Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.
Seizures in epilepsy may be related to a brain injury or genetic predisposition, but often the cause is completely unknown. The word “epilepsy” does not indicate anything about cause of the person’s seizures or their severity.
Many people with epilepsy suffer from more than one type of seizure and may have other symptoms of neurological problems as well. Sometimes EEG (electroencephalogram) testing, clinical history, family history, and outlook are similar among a group of people with epilepsy. In these situations, their condition can be defined as a specific epilepsy syndrome.
Because epilepsy is caused by abnormal activity in the brain, seizures can affect any of the processes your brain coordinates. Symptoms of seizures may include:
Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy tends to have the same type of seizure each time, so symptoms too will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins.
When seizures result from abnormal activity in just one specific area of your brain, they're called focal (partial) seizures. These seizures fall into two categories:
Symptoms of focal seizures may be confused with other neurological disorders such as migraines, narcolepsy or mental illness. Thorough examinations and testing are needed to distinguish epilepsy from other disorders.
Seizures that involve all areas of the brain are called generalized seizures. There are six types of generalized seizures.
Patient are required to have an electroencephalograph (EEG), which is carried out to read the electrical activity of the brain. Seizure presence is confirmed by taking this test. It is essential to conduct prolonged EEG monitoring as EEG can return to normal between seizures. In order to locate any damaged brain tissue or scar tissue, computer tomography (CT) scanning and magnetic resonance imaging (MRI) can be done. Most times PET (positron emission tomography) can also be performed for examining blood flow to the brain.
Surgery is only performed after different tests confirm that the seizures develop in a well defined area of the brain without disturbing vital functions like motor function, hearing, vision, language or speech. During the surgical procedure, the affected area of the brain that causes seizures is removed. A different type of surgery is required when seizures occur in a part of the brain that cannot be removed. In such a case, the surgeon makes cuts in the brain in order to prevent spread to different parts.
Treatment for epilepsy does not begin till the patient has a second seizure. Quite often a person may have one seizure and never a second one. Medicines do not cure epilepsy, they prevent recurrence of the seizures. These medicines changes the chemical and electrical transmissions in the brain in a way that decreases the chance of a seizure.
Vagus Nerve Stimulation (VNS) : VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one a nerve on the left side of the neck. This is the vagus nerve. The device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces severity and frequency of seizures. If a person is feeling a warning symptom of a seizure, then extra stimulation is provided to prevent recurrence.
Ketogenic Diet : Also considered as one of the treatments for epilepsy, the ketogenic diet is recommended for children. It involves a diet low in proteins & carbohydrates and high in fats. The chemical balance of the brain can be altered to reduces the chance of having a seizure. Ketogenic diet is not meant for adults as the diet can result in serious medical condition like heart disease, high blood pressure or strokes.