Epilepsy is a condition in which people have epileptic attacks (also known as seizures). It is one of the more common neurological conditions, affecting 0.5-1 per cent of the population. Epilepsy is not a single condition, but a group of conditions with differing causes, treatments and prognoses Epilepsy is not a single medical condition in itself. It is a symptom of a range of other conditions that cause somebody to have repeated fits, which are also known as seizures.

Symptoms

There are many signs and symptoms of epilepsy. In many cases, the symptoms are unnoticeable. The most common symptom is a seizure. Seizures are classified as grand mal or petit mal. Grand mal seizures may consist of rapid pulse, whole body spasms, jerking muscles, biting of the tongue, bladder and bowel incontinence, and dilated pupils. Petit mal seizures are less severe and typically include temporary lack of awareness. Sufferers may appear to have a blank expression on their face, or temporarily “space out.” Once the seizure concludes, the sufferer is usually unaware of their previous condition. For this reason, petit mal seizures can often overlooked.

Causes

Causes of seizures (and sometimes epilepsy) are further divided into acute and remote causes. This subclassification depends on whether there is active brain disease (an acute cause) or whether the brain abnormality is the result of an injury caused by a previous event (in which case it would be called remote). For example, if a child with meningitis experiences seizures during the illness, they would be termed acute symptomatic seizures. If that same child developed seizures that persisted for years afterwards, she would be diagnosed as having remote symptomatic epilepsy

Epilepsy stems from dozens of causes: genetics, heredity, brain tumours, viral infections, head trauma from accidents or falls, alchoholism, Alzheimer’s disease, trauma during birth, strokes, heart attacks, high blood pressure, AIDS, poison or environmental conditions, nicotine from cigarette smoke, overmedicating from certain types of drugs, hormonal changes and even lack of sleep. Epilepsy is also associated with other disorders like autism, TB, and cerebral palsy. This is one reason why the disease is often difficult to diagnose, and why, for some, it remains such a confusing disease.

Treatment

Many people have their seizures successfully controlled with anti-epileptic drugs (AEDs). This is the most common way that epilepsy is treated. AEDs do not cure epilepsy. At the moment there is no cure for epilepsy. The aim of AEDs is to prevent seizures by controlling the excitability of the brain. How they do this is not totally understood. Despite this, their effectiveness in treating epilepsy has been scientifically proven.

Vagus nerve stimulation

Vagus nerve stimulation (VNS) can reduce seizures in some people. This is when an electrical device, implanted in the chest, regularly stimulates a nerve in your neck called the vagus nerve. The vagus nerve then sends signals to areas of the brain. This treatment is only available if other medicines haven’t helped and neurosurgery (brain surgery) isn’t possible.

Surgery

You may be offered neurosurgery if your epilepsy is severe and is not controlled after trying several different epilepsy medicines. This can only take place if the epilepsy is associated with a specific area of your brain. Your specialist will be able to explain your options to you.

 

Epilepsy is a common chronic neurological disorder that is characterized by recurrent unprovoked seizures.[1][2] These seizures are transient signs and/or symptoms due to abnormal, excessive or synchronous neuronal activity in the brain.[3] About 50 million people worldwide have epilepsy at any one time.[4] Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood.

What Causes Epilepsy?

This is a tricky question with no clear-cut answer. Often doctors can’t pinpoint exactly what causes epilepsy in a particular individual. But scientists do know that these are some of the things that can make a person more likely to develop epilepsy:

A brain injury, such as from a car crash or bike accident

An infection or illness that affected the developing brain of a fetus during pregnancy

Epilepsy can arise as a result of many different conditions that affect the brain. Examples of these conditions include stroke (resulting from a blockage of the blood supply to parts of the brain), complications during childbirth, infections (such as meningitis, encephalitis, cysticercosis, or brain abscess), head trauma, and certain genetic disorders.

Epilepsy Symptoms

Eyes are generally open.

The person may not appear to be breathing. The person is often breathing deeply after an episode.

The return to consciousness is gradual and should occur within a few moments.

Simple partial – person fully aware; abnormal twitching movement of part of the body, for example, head, eyes, hand or arm, or tingling sensation; person may sense odd smells, sounds or tastes

Complex partial – person experiences odd tastes or smells or déjà-vu; dream-like state follows; during an attack, lip smacking, grimacing or fidgeting may occur; can be followed by generalised seizure

How Is Epilepsy Treated?

Drug Therapy

Many drugs are available to treat epilepsy, several of which have only recently been released.

Older, classic medications used to treat epilepsy include:

Dilantin or Phenytek

Phenobarbital

Tegretol or Carbatrol

Vagus nerve stimulation — This procedure involves minor surgery and is a relatively new treatment that helps prevent or lessen the severity of seizures. An electrical stimulator is placed beneath the skin of the upper chest. The stimulator, which emits electrical impulses, is connected to an electrode that is attached to a nerve in the neck through a small incision. A patient with a vagus nerve stimulator continues to take medication but sometimes can reduce the amount or number of medications.

Surgery

Surgery is an option for a small number of patients whose epilepsy cannot be controlled with medication. A good candidate for surgery has seizures that always begin in the same cerebral location, which can be removed (resected) without creating deficits. Neurosurgeons generally avoid performing surgery in areas of the brain responsible for speech, hearing, and other important functions.

What is the prognosis?

Most people with epilepsy lead outwardly normal lives. While epilepsy cannot currently be cured, for some people it does eventually go away. Most seizures do not cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems, sometimes the consequence of embarrassment and frustration or bullying, teasing, or avoidance in school and other social setting. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities.