Epilepsy : Types, Triggers, and Treatment

Overview

What is Epilepsy ?

Epilepsy is a brain disorder whose hallmark symptoms include recurrent convulsions. The term “seizure” refers to an abrupt shift in behavior caused by a transient disruption in the brain’s electrical activity. In a healthy brain, a steady stream of minuscule electrical impulses is produced. Chemical messengers, or neurotransmitters, transmit these signals along the brain’s neural network and across the body.²Overview| Researched based study from Medlineplus.gov

Two or more seizures in the absence of a proven medical reason, such as alcohol withdrawal or severely low blood sugar, are required for a diagnosis of epilepsy.

Types

Types of epilepsy

Focal or simple partial seizures

It can cause-

• Involves a strange sensation like a” sensation in the stomach, like that experienced on a fairground ride ⁵Types | Researched based study from Nhs.uk
• A sense of having experienced the similar events previously (déjà vu).
• Tingling in arms and legs
• Strange taste in your mouth
• A sudden, strong emotion like terror or happiness
• Muscle stiffness or twitching in a specific area
• While this is occurring, you continue to be awake and alert.

These convulsions are frequently called “warnings” since they might foreshadow the onset of another kind of seizure.

Complex partial seizures

Complex partial seizures cause you to lose consciousness and exhibit irrational behavior, such as: ⁵Types | Researched based study from Nhs.uk

• Smacking lips
• Hand rubbing
• Making random sounds
• Flailing your arms about
• Messing with your clothing or other things
• Chewing or swallowing

During the seizure, you will not be able to communicate with anyone and won’t remember anything about the seizure.

Tonic-clonic convulsions

Most people’s mental image of an epileptic seizure is of a tonic-clonic seizure sometimes called a “grand mal” ⁵Types | Researched based study from Nhs.uk

• They consist of two phases, a first “tonic” phase, and a subsequent “clonic” phase.
• Tonic state, when one loses awareness, becomes rigid, and may pass out or fall to the floor
• During the clonic phase, you may experience twitching in your limbs, involuntary urination or defecation, biting of the tongue, and/or breathlessness.
• Most seizures end in a couple of minutes, but some can last for much longer.

Absences

Absence seizures, formerly known as “petit mal,” cause brief amnesia of one’s surroundings. Although they are more common among children, they may afflict anybody. ⁵Types | Researched based study from Nhs.uk

A person having an absence seizure may:

• Act as though they are “daydreaming”
• Stare out into space with fluttering eyelids and minor jerking motions of the torso or limbs.
• Seizures last no more than 15 seconds.

Myoclonic seizures

• Abrupt, involuntary muscle twitches or jerks all throughout the body, like the effects of an electric shock. ⁵Types | Researched based study from Nhs.uk
• They frequently occur soon after you wake up.
• Myoclonic seizures typically last only milliseconds but can occur repeatedly in rapid succession.

Clonic seizures

• The body shakes and jerks in a clonic seizure, much as it does in a tonic-clonic seizure, but there is no initial stiffness. ⁵Types | Researched based study from Nhs.uk
• You might lose consciousness during these seizures.
• Tonic seizures
• Like the onset of a tonic-clonic seizure, the tonic phase of a seizure causes all your muscles to stiffen quickly.
• You might get unsteady and fall over due to such seizures.

Atonic seizures

• Atonic seizures produce abrupt muscular relaxation, which might result in falling to the floor.
• In most cases, you can get back up and continue your activities right after a seizure.

Status epilepticus

• Status epilepticus is the medical term for a prolonged seizure or a cluster of seizures from which the patient does not recover consciousness. ⁵Types | Researched based study from Nhs.uk
• This is a serious medical situation that requires immediate attention.

Causes

Causes of epilepsy

A brain disorder or damage might be at the root of epilepsy. Epilepsy often stems from these common causes: ¹Causes | Researched based study from Medlineplus.gov

• Acute ischemic stroke or mini-stroke
• Dementia like Alzheimer’s disease
• Accidental brain damage
• Diseases including septic brain abscess, bacterial meningitis, viral encephalitis, and HIV/AIDS
• Prenatal or postnatal brain damage
• Birth defects resulting from abnormal metabolism (such as phenylketonuria)
• Tumors of the brain
• Abnormalities of the brain’s blood vessels
• An alternate disease that causes brain tissue death
• Congenital forms of epilepsy (hereditary epilepsy)

Symptoms

Generalized symptoms of epilepsy

The origin and extent of the abnormality in the brain determine the seizure’s unique characteristics. ³Symptoms | Researched based study from Who.int

Psychological symptoms

• Amnesia
• Disorientation
• Changes in perception (including sight, sound, and taste), emotion, and thought.

Physical symptoms

Due to seizure episodes could include

• Broken bones
• Bruises
• Falls
• Burns
• Drowning

Triggers

Triggers for epilepsy

Seizures often seem to occur at random for persons with epilepsy. However, there is often a precipitating factor, such as: ⁵Triggers | Researched based study from Nhs.uk

• Lack of sleep
• Stress
• Alcohol consumption
• Medicinal and illicit drug use
• Menstruation in females
• Flashing illumination

Seizure triggers can be identified and avoided if you keep a record of your seizures and the events leading up to them.

Risk

Risk factors of Epilepsy

• Premature or underweight births ¹Risk | Researched based study from Medlineplus.gov
• Perinatal trauma (such as lack of oxygen)
• Birth defects that cause seizures Abnormal brain structures
• Intracerebral hemorrhage
• Abnormalities of the brain’s blood vessels
• Death or serious disability due to brain damage or hypoxia
• Tumors of the brain 2
• Meningitis and encephalitis
• Stroke caused by arterial obstruction
• Cerebral palsy
• Seizure occurring within a few days of a head injury
• Mental disabilities
• Seizures caused by fever
• Family-related history of epilepsy
• Onset of Alzheimer’s disease
• Prolonged convulsions elicited by fever
• Drug and alcohol abuse

A new change in medical treatment or general lifestyle could also elicit seizures in both adults and children with epilepsy. Consult your physician about¹Risk | Researched based study from Medlineplus.gov

• Recent vitamin, mineral, or pharmaceutical additions
• Psychological strain
• Infectious disease or other illness
• Sleep deprivation
• Pregnancy
• Not taking your epilepsy medication as prescribed.
• Addiction to alcohol or other substances
• Intense visual or auditory stimulation
• Hyperventilation

Diagnosis

Diagnosis of epilepsy

The doctor performs a full body check. The central nervous system and brain will be the focus of this investigation. ¹Diagnosis | Researched based study from Medlineplus.gov

Electroencephalogram (EEG)

• The electrical activity of the brain will be measured by means of an EEG. This test often reveals aberrant electrical activity in patients diagnosed with epilepsy.⁶Diagnosis | Researched based study from Nationwidechildrens.org
• The test can sometimes pinpoint the precise region of the brain wherein the seizures first begin. After a seizure or in the time in between them, the brain may seem normal.

Magnetic resonance imaging

• MRI is a diagnostic technique that employs powerful magnets, radio waves, and a computer to create high-resolution pictures of inside body structures and organs.

Computed tomography (CT) scan

• CT is used to create horizontal or axial pictures (commonly referred to as slices) of the body using a mix of X-rays and computer technology. Any aspect of the body, from bones and muscles to fat and organs, may be seen clearly in a CT scan.
• CT scans provide more information than standard X-rays.

Spinal tap

• A specialized needle is inserted into the lower back, into the spinal canal, to perform a lumbar puncture (spinal tap). The spinal canal houses the spinal cord. It thus becomes possible to assess intracranial pressure.
• To diagnose an infection or other condition, a doctor may take a sample of cerebrospinal fluid (CSF) from the back or neck.

Other diagnostic procedures

• Blood chemistry work
• Glucose levels
• Complete blood count (CBC)
• Evaluation of renal function
• Genomic analysis
• Evaluation of liver health
• Diagnostics for contagious illnesses

Treatment

Treatment of epilepsy

Medication, changes in diet and routine, and even surgery are all part of the treatment for epilepsy. ¹Treatment | Researched based study from Medlineplus.gov

Medication

Anticonvulsants (also known as antiepileptic medications) are medicines used to prevent seizures, and they may lessen the frequency of future seizures.¹Treatment | Researched based study from Medlineplus.gov

• These medicines are to be taken orally. The kind of seizures you’re experiencing will determine the medication your doctor recommends.
• Your dose may occasionally require adjustment. Possible side effects necessitate frequent blood testing.
• It’s important to take the medication exactly as prescribed. If you forget to take your medication, you might have a seizure. Do not alter your medication schedule without consulting your doctor. See a medical professional first.
• Birth abnormalities are a common side effect of several drugs used to treat epilepsy. Women who are planning pregnancies should inform their doctors early so that appropriate adjustments may be made to their treatment plans.
• Bone health may be negatively impacted by several epileptic medications. You should discuss the use of nutritional supplements with your doctor.

Dietary therapy

• Some people with certain types of epilepsy may benefit from dietary treatment. Ketogenic and modified Atkins diets are the most popular choices.
• The ketogenic diet is a high-fat, moderate-protein, and low-carbohydrate eating plan that is often started in the hospital and followed for three to four days. Ketones are produced as a result of this diet. The breakdown of fat results in the production of ketones in the liver. ²Treatment | Researched based study from Aans.org

Surgical therapy

Medically resistant epilepsy is characterized by a lack of response to two or more anti-seizure medications. Surgery to remove a tumor, repair faulty blood arteries, or repair bleeding in the brain can sometimes eliminate epileptic episodes.

The surgical option may be suggested by the doctor to eliminate the seizure-causing aberrant brain cells: ⁶Treatment | Researched based study from Nationwidechildren.org

• This is done by implanting a vagus nerve stimulator (VNS).
• A cardiac pacemaker might be compared to this device.
• It may help decrease the frequency of seizures.

Prevention

Prevention of epilepsy

The onset of epilepsy can sometimes be avoided. Some of the most frequent preventative measures against epilepsy include the following:⁴Prevention | Researched based study from Cdc.gov

• Reduce the risk of brain trauma.
• Reduce the danger of having a stroke or heart attack.
• Get your vaccinations in time
• In order to avoid cysticercosis, it is important to practice good hygiene and cook meals properly.

Takeaway

Key Takeaways

People with epilepsy experience the effects of this chronic disorder in a variety of ways. Despite having epilepsy, many people go on regular, fulfilling lives. Medication and surgical procedures have been shown to reduce or eliminate seizures for 70–80% of persons with epilepsy.

For some, epilepsy isn’t something they have to give much thought to until when it’s time to take their medicine or visit the doctor. No matter how epilepsy affects a person, it is essential to educate oneself on the disorder and have a positive outlook.

In order to help manage seizures and allow the patient to enjoy a full and balanced life, close collaboration with a healthcare team and faithful adherence to prescribed drugs are important.