Epilepsy

Epilepsy

Epilepsy is a non-communicable neurological disorder in which brain activity becomes abnormal and is characterised by recurrent seizures. It is the fourth most common neurological disorder in the world.  When normal impulse transmission between neurons of the brain is disturbed, it leads to uncontrolled signals causing seizures. As a result, people having seizures may experience periods of unusual behaviour and sensations, and they may have intense muscle spasms and sometimes lose their senses.

The primary symptom of epilepsy is seizures. Other signs and symptoms of seizures include:

1. Temporary confusion
2. Muscles becoming stiff
3. Uncontrollable jerking and shaking of the arms and legs
4. Loss of consciousness or awareness
5. Psychological problems like anxiety, fear or deja vu
6. Difficulty in breathing
7. Staring or rapid eye blinking
8. Uncontrolled bladder or bowel

As per WHO, in about half of the total people who have epilepsy, the causes can not be traced. While in the other half, a variety of factors can lead to the development of the seizure-causing epilepsy, such as:

1. Genetic influence - Some epileptic conditions occur due to a particular seizure type affecting a specific brain region, and run in families. These cases are likely due to single or multiple genetic factors. Researchers have identified some genes associated with particular types of epilepsy; however, these genes only partially influence the occurrence of epilepsy. Specific genes can make a person more prone to environmental conditions that cause seizures.
2. Head trauma - Epilepsy can occur due to head trauma resulting from a car accident or other traumatic injury.
3. Brain abnormalities – Any abnormality in the brain, such as brain tumours or other brain disorders, can cause misfiring of electrical signals from the brain leading to epilepsy. 
4. Stroke- In adults above the age of 35, stroke can be the leading reason for epilepsy.
5. Infections – Some viral or parasitic infections such as HIV, Meningitis or viral encephalitis can also lead to epilepsy.
6. Prenatal Injury - Unborn babies are susceptible to brain damage inside a mother smothers womb. Several factors can cause brain damage in unborn babies, such as poor nutrition, infection in the mother, or oxygen deficiencies, resulting in epilepsy or cerebral palsy.
7. Developmental Disorders - Developmental disorders like autism can sometimes lead to epilepsy.

Certain factors can increase the chances of developing epilepsy, such as:

1. Family history
2. Premature birth
3. Abnormal brain structure at birth
4. Brain Tumour
5. Brain haemorrhage
6. Head injuries
7. Cerebral Palsy
8. Mental disabilities
9. Seizures occurring within days after head injury
10. Alzheimer’s disease (late in the illness)
11. Stroke and other vascular diseases
12. Dementia
13. Infections of the brain such as meningitis, encephalitis, etc.  
14. Seizures in childhood
15. Seizures in older age
16. Lengthy fever-related (febrile) seizures
17. Alcohol or drug abuse

Epilepsy can be diagnosed by certain brain imaging techniques such as:

1. Computed Tomography (CT) 
2. EEG (Electroencephalogram) 
3. Magnetic Resonance, Functional (fMRI) 
4. Pharmacogenetic Tests: Tests that can perform a complete blood count (CBC) and investigate the chemistry of your blood to determine signs of infectious diseases, liver and kidney function and blood glucose levels can be used to identify epilepsy.

1. Anti-epileptic (anticonvulsant, antiseizure) drugs – Some anti-epileptic medications can reduce the number of seizures in some people; they are highly effective and can eliminate seizures. 
2. A Vagus nerve stimulator is a device that is surgically implanted under the skin on your chest, capable of electrically stimulating the nerve running through your neck to prevent seizures.
3. Ketogenic Diet – According to some reports, many children who do not respond to anti-epileptic medications benefit from the ketogenic diet that includes high fat and low carbohydrate diet.
4. Brain surgery – Through brain surgery, the brain area affected by seizure activity can be removed or altered to provide relief from seizures.

Anti-Epileptic Medications

There are many anti-epileptic medications available on the market, including:

1. Levetiracetam (Keppra)
2. Lamotrigine (Lamictal)
3. Topiramate (Topamax)
4. Valproic acid (Depakote)
5. Carbamazepine (Tegretol)
6. Ethosuximide (Zarontin)

Though these anti-epileptic medications help combat seizures, however, they also cause several side effects, which include:

1. Fatigue
2. Dizziness
3. Skin rash
4. Poor coordination
5. Memory problems

1. Lowered risks of epileptic emergencies like injuries or death.
2. Improved quality of life
3. An individual can work or drive normally
4. Lowered health care costs related to treatment of epilepsy

1. Injuries from falling
2. Injuries from operating a machinery
3. Pregnancy complications
4. Emotional health issues
5. Learning difficulty
6. Brain damage from prolonged and uncontrolled seizures
7. Side effects due to any medication