As per WHO, epilepsy is a chronic disorder characterized by recurrent seizures which may vary from a brief lapse of attention or muscle jerks, to severe and prolonged convulsions.
The seizures are caused by sudden, usually brief, excessive electrical discharges in a group of brain cells (neurons). In most cases, epilepsy can be successfully treated with anti-epileptic drugs. Epilepsy is a chronic non communicable disorder of the brain that affects people of all ages. WHO statistics shows that around 50 million people worldwide have epilepsy.
- Changes in the way things look, smell, feel, taste or sound
- An intense feeling that events have happened before (déjà vu)
- Tingling sensation, or ‘pins and needles’, in arms and legs
- A sudden intense emotion, such as fear or joy
- The muscles in arms, legs and face may become stiff
- Experience twitching on one side of your body
Exact cause of epilepsy is still unknown but it is thought that it results from excess neuronal firing/activity. Epilepsy is caused when there are disruptions to the normal connections between nerve cells in the brain (much like disruptions in wiring of a complex electrical circuit), when there are imbalances of natural chemicals or neurotransmitters that are important to the signaling among nerve cells, or when there are changes in the membranes of nerve cells, including proteins called ion channels, that alter their normal sensitivity.
Some of these disruptions, imbalances, and changes may develop early in life, sometimes related to early exposures and events and sometimes related to hereditary factors.
There are three main categories of epilepsy:
Metabolic/ structural epilepsy There is a known cause for a person’s epilepsy, such as a head injury, infections, birth hypoxia etc.
Idiopathic epilepsy – No apparent cause for epilepsy can be found despite investigations.
Epilepsy due to unknown cause like idiopathic epilepsy, no apparent cause can be found. However, there is strong evidence that this type of epilepsy may be the result of brain damage. Status epilepticus: Any seizure lasting for more than 5 minutes is defined as a status epilepticus and the PWE must be rushed to hospital or emergency medication be given as prescribed by the doctor by nose etc, this is a medical emergency.
The diagnosis of epilepsy usually requires that the seizures should occur spontaneously.Other precipitants can trigger an epileptic seizure in patients who otherwise would be susceptible to spontaneous seizures commonest are missing epilepsy medication dose, lack ofsleep, stress, taking certain medication which may precipitate seizures. Rarely certain epilepsy syndromes require particular triggers for seizures to occur. These are termed reflex epilepsy. For example, patients with primary reading epilepsy have seizures triggered by reading Photosensitive epilepsy can be limited to seizures triggered by flashing lights.
Magnetic resonance imaging scan (MRI): An MRI scan can often detect possible causes of epilepsy, such as defects in the structure of your brain or the presence of a brain tumor. For epilepsy, an epilepsy protocol MRI should be done. This test is not painful.
Electroencephalograph (EEG): An EEG test measures the electrical activity of the brain through electrodes placed on the scalp. During the test, patient may be asked to breathe deeply or close the eyes, as these actions could reveal unusual brain activity associated with epilepsy. Patient might also be asked to look at a flashing light, but the test will be stopped immediately if it looks like the flashing light could trigger a seizure.This test is not painful.
Your diagnosis may vary so it is advisable to consult your physician for further diagnosis.
Dos and donts during a convulsion:
|1. Stay CALM||1. DO NOT CROWD around|
|2. CUSHION the person’s head||2. DO NOT RESTRICT the person|
|3. PROTECT from injury||3. DO NOT PUT anything in the mouth|
|4. LOOSEN anything tight around neck||4. NO WATER OR FLUID till fully alert|
5. Turn to side to prevent choking- right or left
5. Do not make the person smell a shoe / onion
|6. TIME the seizure||6.Do not force down|
|7. More than 5 mins, RUSH TO HOSPITAL||7.Do not leave person unattended|
|8. After recovery, REASSURE & OFFER HELP||8.Do not get frightened|