Epilepsy – Causes, Symptoms, Diagnosis, Treatment, and Medication
Epilepsy is a chronic disorder that causes persistent seizures without any provocation; a neurological disorder affecting around 65 million people throughout the globe. While anyone may develop epilepsy, young children and older adults are more at risk.
It has also been seen that epilepsy occurs slightly more in men than in women. A seizure is an abrupt surge of electrical activity in the brain. There exist 2 types of seizures, namely generalized and focal or partial seizures. While generalized seizures affect the whole brain, partial seizures affect only a part of the brain.
A mild seizure may be difficult to recognize; it may last only a few seconds, during which a person will have no awareness. Stronger seizures may cause spasms and uncontrollable muscle twitches. These may last from a few seconds to several minutes; the sufferer may lose consciousness or become confused during this time.
Several reasons that may cause seizures are as follows:
- High fever
- Head trauma
- Low blood sugar
- Alcohol withdrawal
Even though there is no definite cure for epilepsy, the disorder may be managed with medications and other medical interventions.
Doctors at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad are always ready to provide you with all the essential information you may need regarding various health concerns.
Symptoms/types of epilepsy
The major symptom of epilepsy is a seizure. However, the symptoms may vary from person to person, depending upon the type of seizure.
While the loss of consciousness does not occur in a simple partial seizure, some of the symptoms that may occur are as follows:
- Change in the sense of taste, smell, hearing, sight, or touch
- Twitching of limbs
However, complex partial seizures may involve loss of consciousness and other symptoms as well such as:
- Perform similar movements repeatedly
- Staring blankly
- Absence seizures, also known as “petit mal seizures”, may cause a blank stare and repetitive movements such as blinking or lip-smacking with a short loss of awareness.
- Tonic seizures may have symptoms such as muscle stiffness.
- Atonic seizures may have symptoms such as loss of muscle control. Consequently, a person may also fall suddenly because of a seizure.
- Clonic seizures may have symptoms such as persistent, jerky movements of the muscles of the face, neck, and arms.
- Myoclonic seizures may cause quick twitching of arms & legs.
- Grand mal seizures, also known as tonic-clonic seizures, may have symptoms such as:
- Stiffening of the body
- Loss of bowel control or bladder
- Loss of consciousness
- Biting of the tongue
You may not remember having a seizure or you may also feel ill for a few hours following a seizure.
What triggers an epileptic seizure?
Some of the most common situations or things that may trigger seizures are as follows:
- Lack of sleep
- Bright or flashing lights & patterns
- Alcohol, caffeine, medicine, or drugs
- Overeating, skipping meals, or specific food ingredients
It is very difficult to identify triggers as a single incident does not always imply that seizures may occur; a combination of factors may cause a seizure to trigger.
Is epilepsy hereditary?
- Around 500 genes are related to epilepsy. A natural seizure threshold may also be provided by genetics. You are more likely to have seizure triggers if you inherit a low seizure threshold. A higher threshold means that you are less vulnerable to seizures.
- The risk of inheriting epilepsy is low. Most children do not have epilepsy even if their parents have epilepsy.
- The risk of having epilepsy by the age of 20 is around 1% which increases to 2-5% if the parent has epilepsy due to a genetic cause. In addition, if your parent has epilepsy due to some other cause, your chances of developing epilepsy do not increase.
- Tuberous sclerosis and neurofibromatosis are a few rare conditions that may cause seizures, being hereditary.
- Epilepsy does not impact your ability to have children but certain medications may affect your unborn baby. Don’t stop taking your medications during pregnancy and consult your doctor before getting pregnant or as soon as you become aware of your pregnancy.
Causes of epilepsy
Seizures can be caused by a variety of factors; it is difficult to determine the causes. However, some of the possible causes may include:
- Serious illness
- Brain tumour or cyst
- Traumatic brain injury
- Alzheimer’s disease or dementia
- Lack of oxygen supply to the brain
- Infectious diseases such as AIDS/meningitis
- Stroke, especially in people above 35 years of age
- Genetic, neurological, or developmental disorders
- Prenatal injury, lack of oxygen at birth, or brain malformation
- Post-traumatic epilepsy or scarring on the brain after a brain injury
Diagnostic procedures for epilepsy
Doctors at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad, always advise people to consult a doctor if a seizure is suspected. This can be a symptom of a serious medical issue.
Doctors may also ask about the patient’s medical history and symptoms to determine tests that may be helpful in diagnosis. Likewise, a neurological examination may be conducted to test motor abilities and mental functioning.
The following tests may be recommended to determine:
- Any signs of infectious disease
- Liver & kidney function
- Level of glucose in the blood
Electroencephalogram (EEG) is a non-invasive and painless test that is generally used to diagnose epilepsy.
Electrodes are attached to the scalp with the help of a paste. This test may require patients to complete a task. EEG may also be performed while the patient is sleeping. The electrical activity of the brain will be recorded by electrodes. Doctors may also perform certain imaging tests that may help reveal tumours and other abnormalities responsible for seizures.
These imaging tests may include:
- CT scan
- MRI scan
- PET scan
- Single-photon emission computerized Tomography (SPECT) scan
Types of treatment:
Doctors at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad are well experienced. They diagnose and provide appropriate treatment based on the severity of symptoms and the patient’s health.
Anti-epileptic (anticonvulsant and antiseizure) drugs:
These medications help in reducing the number of seizures you may have; in some cases, they may also help in eliminating seizures. You must follow the instructions given by your doctor while taking this medicine.
Vagus nerve stimulator:
This is a device used to electrically stimulate the nerve that runs through the neck, thus helping prevent seizures. The device is placed under the skin on the chest through surgery.
People who do not respond to medication may benefit from this diet high in healthy fats and low in carbohydrates.
In this, the part of the brain that causes seizure activity may be removed or changed.
Doctors are still researching new treatments for epilepsy; deep brain stimulation is one of the treatments that may be used in the future.
In this, electrodes are placed in the brain and a generator is implanted in the chest. Using a generator reduces seizures by sending electrical impulses to the brain. It is currently under investigation for radiosurgery and minimally invasive surgery.
Medications for epilepsy
Anti-seizure medication helps in reducing the severity and frequency of seizures. However, these drugs are not a cure for epilepsy and they even cannot stop a seizure that is already in progress.
These drugs are absorbed by the stomach from where they travel through the bloodstream to the brain. They affect neurotransmitters thus helping in reducing the electrical activity that causes seizures.
Doctors may recommend a single drug or a combination of these drugs based on the type of seizure you may have. Some of the common medications for epilepsy include:
- Levetiracetam or Keppra
- Topiramate or Topamax
- Valproic Acid or Depakote
- Carbamazepine or Tegretol
- Ethosuximide or Zarontin
- Lamotrigine or Lamictal
These medications are available in tablet, liquid, or injectable forms. One must take a proper consultation with a doctor before taking these medications. The potential side effects that may occur from these medications include:
- Skin rash
- Poor coordination
- Memory issues
In rare cases, depression and inflammation of the liver or other organs may also occur.
Is surgery helpful in treating epilepsy?
Surgery may be preferred by doctors if medications do not help in decreasing the number of seizures.
- Resection is the most common surgery that is performed. Under the procedure, a part of the brain where seizures start is removed.
- Temporal lobectomy is another procedure in which the temporal lobe is removed. Doctors may ask you to be awake during surgery. This ensures that they do not remove any area of the brain that controls essential functions like hearing, vision, speech, or movement.
- Doctors use multiple subpial transections or disconnections when large or significant parts of the brain must be removed.
In this, to keep seizures from travelling to other parts of the brain, doctors make cuts in the brain to hinder the nerve pathway.
Surgery may cause anaesthesia, bleeding, and infection, and sometimes cognitive changes may also develop. Before undergoing any of these surgeries, consult your doctor so that you are aware of all possible risks.
What are the dietary recommendations for people with epilepsy?
- Ketogenic diets, low in carbohydrates and high in fats, are generally recommended for children with epilepsy. This diet compels the body to use fat for energy rather than glucose, a process that is known as ketosis. Children following this diet should be monitored by a doctor. The ketogenic diet helps in reducing the frequency of seizures; however, it may not benefit everyone and works better for particular types of epilepsy as compared to others.
- A modified Atkins diet may be suggested for adolescents and adults with epilepsy. This is also a diet that controls the intake of carbohydrates and is high in fat. These diets though helpful for keeping epilepsy in check may cause constipation because of low fiber and high fat
What is the connection between epilepsy & behaviour?
Children with epilepsy may have learning and behavioural issues compared to those who do not have epilepsy. It has been seen that around 15-35% of children with intellectual disabilities also suffer from epilepsy. Certain people may experience a change in their behavior in the minutes or hours before a seizure.
This can be seen as abnormal brain activity caused before a seizure and may include:
Most children adapt over time to the uncertainties they may experience due to epilepsy. However, social dysfunction may continue into adulthood. 30-70% of people with epilepsy also suffer from anxiety, depression, or both.
Keeping all this in mind, it is imperative to discuss behavioural problems with your doctor. Individual or family therapy, or certain groups may provide you with care and support.
What to expect when living with epilepsy?
Many parts of your life may be affected by epilepsy as it is a chronic disorder. Laws differ from state to state, but you may not be allowed to drive if your seizures are not controlled.
Many activities, such as crossing a street may become dangerous as seizures may occur anywhere and anytime when you have epilepsy.
Some of the other complications that may arise due to epilepsy include:
- Risk of permanent damage or death due to severe seizures lasting for more than 5 minutes (status epilepticus).
- Risk of seizures occurring again without regaining consciousness in between (status epileptic)
- Sudden unexplained death in epilepsy (it occurs in about 1% of people with epilepsy)
Some of the steps to be followed to cope with epilepsy include:
- To identify possible triggers, keep a seizure diary
- Teach people close to you about seizures and what they should do in case of an emergency.
- Be a part of a support group for people with seizure disorders
- Consult a doctor if you have symptoms of anxiety or depression
What is the cure for epilepsy?
Although there is no cure for epilepsy, treatment may make a significant difference. Uncontrolled seizures may lead to brain damage and even raise the risk of sudden, unexplained death.
Medication may help control seizures. Surgery such as resection and disconnection may help in eliminating or reducing surgery numbers. Recent research has shown that around 81% of people with epilepsy became completely or almost seizure-free after 6 months of surgery.
Facts about epilepsy
- The cause of a seizure cannot be determined for 6 out of 10 people.
- For people above 35 years of age, stroke is a leading cause of epilepsy.
- Around 60-70% of people with epilepsy have a favourable outcome on the first anti-epilepsy drug they try.
- About 50% of people stop taking medications after 2-5 years of no seizures.
- One-third of people with epilepsy experience uncontrollable seizures because they cannot find a treatment that works.
- For more than half of people with epilepsy, medication does not work even with the help of a ketogenic diet.
- Studies have shown that people who opt for a modified Atkins diet may experience fewer seizures.
Consult the best doctors or specialists for epilepsy in Delhi NCR
The Centre for Neurosciences at Yashoda Hospital & Research Centre, Ghaziabad, has the most experienced and trained team of doctors comprising neurosurgeons, neurologists, psychiatrists, and psychologists.
These doctors are committed to providing you with the best care and support throughout your treatment. They use highly advanced machines to perform your treatment quickly and effectively.
Consult our specialists now by booking an appointment at Yashoda hospital.
Visit our official website: www.yashodahealthcare.com