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A serious neurological problem that commonly affects people is epilepsy. It can strike any person regardless of age, gender, race or social class. However, it tends to appear more commonly is children and people over the age of 65 years. There are different types of epilepsy seizures that can affect different individuals. This article will help explain more about epilepsy and its prognosis.

What is Epilepsy?

Epilepsy is a word derived from ancient Greek word ‘epilepsia’. It is characterized by seizures occurring within the brain due to an abnormal or excessive neuronal activity. These are usually unprovoked seizures that briefly affect a person’s movements, actions or level of consciousness. Epilepsy can be controlled with the help of medications. However, there is no cure for epilepsy.

A person, who suffers from more than one seizure that was not caused by any known medical conditions or as a symptom of alcohol withdrawal as well as low blood sugar, is said to be suffering from epileptic seizures. The normal electrical activity within the brain is disturbed and causes the nerve cells to spark off random signals. This leads to seizures that last for a few seconds to several minutes.

What Leads to Epilepsy?

There are millions and millions of nerve cells in the brain. They are constantly passing signals to each other that help us move, think, laugh, walk and even concentrate. However, any disruption occurring during the passage of these signals leads to seizures. These seizures are commonly called as ‘fits’ or ‘attacks’. When one suffers from seizures, all senses, consciousnesses as well as movements are affected. Although, epilepsy is a neurological condition, it is also partly a physical condition as the body too is affected during a seizure. The person becomes lost, confused, and suffers from loss of control over the body movements during an epileptic fit. All because of the short circuit occurring within the electrical signals of the brain neurons.

What Causes Epilepsy?

Epilepsy is often categorized into two types. This division is based on the causes of epilepsy. The first type is called as ‘symptomatic epilepsy’ and the other is called as ‘idiopathic epilepsy’.

Symptomatic epilepsy means there is a known cause for the development of epilepsy in a particular patient. This includes:

  • Head injury
  • Meningitis infection
  • Underdeveloped brain
  • Stroke
  • Tumor or scar tissue in the brain
  • Tuberous sclerosis, a genetic condition affecting certain people

In children who suffer from symptomatic epilepsy, the causes include:

  • Hypoxic ischemic encephalopathy
  • Congenital CNS abnormalities
  • Trauma before or during birth
  • Febrile seizures (seizures due to high fever)
  • Brain tumors
  • Alcohol withdrawal or illegal drug use in adolescents

In case of idiopathic epilepsy, the condition has no known cause for developing epilepsy. It can either be termed as a hereditary or genetic condition. Thus, a person’s genes were programmed to be prone to seizures leading to epilepsy.

There is a third type, called as cryptogenic epilepsy where the exact cause symptomatic or idiopathic is not found after conducting various tests and investigations.

Types of Seizures

There are different types of seizures that are categorized into two groups primary generalized seizures and partial seizures. These types are divided based on how they begin in an affected person. Seizures occur in different parts of the brain, that is, lobes.

Primary Generalized Seizures

Generalized seizures are those tend to affect both sides of the brain. The seizure first begins on one side (hemisphere) of the brain and then spreads to the other hemisphere as well. This causes the patient to lose consciousness. After a seizure episode the patient may not remember anything that happened during the attack. There are different types of generalized seizures that include:

  • Absence seizures
  • Atypical absence seizures
  • Atonic seizures
  • Myoclonic seizures
  • Clonic seizures
  • Tonic seizures
  • Tonic-clonic seizures

Partial Seizures

Also called as focal seizures, these begin and affect just one part of the brain. This part is called as the ‘focus’. It can either occur in one small region of a lobe or large area in the hemisphere. These seizures are usually related to a brain injury, infection, tumor or stroke. In this case, either the patient may partially or fully remember the occurrences during an episode.

However, many suffer from varied levels of consciousness. Some of the types of partial seizures are as follows:

  • Complex partial seizures
  • Simple partial seizures
  • Secondarily generalized seizures

How is Epilepsy Diagnosed?

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Epilepsy is diagnosed only after a person suffers from more than one seizure. Febrile seizures are generally not considered as epileptic seizures. There are different tests that are used to diagnose epilepsy. These include:

  • Blood tests that help in determining anemia, diabetes, electrolyte imbalance, etc. due to seizures
  • Neurological examination to check motor and behavioral capacity
  • CT Scan
  • MRI Scan
  • Electroencephalogram (EEG)
  • Positron emission tomography (PET), etc.

How is Epilepsy Treated?

Epilepsy is generally treated using epilepsy drugs and medication. These medications help people overcome their seizures. The frequency of seizures decreases greatly, thus, improving their quality of life. However, the doctor may decrease or increase the dose and strength of the drugs for a while to find the best suitable dose for an individual. But, keep in mind, these anti-seizure medications are not free from side effects. Thus, make sure you learn all about the possible side effects from your doctor related to the drug prescribed.

Surgery is advised only to people who are resistant to drug therapy. In this case, if the seizure occurs in a part of the brain that is not concerned with one's senses, thinking or motor ability, surgery will be advised. The affected part will be removed to control the epileptic seizures. If the seizures occur in an important part of the brain, surgery is discouraged.

Other than this, alternative methods such as the ketogenic diet, is advised. Vagus nerve stimulation, deep brain stimulation is opted for where a device is inserted into the body like a pacemaker to control the seizures.

Seizures can occur at any point in life. Thus, it is very difficult to pinpoint the exact reason for a seizure. People suffering from epilepsy have always been socially stigmatized due to the poor awareness regarding the disease in the general public. However, over the years, people have been accepting the fact that epileptic seizures are not demonic possessions and they can be controlled with medications. One should seek medical advise related to seizures and get a control over the seizures as well as their lives.

Written by: Saptakee sengupta
Date last updated: February 4, 2015