Epilepsy is a common illness that produces repeated seizures. It isn't a form of mental disease or retardation. It normally does not have an impact on how well someone thinks or learns. But myths, misconceptions and misunderstandings still surround epilepsy.
Epilepsy is a neurological disorder characterised by recurring seizures, which are caused by electrical disturbances in the nerve cells in a section of the brain. A seizure can be described as being due to a burst of electrical energy in a certain part or parts of the brain that temporarily disturbs normal brain function and may disrupt consciousness and the actions and movements of muscles.
The most accurate records available indicate that chronic, recurrent epilepsy occurs in about 10 per 1,000 people, or in 1% of the general population, affecting males and females in equal numbers.
Causes of epilepsy
The causes of epilepsy are often unknown. A direct cause can only be identified in less than 50% of cases. There may be a family link and researchers are focusing on chromosome 6 as a possible cause.
Occasionally, other problems such as a head injury, birth trauma, brain tumour, low blood sugar, central nervous system infection, serious infections of the brain or stroke cause epilepsy.
A seizure may be brought on by certain triggers or stimulants such as flickering lights or excitement. Therefore, people living with epilepsy need to be aware of possible triggers and to avoid them when possible.
Symptoms of epilepsy
The major symptom of epilepsy is recurrent seizures that happen without warning. Without treatment, seizures might continue, occur more often and even get worse over time. Seizures could result in problems with muscle coordination, movement, speech, sight or awareness.
Seizures generally do not last long, but they can be frightening. The frequency and type of seizure differ from person to person. A person may suffer from only one or multiple types of seizure. There are more than 30 types of seizure.
Depending on the specific type of seizure:
It is important to note that not everyone who experiences seizures suffers from epilepsy. Seizures may occur due to an illness, injury or additional problem. In these instances, the seizures discontinue when the problem improves or disappears. Having one or two seizures does not mean that a person has epilepsy.
Diagnosis of epilepsy
Correct diagnosis is critical for the treatment of seizures, but diagnosing epilepsy can be difficult. If you believe that you or someone close to you has experienced a seizure, your doctor will first attempt to find out if the incident was indeed a seizure or something else with similar signs and symptoms. A muscle tic or a migraine headache could look or feel similar to a type of seizure.
The doctor will ask many questions when taking your clinical history. He or she may wish to know what took place just before, during and immediately after the seizure. Someone who witnessed the seizure can also help describing what happened.
An electroencephalogram (EEG) may be taken to help detect the patterns of increased brain activity. Other tests may include computerised axial tomography (CAT) scans, magnetic resonance imaging, single photon emission, computerised tomography and positron emission tomography.
Epilepsy cannot be prevented but treatment is available. Most people with epilepsy live normal, productive lives, but epilepsy can be a difficult condition to manage. Treatment includes the correct diagnosis, evaluation and medication, and dealing with psychosocial issues that may arise from the condition.
The treatment consists mainly of anticonvulsant medication, of which a number of products are available. The medication dampens the nerves' conductivity and areas in the brain that are hyper excitable.
Brain surgery to remove damaged areas in the brain and to alleviate seizures has been proven effective in many cases.
Research has also indicated the role that nutrition plays in the treatment of epilepsy. A ketogenic diet, which is high in fat, adequate in protein and low in carbohydrates, is primarily used to treat difficult-to-control epilepsy in children. People whose epilepsy cannot be control by anticonvulsants (approximately 30%) may follow the ketogenic diet.
Vagus nerve stimulation (VNS) is also used as a treatment for epilepsy. VNS uses an implanted stimulator that sends electric impulses to the left vagus nerve in the neck via a lead wire implanted under the skin. Once successfully implanted, the generator sends electric impulses to the vagus nerve (the tenth cranial nerve) at regular intervals. Research is continuing to understand the exact working of this device.