat exhaustion
- A second seizure follows immediately
If you experience a seizure for the first time, you seek medical advice.
What causes Epilepsy
Epilepsy has mo identifiable cause in about half of those with the condition. In the other condition may be traced to various factors.
Genetic influence. Some types of epilepsy, which are classified by the kind of seizure you have or the portion of the brain that is affected, run in families. In particular cases. It is likely that there’s a genetic influence.
Doctors have linked some types of epilepsy to specific genes, through it is estimated that up to 500 genes could be associated with epilepsy. For most people genes are not part of the cause of epilepsy. Specific genes may cause a person more to become susceptible to environmental conditions that trigger seizures.
Head trauma, Head trauma as a consequence of a car accident or other traumatic injury can cause epilepsy.
Brain conditions that trigger damage to the brain, such as tumors or strokes, can cause epilepsy, Strokes are the leading cause of epilepsy in adults older than age 35.
Infections disease infectious disease, such as meningitis AIDS and viral encephalitis, can cause epilepsy,
Prenatal injury – Before birth, babies are sensitive to brain damage that could be caused by several factors, poor nutrition or oxygen deficiencies such as an infection in the mother; The brain damage can result in employs or cerebral palsy.
Developmental disorders. Epilepsy can sometimes be related to developing ATL disorders, such as autism and neurofibromatosis.
Several factors may increase your risk of epilepsy
Family history – If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder.
Age, the onset of epilepsy, is most prevalent during early childhood and the age 60, but the condition can occur at any age.
Head injuries. Head injuries are responsible for some cause of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, ride a motorcycling or engage activists that a high risk of head injury
Stroke and other vascular diseases – Stroke and other blood vessel (vascular ) diseases can lead to brain damage, triggering epilepsy. You can take measures to reduce your risk of these diseases by limiting your consumption of alcohol;, not smoking, eating healthy and regular exercise.
Brain infections – such as meningitis can cause inflammation in the brain or spinal cord causing increased risk fo epilepsy.
Dementia can increase the risk of the disease in older individuals
Seizures that occur in childhood can increase the risk epilepsy. High fevers in childhood can be related to seizures. Children, who suffer from seizure from high fevers, normally will not develop epilepsy. However, the risk is greater if they have long seizures or other nervous system conditions, or have a family history of epilepsy.
Complications from having Epilepsy
Having seizures can lead to an increase in dangerous circumstances for yourself and others.
Falling – If you fall during a seizure can injury yourself, break a bone, injure your head.
Drawing If you have epilepsy, your likely of drowning while swimming, or bathing can increase by 15X to 19X compared to the rest of the general population because the likely hood of having a seizure while being in the water.
Automobile Accidents – A seizure that causes lose of senses and awareness or control over the body is primarily dangers when one is driving a car or operating other equipment.
Many states have driver’s license restrictions concerning your ability to control seizures and imposes a minimum of timeframe that you’ve been seizure-free, ranging from months to years, before you are allowed to operate a vehicle.
Complications during pregnancy – Seizures that occur during pregnancy pose a risk to the mother and the baby, and particular anti-epileptic medication can increase the possibility of birth defects. If you are considering having a child, you should talk to your doctor about the pregnancy,
Most women with epilepsy, who become pregnant, have healthy babies. You will need to be carefully monitored throughout the pregnancy, and medications you are taking will need to adjust. It is important to get guidance from your doctor.
Emotional health issues – People with epilepsy are more likely to have psychologic challenges, specific conditions like anxiety, depression, and extreme cases thoughts of suicide. Problems may be a result of dealing with the epilepsy itself as well as medication side effects.
There are also rare, life-threatening complications from epilepsy.
Status Epileptics, This condition occurs if that person is in a state of continuous seizure activity, lasting more than five minutes. Alternatively, if you have frequent recurrent seizures, without regaining full consciousness between them. People with status epileptics have an increased risk of permanent brain damage and death
Sudden unexplained death in epilepsy or (SUDEP), individuals with epilepsy also have a minor risk of sudden unexplained death. The cause is unknown. However, reach indicates may occur during to heart or respiratory conditions.
People with a recurrence of tonic-clonic seizures or with seizures that are not controlled by medication may be a higher risk of SUDP. Overall around one percent of people with an epilepsy die of SUDEP.
Diagnosing your condition requires the doctor to review your symptoms and medical history. You doctor may want you to have several test complete to diagnose epilepsy to determine the cause of seizures.
Neurological examination- Your physician may test your behavior along with you mental functions, motor abilities and other areas of diagnosing your donation. Then he/she will determine the type of epilepsy.
Blood test -You doctor may take a blood sample to check for sign of infections, genetic conditions or other condition that may be associated seizures.
There are several test that the doctor may suggest testing to detect brain abnormalities: Such as
Electroencephalogram (EEG). This is the most common test used to indicate and diagnose epilepsy. In this examination, doctors will connect electrodes to your scalp with a paste-like substance. The electrodes record the electrical active of your brain.
If you have epilepsy, it is common to have changes in your normal pattern of brain waves -even when you are not having a seizure. You, physician, may monitor your behavior on video while conducting an EEG while you are awake or asleep, to document any seizure you may experience. Documenting and recording the seizure may help your physician determine what type of seizure you are exhibiting or rule out other types of condition.
Your doctor may give you instructions to do something that causes seizures, such as getting little e sleep before the test.
Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal atonality in your brain that might cause your seizures such as bleeding, cyst, and tumors.
Magnetic Resonance Imaging (MRI). An MIR uses magnets and radio waves to create a very detailed view of the brain. Your physician may be able to detect abnormalities such as lesions in your brain that could be causing your seizures.
Functional MRI (fMRI). A functional MRI measures the shifts in blood flow that occurs when particular parts of your brain when they are working. Doctors may use an fMRI proceeding energy to identify the precise locations of significant functions such as speech and movement. This helps surgeons avoid injuring those places while operating.
Positron Emmons tomography (PET). PET scans use a small amount of low-dose radioactive material; that is injected into a view to assisting in visualize active areas of the brain and identify abnormalities.
SIngle-phone emission computerized tomography (SPECT) this type of test is usually done if an MRI and EEG was not able to determine the exact location in the brain where the seizures originated.
A SPECT test holds a tiny amount of low -dose radioactive material that’s injected into a view to creating a detailed, 3-D map of the blood flow activity in your brain during seizures.
Doctors may also conduct a form of a SPECT test called an (SISCOM subtraction Ictal PECT co-registered to renounce magnetic imaging, which can provide a significant more amount of details
Neuropsychological test. These test where the doctors look at your thinking motor skills, memory, speech skills. The test results will assist doctors in determining which areas of your brain are affected.
Doctors will begin treating epilepsy with medication. If medications do not treat the condition, doctors may propose surgery or another type of treatment.
Most people with epilepsy is can become free from seizures by taking one anti-seizure medication; these are called anti-epileptic medications. Others may be able to decrease the frequency and force of their seizures by taking a combination of medications. Your doctor will tell you the proper time that you can stop taking medications.
More than half the children with epilepsy, who are not is expiring epilepsy symptoms, can eventually discontinue medications and live a seizure-free life. Many adults also can stop medications after two or more years without seizures.
Finding the right medication and dosage can be difficult. You doctor will evaluate your condition, frequency of seizure, your age, and another factor when choosing which medications to prescribe. You doctor will also review any other medications you be prescribed, to ensure that your anti-epileptic medications will not interact with them.
Your doctor will likely only prescribe a single drug, at a relatively low dosage and may gradually increase the dosage until your seizures are under control.
However, anti-seizure medications may have some side effects. Mild side effects include;
- Weight gain
- Skin rashes
- Memory and thinking problems.
- Loss of coordination
- Speech problems
More severe but rare side effects include:
- Serious crashes
- Internal inflammation of certain organs, such as your liver
- Suicidal thought and behaviors
To accomplish the best seizure control possible with medication, follow these steps
- Take medications exactly as prescribed.
- You should always call your doctor before changing your medication to a generic version of your medication or taking other prescription medications. Even over counter drugs or herbal medications should be evaluated.
- Do not stop taking your medicine without talking your doctor.
- You should notify your doctor if you notice newly or increased feeling of depression suicidal thoughts or unusual changes in your behavior or mood.
- Notify your physician if you have machines. You doctor may be able to prescribe an antiepileptic medication that prevents you from suffering from migraines as well as treat epilepsy.
About half of the individuals who receive the initial diagnoses of epilepsy will become seizure-free with their first medication. If anti-epileptic medication does not provide effective results, you doctor may recommend other therapies or surgery. You will have to follow-up regularly with your doctor to evaluate your doctor and medications.
Surgery is most commonly conducted after test show that your seizures begin in a little, well-defined area of your brain that does not affect vital capacities such as speech, language, motor function, vision or hearing, In surgery, your doctor removes the area of your brain that is causing the textures.
If your seizure originates in the area of the brain that controls movement, speech other functions, you can be wake during part of the surgery. Doctors will monitor you and ask you questions during the procedure.
If your secure originate in a part of the brain that can not be removed, your physician may recommend a different type of surgery in which surgeons make several incisions into the brain (multiple subpial transections). These incisions are designed to prevent seizures from spreading to other parts of your brain.
Although many people continue to need some drugs to help block seizures after successful surgery, you may be able to take fewer drugs and replace your dosages.
In a small number of cases, surgery for epilepsy can trigger difficulties such as permanently changing your thoughts (cognitive abilities). Discuss with your surgeon his/her experience, rates of success and complication rates with the medical procedure you are considering.
Vagus nerve stimulation. In vagus nerve stimulation surgeons implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck.
This is a battery-powered medical device sends discharge of electrical pulse through the vagus nerve and to your brain. It is not clear how this inhibits seizures, but the device can usually reduce seizures by w0 to 50 percent.
The majority of individuals, who have surgery, still need to take anti-epileptic medication, although some people may be able to lower their drug dosage. You may experience side effects from vagus nerve stimulation, such hoarse voice, throat pain, shortness of breath or coughing.
Ketogenic diet – Some children with epilepsy have been able to reduce their seizures by observing a stringent diet that’s high in fats and low in carbohydrates.
In this diet, called a ketogenic diet, the body break down fats instead of carbohydrates for energy, after a few years, some children may be able to stop the ketogenic diet and remain seizure-free.
Consult a doctor if your child is considering a ketogenic diet. It is critical to making sure your child does not become malnourished due to the diet.
The side effects of ketogenic diet may be dehydration slowed growth because of nutritional deficiencies and buildup or uric acid in the blood, which tends to cause kidney stones. These side effects are not common if the diet is supervised by a medical professional.
Future Epilepsy Treatment
Doctors are researching deep brain stimulation as a potential treatment for epilepsy. Deep brain situations are done through surgeons implanting an electrode into specifying part of your brain. The electrodes are attached to a generate embedded in your chest or the skull and sends electrical pulses to your brain and can reduce your seizures.
Pacemakers which are implantable help prevent seizures are still being researched. These responsive stimulation devices evaluate brain activity patterns to identify seizures before they occur and deliver an electrical charge or drug to stop the seizure.
Also, new minimally invasive surgical techniques such as MIR guided laser ablation show some evidence of reading seizures and cause fewer risk than traditional brain surgery for epilepsy.
Researchers are also studying stereotactic radiosurgery, in which doctors direct radiation into a particular area of the brain that is causing a seizure.