Epilepsy

Seizure/Epilepsy

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Seizure/Epilepsy is a neurological disorder characterized by abnormal brain activity, resulting in seizures or episodes of unusual behavior, feelings, and, in some cases, loss of awareness.

  Epilepsy is defined as a disorder of the brain characterized by any of the following conditions:

(1) At least two unprovoked (or reflex) seizures occurring >24 h apart

(2) One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least
60%) after two unprovoked seizures, occurring over the
next 10 years and

3) Diagnosis of an epilepsy syndrome.

    Provoked seizure is a seizure that occurs in reaction to an acute, transient condition affecting the brain. Provoking factors include, but are not limited to, head trauma, stroke, intracranial infections, acute metabolic disruptions (e.g., hypoglycemia, anoxia) and acute drug or toxin poisoning.

What are the Different types of epilepsy?

  • Generalized seizure: tonic-clonic, absence, myoclonic, clonic, tonic, atonic
  • Focal seizure
  • Unknown: epileptic spasms

What is the cause of epilepsy?

 It may be caused by injury or abnormality of a brain region. The following are the most typical causes:

  • Traumatic brain/head injury
  • Infections such as brain abscess, meningitis, encephalitis
  • Tumor of the brain
  • Metabolism disorders present at birth
  • Vasculitis
  • Idiopathic                                                                                                                                                                                                                            Principal risk factors for seizures in children are correlated with: positive family history, high temperature, mental disability, delayed discharge from NICU or premature birth, mother’s alcohol abuse and smoking in pregnancy doubles the risk of seizure incidence

What is the diagnosis for epilepsy?

 A number of imaging tests may assist a doctor in diagnosing epilepsy. Among these tests are:

  • EEG: to detect abnormal brain waves and see for specific changes in different epileptic syndromes
  • MRI brain: to come to an etiological diagnosis like congenital brain malformations,tumour and see for extent of damage to brain
  • CT brain: to see for hemorrhage

What is the treatment for epilepsy?

Anti-Epileptic Drugs: This is generally the first medication that a doctor prescribes to manage seizures. The goal is to control seizures as completely as possible while minimizing pharmacological adverse effects. Commonly prescribed antiepileptics are- phenobarbitone, phenytoin, valproate, lamotrigine, leveteracetam, carbamazepine, clobazam, lacosamide, topiramate, steroid, vigabartin etc.

Ketogenic Diet: It is a specialized high-fat, low-carbohydrate diet used for drug-resistant epilepsy. It provides 3-4 gm of fat for 1gram of carbohydrate and protein. It is advised by neurologist and prepared by dietician. 

Vagal Nerve Stimulation (VNS): This procedure includes implanting devices to reduce the aberrant electrical activity that causes seizures. They may be considered for persons whose anti-epileptic drugs have failed to control seizures.

Surgery: This is a possibility for patients who have uncontrollable seizures. Despite taking various drugs, around 20 to 30 percent of persons have poorly controlled epilepsy. In such cases, surgery can always cure epilepsy. Video-EEG Monitoring and MRI/functional MRI may be used to locate the cause of seizures.