Epilepsy

What is Epilepsy?

Epilepsy is a chronic neurological disorder causing unprovoked seizures. There are over 50 million people who have epilepsy worldwide. Two or more seizures must take place before a patient can be diagnosed with epilepsy. Having a seizure does not necessarily mean you are an epileptic. Seizures are common; between 5 and 10 percent of the population worldwide will have a seizure during their lifetime. An epileptic seizure occurs when the brain, usually powered by approximately 80 pulses of electrical signaling per second, pulses more rapidly (up to 500 pulses per second). This action only occurs for a short time. The rapid pulses may cause changes in sensation, behavior, movement, or consciousness temporarily. Epilepsy is most common for children, teens, and people over the age of 65. The treatment for epilepsy may leave the patient free of seizures, but sometimes can only reduce the frequency and intensity of the seizures.

Signs and Symptoms of Epilepsy

The abnormal brain activity which causes seizures also causes other abrupt changes in your body, such as slight temporary confusion, complete loss of consciousness, a staring spell, muscle spasms, or uncontrollable, jerking movements of one’s limbs. Seizures starting in the temporal lobe offer different results. Déjà vu, panic, or an uneasy sensation in your stomach possibly followed by unconsciousness can all be attributed to seizures occurring in the temporal lobe.Many symptoms of epilepsy remain the same with each epileptic seizure a patient has, but for a few patients, the symptoms and type of seizure always change. Some symptoms vary depending on the type of seizure. Seizures are classified as partial or generalized. This classification is based on how the brain activity began. It is classified as partial when seizures appear from activity of just one part of the brain. A seizure is classified as a generalized seizure when the activity involves most of the brain. From these classifications both categories are separated into more specific sub-categories. Many people who have experienced a partial seizure have felt aware of a warning feeling before the seizure.

Partial seizures have 3 sub-categories: simple partial, complex partial and secondary generalized seizures. Simple partial seizures start in a small section of your brain and do not cause unconsciousness. A simple partial seizure generally causes uncontrolled shaking of a limb or other part of your body. It may also temporarily change your emotions, alter the way things seem to your 5 senses, or cause a impediment in your speech. Complex partial seizures also begin in a small section of your brain. They cause more serious effects and symptoms than simple partial seizures. Complex partial seizures can cause lack of consciousness, staring, and memory loss. They also cause small uncontrolled movements, such as lip smacking, swallowing, making sounds, or changing your position or your arm. When the seizure concludes, the sufferer may be confused or sleep for a few minutes. They may also not remember having a seizure. Most complex partial seizures take place in the temporal lobe. Secondary generalized seizures arise when simple or complex seizures change from a small portion of your brain and occupy your entire brain. This intensifies the seizure and leads to serious symptoms such as shaking and stiffening of your body, called convulsions. Generalized seizures have 4 sub-categories: absence (petit mal), myoclonic, atonic and generalized tonic-clonic (grand mal) seizures.Absence seizures, also called petite mal seizures, are distinguished by the staring, slight body movements and short periods of unawareness symptoms.

These absence seizures last only brief periods of time and don’t cause sleepiness symptoms or confusion following the seizure.Myoclonic seizures are characterized by sudden jerks of your limbs. Normally they only affect one side of your brain, thus only affecting one side of your body, but it may affect both. Myoclonic seizures are also brief, and can last between less than a second to a few seconds. Atonic seizures or drop attacks cause the sufferer to immediately collapse. A few seconds after the attack the person regains consciousness.Generalized tonic-clonic, or commonly known as grand mal seizures, are the worst, most intense type of seizure. They cause the sufferer to lose consciousness. They also cause rapid body shaking and convulsions, and sometimes tongue biting or loss of bladder control. After the shaking, the sufferer is left in a state of confusion or sleepiness between a few minutes to two hours.

Causes of Epilepsy

Causes of epilepsy could be due to either a traumatic accident, disease or medical disturbance which causes injuries to your brain or denies the brain oxygen. This disturbance leaves a tiny scar and causes a big change. It is very unusual for epilepsy to be caused by a brain tumor, but is possible. Often there is no certain reason for the disease. Epilepsy is not a mental disease, but it can be influenced by mental health. Although epilepsy doesn’t cause psychiatric problems or mental retardation, people with epilepsy may also struggle with mental issues.

Epilepsy has been found by various researchers to be a genetic disease, therefore if you have a close relative who has a history of epilepsy; your risk of inheriting the disease may be increased.An especially common cause for epilepsy is head injuries. To avoid head injuries which can possibly lead to epilepsy it is advised that you always wear a seatbelt when in a car, and a helmet while bicycling, skiing, and other possibly dangerous activities. Stroke can lead to brain damage which may possibly lead to epilepsy, as can other diseases which affect your vascular system. In order to reduce these risks of contracting the potentially harmful diseases it is important to limit your alcohol intake, follow a healthy diet, properly manage your weight, exercise regularly and avoid smoking. Various other risk factors are Alzheimer’s disease, brain infections, and lead (and other types of) poisoning.

Diagnosing Epilepsy

Seizures can be caused by many different things, therefore doctors may make you undergo many tests to diagnose epilepsy. The questions and/or tests he may ask or conduct are regarding the content that follows: Medical history, physical and neurologic examinations, blood test, electroencephalogram, computerized tomography, or magnetic resonance imaging. Medical history is important to the doctor as he would need a full explanation of any previous seizures, from either you or anyone who has witnessed your seizures. These accounts of your past symptoms can help your physician classify the type of seizure and ultimately the cause of the problem. Blood tests are important as your doctor can check the chemical disproportions which may relate to your seizures. An electroencephalogram (EEG) catalogs the electrical exertion in your brain.

• (EEG). This procedure records the electrical activity of your brain. An EEG helps determine what type of seizures or epilepsy you have and from which part of the brain seizures may start. During the procedure, which takes about a half-hour, you lie down. Between 16 and 30 small electrodes may be attached to your scalp with paste or an elastic cap. You remain still during the test, but at times you may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times a light may be flashed in your eyes. These actions are intended to stimulate your brain in ways that might be seen on the EEG. The electrodes pick up the electrical impulses from your brain and send them to the EEG machine, which records your brain waves on a moving sheet of paper or digitally on a computer screen.
• Computerized tomography (CT). A CT scan produces detailed cross-sectional images of your brain. The images may reveal abnormalities in brain structure, including tumors, cysts, strokes or tangled blood vessels.
• Magnetic resonance imaging (MRI). An MRI scan uses a powerful magnetic field and radio waves to produce images of your brain. Like CT scans, MRI images may reveal abnormalities in brain structure.

Treating Epilepsy with Medications

Medications for treating epilepsy are widely available. Most people can prevent their seizures with just one antiepileptic drug. Over 50 percent of epileptic children whose seizures are monitored with medications can ultimately stop taking the medication and cure epilepsy. Other people do not get cured by simply taking medication, though it does help to make their seizures less frequent and less intense. Several adults are able to end the use of medication after a few years and never suffer through a seizure again.

It can be difficult to find the correct medication and dosage. It may also be necessary to test more than one drug until the right one is found. Medications available for the treatment of seizures include phenytoin (Dilantin, Phenytek), carbamazepine (Carbatrol, Tegretol), valproic acid (Depakene), divalproex (Depakote), levetiracetam (Keppra), gabapentin (Neurontin), phenobarbital, ethosuximide (Zarontin), clonazepam (Klonopin), lorazepam (Ativan, Lorazepam Intensol) , diazepam (Diastat, Valium), primidone (Mysoline), oxcarbazepine (Trileptal), lamotrigine (Lamictal), topiramate (Topamax), felbamate (Felbatol), tiagabine (Gabitril) and zonisamide (Zonegran).

All of the medications listed above have some side effect. These may include mild fatigue, dizziness and weight gain. A few medications have more adverse side effects, including depression, skin rashes, loss of coordination, speech problems and extreme fatigue. If you are experiencing any extreme side effects, discuss them with your doctor immediately. Although some severe side effects may be listed, plenty of people use these medications on a regular basis and never experience the side effects. Ask your doctor to explain these issues to you when you receive the prescription.To achieve the maximum control of your seizures, take the medications exactly as prescribed. There are seizure prevention medications which increase the risk of birth defects in women. If you or your spouse are considering becoming pregnant, discuss this with your doctor before getting a prescription.

Treating Eplilepsy with Surgery

Unfortunately some people have seizures that cannot be controlled or prevented with any medications. This is because the drugs either cause unbearable side effects or do not provide acceptable seizure control. If this is the case, surgery may be an option. Most epileptic related surgeries occur in the side or front regions of the brain (temporal lobes, or the frontal lobe). If the seizures occur in large areas of the brain, or in many different areas of the brain, it is extremely uncommon for surgery to be an option. The procedure begins with your surgeon making a careful incision in your scalp and removing a piece of skull bone. Next, the surgeon removes the area of the brain causing the seizures, which is found by monitoring brain activity with electrical recordings. Following surgery, those with difficult cases of epilepsy may need to continue taking medication in order to help prevent additional seizures.

Coping Skills

Those who experience epileptic seizures react differently. Several people react to treatment well, therefore gaining control over seizures easily. Some have to try different forms of treatment before finding one that works specifically for them, and some people will never have complete control over their seizures. As with various other chronic illnesses, epilepsy may cause emotional or psychological stress. This stress can be attributed to one’s personal difficulties in dealing with epilepsy. The symptoms caused by epilepsy may require you to forfeit your independence for a while. Epilepsy may also cause stress in relationships due to your condition. Follow the following tips to help you to cope with epilepsy:

Know your condition – Research all you can about your type of epilepsy and the treatments available for it. The more you know, the more independent and active you can be.

Be proactive – Don’t let others make important decisions for you. Although you may feel tired and discouraged it is important to take an active role in your treatment.

Keep a strong support system – Support systems are helpful in any issues and anxieties which may arise. Friends and family are always helpful, but even attending a support group and being with others who are also coping with epilepsy may be helpful. Support groups are also very informative. You may end up creating deep bonds with those suffering the same things you are.

Set goals you can reach – Having goals is always a way to help you accomplish what you desire. As well goals help you feel in control and can help provide a sense of purpose for you. Choose goals that you will be able to reach.

Take time for yourself – Keep healthy! Eat right, exercise lots, and get plenty of rest. Plan ahead for any times when you may require excess resting time.

Stay active – Even though you have been diagnosed with epilepsy you can still get out and enjoy yourself and continue with normal activities. Although you may have to make slight moderations to certain activities, such as driving, you can still have an active life.