What Is Epilepsy? The Types, Causes, And Treatment

Epilepsy or seizures refer to the neurological disorder occurring due to abnormal brain activity. It develops due to problems in your central nervous system. Due to abnormal brain activities, you can observe unusual behavior, loss of awareness, and unusual sensations. Anyone can develop seizures. So, the condition affects both men and women alike irrespective of their ages or ethnic backgrounds. The symptoms associated with the condition can vary from one affected person to another. While some may stare blankly for some time, others can twitch their arms or legs. Having one episode of seizure does not mean you have a neurological disorder. At least two unprovoked convulsions as required to diagnose the problem as epilepsy.

You have no permanent cure for the condition. In children, the seizure may cease to exist once they get older. So, they may outgrow the condition. Some people can remain seizure-free for the rest of their lives after initial treatment. But, most of them need medications or invasive procedures to control convulsions. Here are some of the facts you need to know about the condition.

Symptoms Of Epilepsy

Epilepsy is the condition developing due to abnormal activity in the brain. So, the convulsion can affect any process coordinated by the brain. The signs associated with the condition can include

  • A staring spell
  • Temporary confusion
  • Loss of consciousness or awareness
  • Uncontrollable jerking movements of legs or arms
  • A sense of déjà vu, fear or anxiety (psychic symptoms)

Symptoms exhibited by the affected people depend on the type of seizure. In the majority of the cases, a person suffering from convulsions tends to suffer from some type of seizure each time. So, the symptoms appear similar in every episode.

Types Of Epilepsy Seizures

Depending on how the abnormal brain activity begins, your doctor classifies seizures into two types. Focal and generalized are the two types:

Focal Epilepsy Seizures

It refers to the seizures occurring due to abnormal activity in one area of the brain. Focal (partial) seizures are further classified into two types:

Focal Seizures Without Loss Of Consciousness

It was simply known as partial seizures. The convulsions never result in loss of consciousness. They may result in altering emotions or change the way objects look, taste, smell, or feel. It also results in involuntary jerking of your body parts such as your leg or arm. The seizures can also trigger spontaneous sensory signs like flashing lights, dizziness, and tingling.

Focal Seizures With Impaired Awareness

Earlier known as complex partial seizures, the convulsions included loss of awareness or consciousness. When a person suffers from a specific type of seizure, they may stare into space and find it difficult to respond normally to the environment. They may also perform repetitive movements like chewing, hand rubbing swallowing, chewing, or walking in circles.

Many neurological disorders like mental illness, narcolepsy, or migraine have similar symptoms. To rule out the possibility, your doctor performs a thorough examination and testing. It is needed to distinguish epilepsy from other disorders.

Generalized Seizures

It is a seizure involving all regions of the brain. You can further classify generalized seizures into six other types:

Absence Seizures

Previously known as petit mal seizures, the condition often affects children. It is usually characterized by staring absently into space or subtle body movements like lip smacking or eye blinking. This type of seizure can occur in clusters. So, it can result in a brief loss of awareness.

Tonic Seizures

Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms, and legs and may cause you to fall to the ground.

Atonic seizures

Also known as drop seizures, atonic seizures can result in loss of muscle control. So, it can result in sudden collapsing or falling.

Clonic seizures

This type of seizure is linked to rhythmic or repeated jerking muscle movements. When an affected person suffers from this specific type of convulsions, it affects their face, neck, and arms.

Myoclonic Seizures

Myoclonic seizures can develop as sudden twitches or jerks of the arms or legs. It only lasts for a short time.

Tonic-clonic Seizures

Earlier the known as grand mal seizures, the convulsions appear dramatic. The affected person loses consciousness abruptly and feels their body stiffening and shaking. The seizures can result in loss of bladder control or tongue biting.

See A Doctor For Epilepsy

If you suffer from any of the symptoms suggested below, see a medical professional immediately as you need prompt attention:

  • The convulsion lasts for more than five minutes
  • Your breathing or consciousness does not return immediately after the convulsions cease
  • You suffer from a high fever
  • Sugar levels are high (diabetes)
  • Suffer injury during the convulsions
  • You are pregnant

People experiencing convulsions for the first time in their life need to seek immediate medical assistance to uncover the cause of the problem.

Causes Of Epilepsy

There are no specific or identifiable causes leading to epilepsy. So, half of the people affected by the condition have no clear idea how they develop the problem. While the other half with the condition may develop it due to the following factors:

Genetic Influence

Certain types of seizures, categorized by the type or the specific part of the brain affected by convulsions may run in the family. In such cases, if a close blood relative suffers from the issue, your probability of developing it increases. Researchers have associated some variants of seizures with specific genes. In most cases, genes play only a part of the actual cause triggering convulsions. These genes may make a person more susceptible to environmental triggers causing seizures.

Head Trauma Triggering Epilepsy

Suffering trauma to the head as a result of traumatic injury or car accident can result in developing seizures.

Brain Conditions

When you develop issues to the brain, it can lead to epilepsy. The common complications causing damage to the brain are strokes and tumors. In adults older than 35 years, stroke is the leading cause of convulsions.

Infectious Diseases

The following infectious diseases can cause brain damage triggering seizures in people:

  • AIDS
  • Meningitis
  • Viral encephalitis

Prenatal Injury

When pregnant women suffer from problems such as infections, oxygen deficiencies, or poor nutrition, it can affect their unborn baby. The baby has a high risk of suffering from brain damage, which can result in cerebral palsy or seizures.

Developmental Disorders

Developmental disorders like neurofibromatosis or autism can result in seizures.

Risk Factors Causing Epilepsy

Not all people can suffer from epilepsy. Certain factors can increase the chances of seizures like:

  • Advanced age
  • Family history
  • Suffering from a head injury
  • Suffer from stroke or vascular diseases
  • Dementia
  • Brain infections
  • Seizures in childhood

Complications Associated With Epilepsy

Having a seizure suddenly can endanger your life and cause issues to others. At certain times, it has a high risk of severe complications like:

Falling

You are at risk of falling and injuring yourself when you suffer from sudden convulsions. Such falls can result in head injuries or broken bones.

Drowning

Suffering from epilepsy during swimming can increase the risk of drowning. It is as high as 15-19 times more compared to normal people.

Car Accidents

A person suffering from seizures during driving can lose awareness or control of the car. This risk extends to people who handle heavy equipment and suffer from convulsions.

Complications During Pregnancy

When a pregnant woman suffers from seizures, it puts both mother and child’s life in danger. The use of certain anti-epileptic medications can cause birth defects in babies. So, women suffering from seizures need to consult their gynecologist before getting pregnant. They need to plan their pregnancy to have a healthy baby. The doctor will monitor their condition throughout the pregnancy to avoid any complications. You need to work with your gynecologist for a complication-free pregnancy.

Emotional Health Problems

People suffering from seizures are at risk of developing psychological problems. They are more prone to suffering from issues such as

  • Anxiety
  • Depression
  • Suicidal thoughts/behaviors

You suffer from such complications as a result of dealing with the condition or as a side effect of taking the anti-epileptic medication.

Life-Threatening Complications Of Epilepsy

Epilepsy can result in other life-threatening complications. While they are uncommon, the following complication may occur:

Status epilepticus

It is the condition where you suffer from continuous seizure activity lasting more than five minutes. The condition also develops when you experience frequent recurrent seizures while not gaining full consciousness between the spells. People who suffer from status epilepticus have high chances of suffering from permanent brain damage. They are at risk of dying,

 Sudden Unexpected Death In Epilepsy (SUDEP)

People suffering from convulsions face a small risk of sudden unexpected death. While the underlying cause remains unclear, research indicates the fatality occurs due to respiratory or heart conditions. This risk prevails among people experiencing frequent tonic-clonic seizures or the people whose seizures are difficult to control using medication. It is estimated that 1% of people suffering from epilepsy die as a result of SUDEP.

Diagnosing Epilepsy

To diagnose the condition, you need to see a doctor. The doctor reviews your condition and detects the symptoms along with your medical history. The medical professional can order different tests to determine if you suffer from epilepsy and determine the exact cause of the condition. The evaluation includes the following:

A Neurological Exam

The doctor can suggest a neurological examination to detect the problem. The test will assess the following:

  • Your behavior
  • Mental function
  • Motor abilities

Blood Tests To Detect Epilepsy

You need to provide a sample of your blood for testing. It is tested to detect the signs of infection, genetic problems, and other conditions triggering convulsions.

Test To Detect Brain Abnormalities

In certain cases, brain abnormalities can trigger seizures. So, the doctor may suggest detecting brain abnormalities like:

Electroencephalogram (EEG)

It is the common test used to diagnose convulsions. During the test, your doctor attaches the electrodes to the scalp using a cap or paste-like product. These electrodes measure the brain’s electrical activity. For people suffering from convulsion, the brain wave pattern appears abnormal even when you are at rest or sleep. The doctor records the seizures and determines the kind of seizure you suffer from or rules out other conditions.

High-Density EEG

It is a variation of the common EEG test where the doctor places electrodes more closely compared to the conventional test. The electrodes place just half a centimeter apart help determine the areas of the brain affected by convulsions.

Computerized Tomography (CT) Scan

It is the test used to get cross-sectional images of the brain using x-rays. These scans can detect any abnormalities developing in the brain. It helps detect issues like bleeding, tumors, or cysts causing seizures.

Magnetic resonance imaging (MRI)

It is a sophisticated imaging technique using a magnetic field and sound waves to create a detailed view of the brain. Using the image, the doctor can find out the abnormalities or lesions in the brain triggering the seizures.

Functional MRI (fMRI)

It is the diagnostic method used to measure blood flow changes occurring in specific parts of the brain while it works. The doctors use this technique before surgery. It helps identify the locations in the brain of critical functions like movement and speech. Using the information, surgeons can avoid causing injury in those places while performing the surgery.

Positron Emission Tomography (PET)

PET scans can visualize the active areas of the brain. It helps the doctor detect any abnormalities. To get a detailed image, the doctor injects a low-dose radioactive material into your veins.

SPECT (Single-photon emission computerized tomography)

It is the specific test suggested to diagnose epilepsy when MRI and EEG have failed to pinpoint the exact location where the convulsions originate in the brain. The test uses a small amount of radioactive material (low dose) to create a detailed 3D image of your brain. The material injected into the veins can map the blood flow activity occurring in the brain while having convulsions.

Neuropsychological Tests

The doctor assesses the following to determine the affected area in the brain triggering convulsions:

  • Memory
  • Thinking
  • Speech skills

Analysis Techniques To Detect Epilepsy

The doctor uses a combination of analysis techniques with the test result to specifically pinpoint the area in the brain where seizures start. The techniques include:

Statistical Parametric Mapping (SPM)

It refers to the method used to compare the specific areas of the brain that have increased metabolism during convulsions compared to the normal brain. It helps detect the exact area where the seizures start.

 Curry Analysis

It is the technique taking EEG data. It is then projected onto the brain’s MRI to detect the area convulsions occur.

Magnetoencephalography (MEG)

It identifies the potential areas of convulsions onset by measuring the magnetic field produced by your brain activity.

An accurate diagnosis of the type of seizure you suffer and its onset provides a better chance to find an effective treatment.

Treatment For Epilepsy

To treat seizures, the doctor usually prescribes medications. When medications fail to offer relief from the condition, the doctor suggests other treatments to deal with the condition.

Medications To Treat Epilepsy

In the majority of people suffering from seizures, taking anti-seizure medication can help you get free from convulsions. The medications known as antiepileptic medication can reduce the frequency and intensity of the convulsions. The doctor may suggest one or a combination of medications to deal with the condition. In children, the symptoms may subside at some point. Then, they can discontinue taking the medications. They can live a seizure-free life. Adults who go without experiencing seizures for at least two years can discontinue their medications. You need to consult the doctor regarding the right time to stop taking the medications.

It is important to determine the right medication and the dose to manage convulsions. The process may seem complex. You need to work with your doctor to come to a decision. Here are some of the factors your doctor may consider before prescribing the medication:

  • Your age
  • Frequency of seizures
  • Your overall health

The doctor will also assess other medications you use to prevent any adverse reaction caused due to anti-epileptic medications. To begin your treatment, the doctor prescribes a single anti-seizure medication at a low dose. Your doctor will increase the medication dose gradually until you can control the convulsions.

Steps To Manage Adverse Effects Caused By Epilepsy

The anti-seizure medications prescribed may have some side effects. You need to discuss the adverse effects triggered and how to deal with them by making an appointment with the doctor. To get the best results with the prescribed medication, you need to follow the steps:

  • Take medications as suggested by the doctor. Never miss your medication. You must never decide to stop taking the medication without consulting your doctor.
  • Never change the medication suggested. If you are trying to switch to a generic form of medications, take other medications to treat your health condition, take over-the-counter medications, or herbal remedies, talk to your doctor first.
  • When you observe side effects like enhanced feelings of depressions, unusual symptoms in your behavior or mood, or suicidal thoughts, consult your doctor immediately.
  • Inform your doctor when you suffer from migraines. The doctor can prescribe anti-epileptic medications to prevent migraines and seizures.

In the majority of cases, half of the people diagnosed with seizures can become free from the convulsion when they take their first dose of medication. But, when medication fails to offer results, you need to try other options. Remember, you have to have a regular follow-up check-up with the doctor for evaluating your condition.

Surgery To Control Epilepsy

It is the option suggested by the doctor when medications fail to provide relief from seizures. With invasive surgery, the surgeon chooses to remove the specific area of the brain triggering convulsions. Doctors suggest this option when the diagnostic test shows that:

  • You suffer from convulsions due to issues
  • Your seizures originate in a small, well-defined area of your brain
  • If the operation on the specific area of the brain does not affect the vital functions like language, speech, vision, motor function, or hearing.

After the surgery, you must take certain medications to prevent convulsions. But, the surgery will help take fewer drugs at reduced doses. But, in some cases, the surgery can cause complications like permanent altering of cognitive (thinking) abilities. So, you need to talk to the doctor regarding the success rate, experience in such surgeries, and complication rates.

Other Therapies Used For Epilepsy

Apart from medications and surgery, the doctor can also suggest potential therapies as an alternative to address seizures. Here are some of the options:

Vagus Nerve Stimulation

In this type of therapy, the doctor implants a device underneath the skin. The device, known as the vagus nerve stimulator has a function similar to a pacemaker. It is installed under the chest and connects the wires from the device to the nerves in the neck. The battery-powered device can send electrical energy in bursts to the vagus nerve as well as the brain. While it remains unclear how the device can control seizures, it can reduce its frequency by 20% to 40%.  After installing the device, you need to take medications to control the frequency of convulsions. But, you can lower the dose. It has certain side effects. To get a better idea, discuss it with the doctor.

Try Ketogenic Diet

Some children with seizures have reduced the frequency of convulsions by following a ketogenic diet. The diet low in carbohydrates,  but high in fats break down the fat for releasing energy. It uses fat instead of carbohydrates to release energy. Before considering a keto diet, talk with the doctor. It is important to note your child will not suffer from malnourishment while following the diet.

Deep Brain Stimulation For Managing Epilepsy

In this procedure, the surgeon implants electrodes in a certain part of your brain. Mostly it is implanted in the thalamus. The electrodes are connected to the generated implanted in your chest. In some cases, the skill can send electrical pulses to the brain. Deep brain stimulation can reduce seizures.

Potential Future Therapies For Epilepsy

Researchers are trying to find new therapies and treatments to manage epilepsy. So many studies are underway to manage the frequency of convulsions. Here are some of the therapies expected to provide hope to affected people:

  • Responsive Neurostimulation
  • MRI-guided laser ablation
  • Stereotactic laser ablation
  • The external nerve stimulation device

Lifestyle Changes To Deal With Epilepsy

Remember, you have no home remedies to treat epilepsy. To control the frequency and severity of seizures, you need to understand the condition better and control it in the right manner. Here are some things you need to follow at home to ensure the treatment works well:

Follow Doctor’s Orders

You need to follow your doctor’s instructions regarding taking the medication. Never adjust the dose by yourself. If you feel you need to change the medication or its dose, discuss it with your doctor.

Get Good Sleep

Lack of sleep can act as a trigger to suffering from seizures. So, you need to get adequate rest to ensure you are at less risk of suffering from the problem.

Medical Alert Bracelet

Seizures can occur anytime. So, when you go out, wear a medical alert bracelet that can give an idea about your medical condition. If convulsions develop, the emergency personnel know how to treat you properly.

Exercise Regularly

Depression can cause convulsions. To keep it at bay, you need to exercise regularly. It keeps you mentally and physically fit. But, remember to replenish your body with the fluids lost due to exercise. It will prevent dehydration. Also, get rest when you become tired during the exercise.

Make Healthy Life Choices

In addition to following the doctor’s instructions, you need to make healthy life choices. Avoid certain bad habits acting as a trigger to convulsions. Here are some of them:

  • Manage stress
  • Limit consumption of alcoholic beverages
  • Avoid smoking

Coping And Support To Manage Epilepsy

Uncontrolled convulsion and its effects can have a great impact on your life. It may overwhelm you and lead to mental issues like depression. So, you need to take steps to avoid epilepsy from living your full life. To cope with the condition better, you can follow the tips suggested:

Educate People Around You

Let your loved ones and friends know about your condition. It will help them realize your plight and offer the necessary support. Most people tend to react negatively. Helping them learn about the conditions and erasing misconceptions from their mind regarding the disease will help you get good support.

Try To Live Independently

Never depend on people to live your life. You can live independently by going to work. But, avoid driving due to the chances of unexpected convulsions. You can look for good public transport options to help you move from one place to another. This move will help you gain confidence and have a positive attitude.

Get Desired Help

Living independently does not mean you must not seek assistance from your doctor or support groups. Choose a doctor you feel comfortable with. The ease of communicating your problem helps with controlling convulsions better. Refrain from thinking about suffering seizures as they can put pressure on yourself. Also, find a support group with people who face similar problems. They can understand your plight and offer tips to manage them better.

Conclusion

Epilepsy is a serious condition requiring medical assistance. It affects people in different ways. But, following the tips from your doctor, it becomes possible to lead a normal life. The majority of people can successfully control their seizures with medications or surgical intervention. For dealing with the condition better, you need to get all information and maintain a positive attitude. Work closely with the healthcare team to control the frequency and severity of the convulsions for leading a complete life.

References

https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093

https://www.healthline.com/health/epilepsy#:~:text=Epilepsy%20is%20a%20chronic%20disorder,one%20part%20of%20the%20brain.

https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy

 

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