Epilepsy- Causes, Symptoms, Treatment, Diagnosis & Prevention

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What is Epilepsy?

Epilepsy is a serious neurological disorder that makes the brain activity becomes abnormal, causing seizures or periods of uncontrol behavior, sensations, and sometimes loss of awareness.  Epilepsy is a common brain disorder which is characterized by recurrent seizures.

One is diagnosed with epilepsy after they have two unprovoked seizures. A seizure is known to be an abnormal, disorderly discharging of the brain’s nerve cells, resulting in a temporary disturbance of sensory or mental function. There are two main types of seizures. Generalized seizures affect the whole brain. Focal, or partial seizures, affects only part of the brain.

But also one can have a mild seizure which can last a few seconds during which you lack awareness and can be difficult to detect. There is also stronger seizures which can cause spasms and uncontrollable muscle twitches. It can last a few seconds to several minutes. When a stronger seizure occurs, some people might become confused or even lose consciousness. Afterward, you may forget it even happen.

There are many reasons you might have a seizure. These include:

  • high fever
  • head trauma
  • very low blood sugar
  • alcohol withdrawal

Though there’s no cure for epilepsy, there are medications and other strategies can be used to manage the disorder. Which will be discussed in this article.

What Causes Epilepsy

About half of the people known to live with Epilepsy do not show the causes of it. In the same case, the other half have shown causes of the disorder in them. The causes of Epilepsy is not identified in about half of the people living with the disorder. But causes noted in most cases of Epilepsy include:

  • Genetic influence
  • brain tumor or cyst
  • Head injury from accidents during youth or adulthood
  • Birth injuries
  • Stroke, including hemorrhage
  • dementia or Alzheimer’s disease
  • Brain conditions
  • Chemical imbalance such as low blood sugar or sodium
  • Infectious diseases such as AIDS, meningitis, and viral encephalitis
  • Developmental disorders such as autism and neurofibromatosis.

It is noted that Epilepsy leads to seizures. The Common causes of seizures by age:
In Newborns: 
Brain malformations
Lack of oxygen during birth
Low levels of blood sugar, blood calcium, and electrolyte disturbances
Inborn errors of metabolism
Intracranial hemorrhage
Maternal drug use

In Infants:
Fever (febrile seizures)
Brain tumor (rarely)
Infections
In Children:
Congenital conditions (Down’s syndrome, tuberous sclerosis, and neurofibromatosis)
Genetic factors
Head trauma
Progressive brain disease (rare)
In Adult:
Alzheimer’s disease
Stroke
Trauma

Symptoms of Epilepsy

Symptoms of epilepsy are divided into different forms

Most Common Symptoms of Epilepsy are:

  • A staring spell
  • Psychic symptoms
  • The person might experience temporary confusion
  • Also, there is a loss of consciousness and awareness
  •  There are uncontrollable jerking movements and jerking of the arms an legs

Symptoms of Simple Partial Seizures (Epilepsy)

Some of the motor signs shown include the following:

  • Eye movements and turning of the head are usually notable
  • The limbs are postured asymmetrically
  • Speech arrest, vocalization
  • There are an alternating contraction and relaxation of muscle groups

Sensory Symptoms Include the Following:

  • Seeing flashes of lights or colors
  • The person involved tends to Hallucinate
  • Illusions are common too
  • Hearing buzzing, humming, and hissing noises
  • Nauseating
  • Lightheadedness and dizziness
  • Rumbling noises produced by gas in the intestine (Borborygmi)
  • Experiencing unpleasant tastes and odors
  • Tachycardia which is known as rapid heart rate
  • Piloerection (goosebumps)

Psychic Symptoms include the following

  • Detachment and depersonalization
  • Feeling as if you are in a dreamy state
  • Time distortion
  • Unprovoked emotion: pleasure, displeasure, depression, anger, eroticism, elation fear.

Symptoms of Complex Partial Seizures (Epilepsy)

What distinguishes complex partial seizures from simple partial seizures is loss of consciousness. While unconscious, the patient seems to have a “frightened” look and may have signs and symptoms of a simple partial seizure. During the period of unconsciousness, automatisms may occur.

There are five types of automatisms, they are:

Alimentary: Chewing, rumbling noises caused by gas in the intestines (borborygmi), increased salivation

Mimetic: Bewilderment, discomfort, tranquility, crying, Laughter, a facial expression of fear.

Gestural: Repetitive movements of the fingers, hands and sexual gestures

Verbal: repeated short phrases, sometimes swearing

Ambulatory: Running and wandering

Patients experiencing complex partial seizures over a period of years tend to experience drop attacks. When this occurs, the person in question loses postural tone and fall with the sudden onset of unconsciousness.

Symptoms of Tonic-Clonic Seizures (formerly called Grand Mal)

Tonic-clonic seizures sometimes begin as simple or complex partial seizures. It begins with aura, but some patients do not even remember this phase. The tonic phase consists of the following:

  • Fall
  • Jaws and fingers clenched
  • Loss of consciousness
  • Extension of arms, legs, and/or face
  • Yell or “tonic cry”

Autonomic Symptoms: The main autonomic symptoms are Increased blood pressure and heart rate, flushing, sweating, increased bladder pressure, increased salivation, increased bronchial secretion, apnea (cessation of breathing)

Diagnosis of Epilepsy

Epilepsy is mostly only diagnosed after the patient has had more than one seizure. If you suspect you’ve had a seizure, it is advisable to see your doctor immediately. A seizure might be a symptom of a serious medical issue. The review of your medical history and symptoms will help the doctor decide the most helpful test to determine the cause of seizures. You will probably undergo a neurological examination to test your mental functioning and motor abilities.

Blood tests: In order to diagnose epilepsy, other conditions that cause seizures should not be taken into account. Your doctor should order a complete blood count and chemistry of the blood.

Blood tests may be used to look for:

  • liver and kidney function
  • blood glucose level
  • signs of infectious diseases

Electroencephalogram (EEG): This is the most common test used in the diagnosis of epilepsy. Firstly, electrodes are attached to the patient’s scalp with a paste. It is a noninvasive, painless test. You may be asked to perform a specific task while the test is ongoing. In some cases, the test is performed during sleep. The electrodes compute the electrical activity of the brain. Whether an epileptic patient is having a seizure or not, changes in the normal brain wave patterns are common in epilepsy.

Imaging tests can also reveal tumors and other abnormalities that cause a seizure. Some of the tests include:

  • CT scan
  • MRI
  • Positron emission tomography (PET)
  • Single-photon emission computerized tomography

Epilepsy is diagnosed if you have a seizure for no reversible or apparent reason.

Treatments of Epilepsy

Here are several treatments of Epilepsy

Ketogenic Diet

The doctor may suggest a diet depending on the type of seizure you have. A ketogenic diet is one of these types of diet. It is a diet that is high in fats and low in carbohydrates. It isn’t something you should try to do on your own. Talk to a nutritionist first or a doctor.

Usually, the ketogenic diet is given to children when medication hasn’t improved their seizure in any way, recent studies have shown it can also work for adults. Taking this type of diet might make you feel sluggish at first. Side effects that occur include:

  • High cholesterol
  • Kidney stones
  • dehydration
  • weight gain
  • constipation
  • Broken bones

Nerve Stimulation

There are two kind s of nerve stimulation available:

Vagus Nerve Stimulation: This is a nerve that runs through the chest and abdomen, through the neck, and even up to the lower part of the brain. This nerve controls things that are automatic in the body like the heartbeat.

In this type of treatment, your doctor put a small gizmo known as vagus nerve stimulator under the skin of your chest, and it is connected to the nerve. The device sends a small burst of electricity through your nerve to your brain. You will still probably have to take medication after this treatment has been administered.

Responsive Neurostimulation: In this type of treatment, the doctor puts a small gadget known as  “Neurostimulator” under your scalp. The device looks for patterns in your brain activity that can lead to a seizure. When the neurostimulator identifies one of these patterns, it sends a little pulse to interrupt it.

Surgery

There are two main kinds of this Surgery.

Resective Surgery: In this type of Surgery, the surgeon removes part of the brain that is responsible for the seizures. This surgery is often done when the part of the brain causing the seizures is minimal and has very good boundaries, and also do not control things like movement, sight, speech, or hearing.

Disconnective Surgery: In this type of Surgery, instead of removing parts of the brain, the surgeon cuts the parts between the nerves that are a part of the seizures.

Drugs

Anti-epileptic (anticonvulsant, antiseizure) drugs can reduce the number of seizures a patient have. In some people, the seizure is eliminated. For the medication to be effective, it has to be taken as prescribed by the doctor.

Research is ongoing for new treatments. One treatment that may become available in the future is deep brain stimulation. In this type of treatment, it takes several procedures. First, the electrodes are implanted into your brain. Then a generator is implanted to your chest. The generator then sends in electrical impulses to the brain which helps decrease the seizures.

Another type of research carried out involves a pacemaker-like device which will check the pattern of brain activity and send an electrical charge or drug to help stop a seizure.

On a lighter note, invasive surgeries and radiosurgery are also being researched upon.

Most of the epileptic seizures are controlled by medication, mostly anticonvulsant drugs. The type of treatment prescribed to a patient depends on several factors, which include the severity and frequency of the seizures, the person’s age, overall health, and medical history.

Medications used to treat epilepsy include:

  • Carbamazepine (Tegretol or Carbatrol)
  • Diazepam (Valium) and similar tranquilizers, such as lorazepam (Ativan), Tranxene and clonazepam (Klonopin)
  • Eslicarbazepine (Aptiom)
  • Ethosuximide (Zarontin)
  • Felbamate (Felbatol)
  • Gabapentin (Neurontin)
  • Lacosamide (Vimpat)
  • Lamotrigine (Lamictal)
  • Levetiracetam (Keppra)
  • Oxcarbazepine (Oxteller XR or Trileptal)
  • Perampanel (Fycompa)
  • Phenobarbital
  • Phenytoin (Dilantin or Phenytek)
  • Pregabalin (Lyrica)
  • Primidone( Mysoline)
  • Tiagabine hydrochloride (Gabitril)
  • Topiramate (Topamax)
  • Valproate, valproic acid (Depakene, Depakote)
  • Zonisamide (Zonegran)

Epilepsy Home Remedies
Some of the herbs most commonly used for the treatment of epilepsy are:

  • Scullcap
  • Lily of the Valley
  • Hydrocotyle
  • Groundsel
  • Peony
  • Mugwort
  • Mistletoe
  • Burning Bush
  • Valerian
  • Tree of heaven

Alongside a healthy diet, certain vitamins can also help reduce seizures in epilepsy. Remember that vitamins alone don’t work. Follow your doctor’s prescription to prevent a possible overdose. The most commonly used vitamins for epilepsy are:

  • Vitamin E
  • Vitamin B6
  • Vitamin D
  • Folic Acid

Prevention of Epilepsy

Sometimes epilepsy can be prevented. These are some of the most common ways of reducing your chances of developing epilepsy

Prevent Traumatic Brain Injuries

Brain injuries, also known as traumatic brain injuries, are the most common causes of epilepsy.

  • Ride SafelyExternal: Make use of safety belts, airbags, child passenger seats, motorcycle, and bicycle helmets to reduce motor vehicle and traffic injuries
  • Step Carefully: The leading causes of brain injury are falls. Children and older adults have an increased chance of having brain injuries from falls.
  • Try to get help for traumatic brain injuries if they occur: The chances of having epilepsy is higher with severe brain injuries. It is of utmost importance to take care of the injury to help avoid the occurrence of epilepsy.

Lower the chances of stroke and heart disease

Take vital steps each day to lower the chances of stroke and heart disease. These include exercising, not smoking and eating well. This health actions can help prevent epilepsy later in life.

Wash your hands and prepare food safely

Epilepsy is most commonly caused by an infection known as cysticercosis. It is caused by a parasite. This infection can be prevented through proper hygiene and food preparation practices. Going for health screening and early treatment for cysticercosis can prevent epilepsy.

Get vaccinated

Try to protect yourself and your family from diseases by getting a vaccination. Immunizations (also known as shots or vaccines) reduces your chances of contracting infections that can sometimes lead to epilepsy.

Stay healthy during your pregnancy

Some complications during childbirth or pregnancy can lead to epilepsy. Following a parental care plan with your health care provider, like your nurse or doctor, helps keep you and your baby healthy.

Here are some other vital tips that may help reduce the risk of having an epilepsy seizure
  • Take all of your medications as prescribed by your doctor
  • Avoid playing video games
  • Avoid drugs and alcohol
  • Eat a healthy diet
  • Get plenty of sleep every night-stick to a regular sleep schedule
  • Skip TV and computer time whenever possible
  • Learn stress management and relaxation techniques
  • Avoid bright and flashing lights and other visual stimuli

Complications of Epilepsy

Injury: If an individual experiences a fall during a seizure, they may sustain a head injury. Other complications of epilepsy are drowning, individual having a seizure might drown while swimming or bathing.

Loss of consciousness and awareness: A seizure that leads to either loss of control or awareness can be dangerous if the individual is operating a piece of equipment or driving a car. Medications that are used to control seizures also can cause drowsiness, this may affect the individual’s driving ability. There are licensing restrictions related to the individual’s ability to control seizures.

Pregnancy: Seizures during pregnancy poses a great threat to both baby and mother and most anti-epileptic medications are the causes of birth defects. A doctor’s advice is very important an epileptic patient who is considering becoming pregnant. Most women with epilepsy can become pregnant and also have a healthy baby, but some of them need to adjust their medications and be carefully monitored throughout the pregnancy period.

Life-threatening complications: Life-threatening complications from epilepsy are not very common, but can still occur. Individuals who have prolonged, severe, or continuous seizures (status epilepticus) have an increased risk of permanent brain damage and even death. Individuals with epilepsy, particularly those with epilepsy not properly controlled, also have a small risk of a condition known as sudden unexplained death in epilepsy (SUDEP). The risk of SUDEP might increase if the individual has seizures at an early age, has frequent seizures involving more than one section of the brain, or continues to have seizures notwithstanding the treatments with medications.

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