Epilepsy
Epilepsy in Nagpur is a seizure disorder, described as an age-related condition that affects people, whereby they experience recurrent seizures of no known cause and greater than one seizure in a lifetime, where the seizures are caused by abnormal electrical signals in damaged cells. The seizure would be that uncontrolled burst of electrical activity in the brain that leads to alterations in states of awareness, loss of muscle control, alterations in sensations, emotions, or behavior.
Epilepsy is the world’s fourth most common neurological illness. It is a disorder characterized by recurrent seizures, which occur when a patient suffers from abnormal electrical activity in the brain. We’re here to give you comprehensive information about epilepsy and how to manage it better.
What are the types of epilepsies and their seizure symptoms?
Healthcare providers classify epilepsies based on the type of seizure, considering where they start in your brain and how aware you are while having a seizure. There are two major classes of epilepsy:
Focal onset seizures: These convulsions start in one region or set of cells on one side of the brain. Prior to updated terminology, they were referred to as partial onset seizures. There are two classifications: a. Focal onset aware seizure: You are conscious and alert during the seizure, formerly known as simple partial seizure. Symptoms may include:
- Altered perception regarding perceptions that affect, for example, taste, smell, and auditory senses.
- Cognitive changes.
- Automatic thinking, behavior, or mimicry, and/or
- Muscle spasms, primarily of the limbs.
- Flashy lights sensations, vertigo, or paresthesia.
Focal onset impaired awareness seizure: You become confused or even lose consciousness during the seizure; this used to be called complex partial seizure. Symptoms may include:
- Blank stare or absent expression
- Repetitive movements such as eye blinking, lip-smacking, chewing, hand rubbing, or finger motions.
Epilepsy
- Focal Seizures (Partial Seizures): These start in one specific area of the brain and can be either:
- Focal Aware Seizures (Simple Partial): The person is conscious and aware of their surroundings, but they may experience unusual sensations or movements.
- Focal Impaired Awareness Seizures (Complex Partial): Consciousness is altered, and the person may seem confused or unaware of what is happening.
- Generalized Seizures: These affect both sides of the brain from a beginning. Types include:
- Absence Seizures (Petit Mal): Brief lapses in awareness, often mistaken for daydreaming, lasting just a few seconds.
- Tonic-Clonic Seizures (Grand Mal): Characterized by muscle stiffening (tonic phase) followed by rhythmic jerking (clonic phase) and possible loss of consciousness.
- Myoclonic Seizures: Sudden, brief jerks and twitches of the muscles.
- Atonic Seizures: Sudden loss of muscle tone, which can lead to falls (also known as drop attacks).
- Tonic Seizures: Stiffening of muscles without rhythmic jerking.
- Clonic Seizures: Repeated jerking movements of muscles.
Causes of Epilepsy:
- Genetic Factors: Some forms of epilepsy have the genetic predisposition.
- Head Trauma: Injury to the brain from accidents, falls, or other physical damage.
- Stroke or Vascular Disease: Reduced oxygen flow to the brain can cause epilepsy.
- Brain Infections: Meningitis, encephalitis, or brain abscesses.
- Developmental Disorders: Conditions like autism or neurodevelopmental disorders can increase the risk of epilepsy.
- Brain Tumors: These can interfere with normal electrical brain activity.
- Metabolic Disorders: Imbalances in electrolytes, glucose, or other substances in the body.
Diagnosis:
- Electroencephalogram (EEG): Measures electrical activity in the brain. Abnormal EEG patterns help identify the type of epilepsy.
- MRI or CT Scan: Used to look for structural abnormalities in the brain, such as tumors, injuries, or malformations.
- Blood Tests: To rule out metabolic causes or infections that may be triggering seizures.
- Genetic Testing: In some cases, genetic testing may be done to look for hereditary epilepsy syndromes.
Treatment Options:
- Antiepileptic Drugs (AEDs): The main treatment for controlling seizures. Common medications include: – Phenytoin
– Carbamazepine
– Valproic acid
– Levetiracetam
– Lamotrigine These drugs aim to reduce the frequency and severity of seizures. - Surgery: In cases where seizures are resistant to medication (refractory epilepsy), surgery to remove the part of the brain causing seizures may be an option. Common procedures include:
– Temporal Lobectomy: Removal of the portion of the temporal lobe.
– Lesionectomy: Removal of abnormal brain tissue. - Vagus Nerve Stimulation (VNS): The device implanted in the chest that sends electrical pulses to a brain via the vagus nerve to the reduce seizure frequency.
- Ketogenic Diet: A high-fat, low-carbohydrate diet that has been shown to reduce seizures, especially in children with epilepsy.
- Responsive Neurostimulation (RNS): The device implanted in the brain to detect abnormal electrical activity or deliver electrical stimulation to the prevent a seizure.
- Lifestyle Changes: Managing stress, maintaining a regular sleep schedule, and avoiding known triggers can help reduce the likelihood of seizures.
First Aid for Seizures:
- Stay Calm: Stay with the person during the seizure.
- Prevent Injury: Move nearby objects out of the way to avoid injury.
- Time the Seizure: If it lasts more than 5 minutes or there’s no recovery between seizures, seek emergency medical help.
- Do Not Restrain: Do not try to stop the movements or force anything into their mouth.
- Recovery Position: After the seizure, turn the person onto their side to help keep the airway clear.
- Stay Until Recovery: Stay with the person until they are fully alert.
Prognosis and Living with Epilepsy:
- Many people with epilepsy live full, productive lives, and about 70% can achieve seizure control with proper treatment.
- Long-term management often involves a combination of medication, lifestyle adjustments, or regular monitoring.
- Individuals with epilepsy should be cautious with activities that could be dangerous during a seizure, such as swimming or driving, and should consult their doctor about safety precautions.
Epilepsy in Specific Populations:
- Children: Childhood epilepsy syndromes like absence epilepsy or benign rolandic epilepsy often improve with age.
- Pregnancy: Women with epilepsy can have healthy pregnancies, but medication adjustments and monitoring are important.
- Seniors: Epilepsy in the elderly is often due to stroke, head trauma, or other age-related conditions.
How is epilepsy diagnosed?
In case you have two or more seizures that are not due to another known medical condition such as alcohol withdrawal or low blood sugar, you would most likely be diagnosed with epilepsy. The provider or an epilepsy expert will perform a physical exam, review the patient’s history, and possibly obtain blood tests to rule out other causes, including a discussion on symptoms and potentially further testing.
A parent, guardian, or another witness and you will be asked by your care provider about symptoms you have experienced during a seizure. These can include:
- Muscle jerks.
- Muscle stiffness.
- Loss of bowel or bladder control.
- Changes in breathing.
- Pallor, or pale skin color.
- Blank stare. Loss of consciousness.
- Trouble speaking or understanding speech.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.