Epilepsy

February 1, 2017

Epilepsy, which is sometimes called a seizure disorder, is a chronic disorder of the brain. A person is diagnosed with epilepsy when they have had two or more seizures.

It is characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized), and are sometimes accompanied by loss of consciousness and control of bowel or bladder function.

Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures can also vary in frequency, from less than 1 per year to several per day.

It can be scary watching someone have an epileptic seizure. The person may lose consciousness or seem unaware of what’s going on, make involuntary motions (movements the person has no control over, such as jerking or thrashing one or more parts of the body), or experience unusual feelings or sensations (such as unexplained fear). After a seizure, he or she may feel tired, weak, or confused.

About 200,000 new cases of seizures and epilepsy occur in the USA each year. 10% of all Americans will experience a seizure some time during their lifetime.

Types of seizures

There are three types of diagnoses a doctor might make when treating a patient with epilepsy:

  • Idiopathic – this means there is no apparent cause.
  • Cryptogenic – this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
  • Symptomatic – this means that the doctor knows what the cause is.

Causes

Epilepsy occurs when permanent changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable seizures.

Genetic influence – Some types of epilepsy, which are categorized by the type of seizure a person experiences or the part of the brain that is affected, run in families. In these cases, it’s likely that there’s a genetic influence.

Zinc deficiency has been shown to cause seizures. A study that was published in 1990, entitled. Many epilepsy sufferers have noted significant improvements in their condition with zinc intake.

Common causes of epilepsy include –

  • Stroke
  • TIA
  • or transient ischemic attack ()
  • Dementia, such as Alzheimer disease
  • Traumatic brain injury
  • Infections, including
    • brain abscess
    • meningitis
    • encephalitis
    • HIV/AIDS
  • Brain problems that are present at birth (congenital brain defect)
  • Brain injury that occurs during or near birth
  • Metabolism disorders present at birth (such as phenylketonuria)
  • Brain tumor
  • Abnormal blood vessels in the brain
  • Other illness that damages or destroys brain tissue

Epileptic seizures usually begin between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy.

Symptoms

The main symptoms of epilepsy are repeated seizures. There are some symptoms which may indicate a person has epilepsy. If one or more of these symptoms are present a medical exam is advised, especially if they recur –

  • A convulsion with no temperature (no fever).
  • Short spells of blackout, or confused memory.
  • Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme tiredness.
  • For a short period the person is unresponsive to instructions or questions.
  • The person becomes stiff, suddenly, for no obvious reason
  • The person suddenly falls for no clear reason
  • Sudden bouts of blinking without apparent stimuli
  • Sudden bouts of chewing, without any apparent reason
  • For a short time the person seems dazed, and unable to communicate
  • Repetitive movements that seem inappropriate
  • The person becomes fearful for no apparent reason, he/she may even panic or become angry
  • Peculiar changes in senses, such as smell, touch and sound
  • The arms, legs, or body jerk, in babies these will appear as cluster of rapid jerking movements.

Less common symptoms –

  • A high fever with epilepsy-like symptoms
  • Fainting
  • Narcolepsy (recurring episodes of sleep during the day and often disrupted nocturnal sleep)
  • Cataplexy (a transient attack of extreme generalized weakness, often precipitated by an emotional response, such as surprise, fear, or anger; one component of the narcolepsy quadrad)
  • Sleep disorders
  • Nightmares
  • Panic attacks
  • Fugue states (a rare psychiatric disorder characterized by reversible amnesia for personal identity)
  • Psychogenic seizures (a clinical episode that looks like an epileptic seizure, but is not due to epilepsy. The EEG is normal during an attack, and the behavior is often related to psychiatric disturbance, such as a conversion disorder)
  • Breath-holding episodes (when a child responds to anger there may be vigorous crying and subsequent apnea and cyanosis – the child then stops breathing and skin color changes with loss of consciousness).

Complications

  • Difficulty learning
  • Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia
  • Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure
  • Permanent brain damage (stroke or other damage)
  • Side effects of medications

 

Treatment

Medicine – Anti-seizure drugs are medicines that limit the spread of seizures in the brain. A healthcare provider will change the amount of the medicine or prescribe a new drug if needed to find the best treatment plan. Medicines work for about 2 in 3 people with epilepsy.

Surgery – When seizures come from a single area of the brain (focal seizures), surgery to remove that area may stop future seizures or make them easier to control with medicine. Epilepsy surgery is mostly used when the seizure focus is located in the temporal lobe of the brain.

Other treatments – When medicines do not work and surgery is not possible, other treatments can help. These include vagus nerve stimulation, where an electrical device is placed, or implanted, under the skin on the upper chest to send signals to a large nerve in the neck. Another option is the ketogenic diet, a high fat, low carbohydrate diet with limited calories.

Alternative Treatment

Melatonin is a natural hormone that regulates the biological clock and sleep. It is produced by the pineal gland, located in the brain. One theory on how it may help people with epilepsy is that it enables better sleep and thereby reduces the risk of seizures brought on by fatigue. One study of children with epilepsy found melatonin helpful when taken together with the anti-epileptic drug valproate.

Omega-3 fatty acids have been studied in patients with epilepsy, but the results have been poor. One study found that polyunsaturated fatty acids had no effect on seizures; another found that omega-3 fatty acids reduced seizure frequency at first, but the effect wore off.

Vitamin E is thought to have an effect on neurotransmitter systems in the brain. Some studies have shown vitamin E to be helpful in reducing seizures, while other studies have not shown an effect.

Zinc is effective for seizures.

Magnesium is a vital component of epilepsy recovery, and many believe that magnesium deficiency is the root cause of epileptic seizures. Lots of people choose to supplement with magnesium using Epsom salt (magnesium sulphate).

The valerian herb is a very popular anti-spasmodic medication in Russia and Germany. In America, it is mostly known for its sedative effect, but it also has an anti-convulsant action that is beneficial for epileptic people.

Vitamin B-1 has shown very positive results in helping people who are suffering with epilepsy. Epilepsy has been linked to a vitamin B-1 deficiency.

Kava kava is a herb that contains nuciferine, an anti-spasmodic. Kava kava is relaxing, so it is best taken at night, before sleeping.

Scullcap and Indian tobacco (lobelia inflata) have both been traditionally used for convulsions, seizures, and tremors.

Biofeedback and neurofeedback – In epilepsy, a form of biofeedback known as neurofeedback may be used to teach patients to consciously control their brain activity and thereby avoid seizures. The technique may require many sessions to learn and is unlikely to control seizures completely.

Meditation – There are many different forms of meditation, but in general, meditation is a way of focusing the mind in the present moment. Meditation is being studied in many different conditions, including chronic pain and attention-deficit/hyperactivity disorder.

Relaxation techniques – A few small studies have looked at relaxation techniques for epilepsy. One study taught children to recognize the signs of an approaching seizure and then apply relaxation techniques. Compared with the control group, children in the treatment group had fewer seizures after 10 weeks and at 1 year after the treatment ended.

Yoga is an ancient Hindu system of meditation and low-impact exercise to promote control of the body and mind.Yoga has been explored as a way to reduce seizures because of its aim to reduce stress and promote relaxation.

Acupuncture is a part of traditional Chinese medicine. It involves inserting thin needles at specific points on the body. There have been a few good-quality randomized controlled trials of acupuncture for people with epilepsy, which have not shown any anti-seizure effect from the treatment.

Reference –

http://www.epilepsy.com/learn/epilepsy-101/what-epilepsy

http://www.webmd.com/epilepsy/

http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm

http://www.epilepsysociety.org.uk/what-epilepsy

http://www.medicalnewstoday.com/articles/8947.php

https://www.nlm.nih.gov/medlineplus/epilepsy.html

http://www.mayoclinic.org/diseases-conditions/epilepsy/home/ovc-20117206

http://www.epilepsysociety.org.uk/what-epilepsy

https://www.aesnet.org/

http://www.who.int/mediacentre/factsheets/fs999/en/

http://kidshealth.org/teen/diseases_conditions/brain_nervous/epilepsy.html

http://www.nytimes.com/health/guides/disease/epilepsy/overview.html

https://www.epilepsy.org.uk/

http://www.epilepsy.ie/

http://www.epinet.org.au/articles/understanding_epilepsy

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