Epilepsy Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Epilepsy is a disorder of the central nervous system, in which the activity of the brain becomes abnormal. This disorder can cause seizures or periods during which a person experiences abnormal behavior, abnormal sensations, and sometimes loss of consciousness.
Signs and symptoms of seizures can vary. Some people with epilepsy may only stare blankly for a few seconds during a seizure. While others can experience jerking feet or hands.
Generally, a person is diagnosed with epilepsy if they have had at least two unprovoked seizures. Some children with epilepsy may no longer show symptoms as they get older.
Symptom
Because epilepsy is caused by abnormal electrical activity in the brain, the seizures that occur can affect the coordination processes in the brain. Signs and symptoms of a seizure can include:
- Temporary confusion
- Blank stare
- Uncontrollable jerky movements of the hands and feet
- Loss of consciousness
- Psychological symptoms, such as fear, anxiety, and deja vu
Signs and symptoms of epilepsy can vary, depending on the type of seizure that occurs. In most cases, individuals with epilepsy generally have the same type of seizure each time. Therefore, signs and symptoms may be fairly similar in each episode.
Doctors generally classify seizures into two major groups, namely focal seizures and generalized seizures. This grouping depends on the onset of abnormal activity in the brain.
When seizures appear to occur as a result of abnormal activity in only one area of the brain, the seizures that occur are known as focal or partial seizures. Seizures of this type can be further divided into two categories, namely focal seizures without impaired consciousness and focal seizures with impaired consciousness.
Sometimes, the signs and symptoms of focal seizures can be difficult to distinguish from those of other neurological disorders, such as migraines, narcolepsy, or mental disorders. Therefore, a detailed examination is needed to distinguish epilepsy from other disorders.
Seizures that appear to involve all areas of the brain are known as generalized seizures. Generalized seizures can be divided into six types, namely absence seizures, tonic seizures, atonic seizures, clonic seizures, myoclonic seizures, and tonic-clonic seizures, with each type having different signs and symptoms.
Reason
In about half the patient population with epilepsy, generally, an underlying cause cannot be identified. This condition is thought to be related to various factors, including:
- genetics. Some types of epilepsy, which are grouped based on the type of seizure experienced and the part of the brain involved, can be experienced by more than one member of the family.
In these cases, there is a possibility that genetic influences are involved. Experts have associated several types of epilepsy with certain genetic components.
However, in most people, genetics is only part of the cause of epilepsy. The presence of certain genes can make a person more sensitive to environmental conditions that can trigger seizures.
- Head trauma. Head trauma as a result of a motor vehicle accident or another injury can cause epilepsy.
- Disorders of the brain. Disorders of the brain that cause brain damage, such as a brain tumor or stroke, can cause epilepsy. Stroke is the leading cause of epilepsy in adults over the age of 35.
- Infectious disease. Certain infectious diseases, such as meningitis and encephalitis, can cause epilepsy.
- Disorders during pregnancy. Before delivery, the fetus is sensitive to brain damage which can be caused by several factors, such as infection from the mother, poor nutrition, or lack of oxygen. This brain damage can cause epilepsy.
- Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis.
Several factors are thought to increase the risk of developing epilepsy, including:
- Age. The onset of epilepsy is more common in childhood and the elderly, but the condition can present at any age.
- Family history. A person with a family member who has epilepsy has a higher risk of developing the disorder.
- Head injury. Head injuries can cause some cases of epilepsy. This risk can be prevented by wearing a seat belt when driving a car or wearing a helmet when cycling, motorcycling, skiing, or doing activities with a risk of head injury.
- Stroke and other vascular diseases. Strokes and other blood vessel diseases can cause brain damage which then triggers epilepsy.
Efforts can be made to prevent the risk of the disease from occurring. Some of these include limiting alcohol consumption, avoiding smoking, eating a balanced diet, and exercising regularly.
- Dementia can increase the risk of developing epilepsy in the elderly.
- Infection of the brain. Infections of the brain such as meningitis, which causes inflammation of the brain and spinal cord, can increase the risk of developing epilepsy.
Diagnosis
The diagnosis of epilepsy can be determined based on a detailed medical interview, direct physical examination, and certain supporting examinations if deemed necessary. When carrying out a physical examination, the doctor can evaluate the neurological system by assessing behavior, motor skills, mental function, and other things to diagnose the condition being experienced and determine the type of epilepsy.
Some of the supporting examinations that can be carried out are:
- Blood test. The doctor may recommend blood tests to evaluate for signs of infection, genetic disorders, and other conditions that can be associated with the seizures you are experiencing.
- Electroencephalogram (EEG). This examination is one of the most commonly used tests to diagnose epilepsy.
In this test, the doctor places electrodes on the head that record electrical activity in the brain. In people with epilepsy, there is often a change from the normal pattern of brain waves, even when a person is not having a seizure.
Doctors can also monitor via video when doing EEG while the patient is awake or asleep, to record any seizures that are experienced. Recording seizures can help your doctor determine the type of seizure you are having or rule out other possible causes.
- Computerized tomography (CT). A CT exam uses X-rays to produce cross-sectional images of the brain. This examination can show abnormalities in the brain that may be the underlying cause of the seizures you are experiencing, such as tumors, bleeding, and cysts.
- Magnetic resonance imaging (MRI). An MRI scan uses a strong magnetic field and radio waves to produce detailed images of the brain. Doctors can detect lesions or abnormalities in the brain that can cause seizures.
- Positron emission tomography (PET). PET testing uses a small amount of radioactive substance that is injected into a vein. The goal is to help visualize active areas of the brain and detect any abnormalities.
- Single-photon emission computerized tomography (SPECT). This test is used after a person has had an MRI and EEG that cannot pinpoint the location in the brain where the seizure is originating.
This examination uses a small amount of radioactive substance that is injected into a vein. The goal is to produce a three-dimensional map of the blood flow activity in the brain during a seizure.
- Neuropsychological examination. In this examination, the doctor can evaluate thinking patterns, memory, and speech skills, which can help the doctor determine which areas of the brain may be involved.
Treatment
Treatment of epilepsy generally begins with medication. If treatment cannot overcome this condition, other treatments may be recommended, such as surgery or other procedures.
Some of the treatment options for epilepsy are:
- Treatment. Most people with epilepsy can experience seizure freedom by taking one type of anti-seizure medication, also known as an anti-epileptic drug. In other sufferers, sometimes a decrease in the frequency and intensity of seizures can occur by taking a combination of several types of medication.
Determining the type of treatment and dosage requires an in-depth evaluation with the doctor who treats the patient. Doctors can consider your condition, seizure frequency, age, and many other factors when considering the most suitable treatment.
Some of the side effects that can arise from anti-seizure medication, but are quite rare, are fatigue, dizziness, weight gain, decreased bone density, skin rashes, impaired coordination, speech disorders, and memory and thought processes.
- Surgery. When medications are no longer successful in controlling seizures, doctors may consider surgical procedures. In this procedure, the area of the brain that causes seizures is removed.
Doctors may generally consider surgery if the seizure originates from a small, well-defined area of the brain. Or it could be if the area does not interfere with vital functions such as speech, language, motor function, vision or hearing.
- Therapy. Apart from medication and surgery, there are several types of therapy that can be done to treat epilepsy. Several types of therapy that can be done are vagal nerve stimulation, deep brain stimulation, and so on.
Prevention
Because most epilepsy has no known underlying cause, there are no prevention methods that have proven to be completely effective in preventing the disease.
However, in epilepsy that is based on a specific cause, such as a head injury or stroke, this can be prevented by first preventing the underlying cause. For example, head injuries can be prevented by wearing a helmet when riding bicycles and motorcycles, or when engaging in activities with a risk of head injury.
Likewise with strokes, which can be prevented by adopting a healthy lifestyle by consuming balanced nutrition, avoiding smoking, limiting alcohol consumption, and keeping blood pressure stable.