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Epilepsy

Overview

Epilepsy is chronic neurological disorder with recurrent seizures (altered electrical activity in the brain resulting in physical changes in behaviour and movement) or tendency to have recurrent seizures. This activity of the brain may be due to structural or genetic abnormality.

  • Genetic mutations
  • Head injuries
  • Infections (meningitis, encephalitis)
  • Stroke or haemorrhage
  • Mass lesions in the brain

  • Age: Epilepsy is the most common in children and older adults. However, it can present at any age 
  • Family history
  • Brain injuries
  • Vascular diseases
  • Infections and brain infections
  • Other conditions like dementia, Alzheimer's disease, and certain genetic syndromes can increase the risk of epilepsy
  • Other factors including sleep deprivation, hormonal changes, certain medications, and low blood sugar

  • Depends on the seizure type related with epilepsy
  • Aura, which is an abnormal sensation or feeling before the convulsions start
  • Bloating, nausea, visual phenomenon, olfactory hallucinations, or déjà vu, which means feeling that you have already experienced something which is happening for the first time
  • Convulsions, which are motor reflexes following aura with tonic posturing or jerky movements of the limbs
  • Confusion or a feeling of disorientation
  • Repetitive seizures may lead to cognitive impairment

  • Generalized epilepsy (jerking of all the four limbs accompanied with unconsciousness)
  • Focal seizures (affecting a single part of the brain)
  • Temporal lobe epilepsy
  • Absence epilepsy

Neurologist

  • History
  • EEG demonstrates specific epileptiform discharges, localized to a particular area in focal epilepsy
  • Ictal PET scan shows hypermetabolism of area from where seizure starts
  • Interictal SPECT shows hypometabolism of the area

  • Antiseizure medication
  • Epilepsy surgery can be contemplated, when the seizures tend to arise from a single focus in the brain repetitively and when they are poorly controlled even after using adequate doses of appropriately chosen medication for an adequate duration
  • Vagal nerve stimulation can be implemented based on the principle of stimulation of the vagus nerve in response to detection of generation of abnormal motor excitability of cortex. Stimulating the vagus nerve aborts the abnormal excitability of cortex before it spreads to the neighbouring areas; thereby terminating the seizure
  • Ketogenic diet
  • Lifestyle modification such as regular and adequate sleep, avoiding the use of stimulating medications, and using antiseizure medications helps to decrease the frequency of attacks
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