What is epilepsy??
Epilepsy is the name given to the medical condition in which a patient has recurrent seizures. Seizures are also more commonly referred to as “seizures” or “convulsions”. The normal brain has millions of neurons that generate electricity. These electrical currents travel in a controlled and coordinated manner between brain regions to generate various brain functions.
When these brain currents become excessive and disorganized for a few minutes, the person behaves abnormally for a short period and this constitutes an epileptic seizure.
When seizures occur repeatedly without immediate triggers indicating a low threshold for recurrent seizures, it constitutes epilepsy.
Epilepsy is a common neurological condition that affects 1 in 200 people in society. People with epilepsy have seizures or “seizures.”
Are there different types of fits?
The normal brain has continuous electrical currents in a controlled manner. Seizures or seizures occur due to brief excessive currents in the brain. The symptoms of a seizure vary depending on which part of the brain has abnormal current. Consequently, there are different types of seizures or fits.
Generalized (Grand mal) seizure:
In this type of seizure, the person falls to the ground and becomes stiff and then shakes all over. There may be frothing at the mouth… the person may lose urine and also bite their tongue. These are commonly called “convulsions”.
Focal seizures
These are seizures due to abnormal current in only one part of the brain, the symptoms can vary with the location of the current.
Focal conscious seizure:
The person is fully conscious and has an unusual sensation or twitching in their limbs, and remembers this event later.
Focal unconscious seizure:
The person is not fully in their senses and has some irrelevant automatic behavior such as flapping limbs, or chewing or picking movements, looks blank and unresponsive. The person cannot remember this event later. This is called a focal unconscious seizure/complex partial seizure.
Is epilepsy a disease?
Medicines are the mainstay of epilepsy treatment and modern drugs are quite safe with minimal side effects. Over 70% of people with epilepsy have good control of their seizures with medication. Currently, there are over 15 different types of medications available to treat seizures.
What precautions should a person with epilepsy take?
Seek the right medical help from the expert doctor
Regularity with medications is of the highest priority, even when there are no seizures
Sleeping and mealtimes must be regular. Sleep deprivation is known to trigger seizures
Avoid driving motorized vehicles, swimming, cooking over an open fire, or operating heavy machinery if epilepsy is active
Many factors predispose one to epilepsy. Known to run in families, the onset may follow a headache, high fever, hypoglycemia or even trauma to the brain. But in several cases no such risk factor can be determined and the individual has spontaneous seizures. When epilepsy develops suddenly in a previously healthy person, it may signal an underlying brain injury or abnormality.
Impact on physical and mental health
The the effects of epilepsy for most people goes beyond the physical seizure, but for some the seizure itself is followed by physical incapacitation. For example, when epilepsy is secondary to brain damage from a birth-related complication (perinatal injury) or head injury due to a traffic accident or cerebral infarction, the individual may have additional disability due to paralysis or cognitive damage due to the brain insult.
The mental and emotional effects of epilepsy can also be a challenge. Patients with epilepsy may face stigmatization, bullying or social isolation due to societal stigma arising from poor knowledge and understanding of the problem. Overprotection and restriction of daily activities such as going to school, traveling or spending time with friends can affect self-confidence and self-worth which in turn can lead to anxiety and depression. Seizure-related anxiety can contribute to further lifestyle limitations. Unfortunately, stigma against epilepsy often affects the mental health of the person with epilepsy due to ignorance and misconceptions about the disease. A few patients with epilepsy may have other challenges such as attention deficit hyperactivity disorder, depression and anxiety.
The best way to overcome this is to spread the right information about the nature of epilepsy and the fact that it can be treated well with medication or surgery. Awareness programs through public forums, communication through radio, TV and social media, focused conversations are a major way to dispel myths. November 17th is celebrated every year as National Epilepsy Day to spread the right message about the nature of epilepsy: it is a treatable medical condition.
(Author: Dr. Jayanti Mani, Consultant, Neurology, Kokilaben Dhirubhai Ambani Hospital, Mumbai)