Epilepsy is a neurological condition that makes people susceptible to seizures. A seizure is a change in sensation, awareness, or behavior caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. This results in the brain's messages becoming temporarily halted or mixed up. Seizures vary from a momentary disruption of the senses, to short periods of unconsciousness or staring spells, to convulsions. Some people have just one type of seizure.
Causes of epilepsy
Brain damage caused by a difficult birth, a severe blow to the head; a stroke which starves the brain of oxygen; or an infection of the brain such as meningitis.
Hereditary. Some people may inherit a low seizure threshold, which means that they have a lower resistance to seizures than other people.
Very occasionally the cause is a brain tumor
The main thing to bear in mind is that seizures can be of two types :-
Generalized or Partial
Generalized seizures involve the whole brain. There are several types, including - tonic-clonic, absence and myoclonic
Partial seizures, as the name suggests, start in just one part of the brain. They can be either simple partial seizures or complex partial seizures but either way the electrical discharge may stay in one spot or may spread to the rest of the brain.
Possible triggers of seizures are alcohol, stress, patterns of light, lack of sleep, fever in young children, Hormones - seizures are linked to the menstrual cycle in some cases, Food - skipping meals and eating an unbalanced diet
The diagnosis of epilepsy is mainly based on descriptions of the attacks given by the person themselves and, if available, eye witness accounts.
Tests that can add to the diagnosis are
EEG –electroencephalogram.This test involves placing around 20 pads on your head while you sit or lie down. This records the electrical activities of the brain and transmits it to an instrument that produces a graphical representation of the electrical of brain. The test is performed while you open and close your eyes, breathe deeply and during exposure to a flashing light. The whole thing usually takes less than half an hour. The specialist may ask for more specialized types of EEG to help diagnose attacks of uncertain cause.
The most common type of scan is CT (computed tomography) and MRI (magnetic resonance imaging). These provide a high-quality image of the brain which is fed into a computer which creates an image of the area being scanned and displays it on a screen. This is for locating pathological lesions in the brain.
1. Antiepileptic drugs
2. Surgery in some cases
The Epilepsy Surgery is for treatment of medically refractory seizure disorders in and adults. The operations generally involve removal of epileptogenic tissue from the area where seizures arise or interruption of nerve pathways along which seizure impulses spread. There are currently three major categories of epilepsy surgery:
Resective surgery; in which the part of the brain that causes partial-onset seizures is removed. This include:
Lobectomy and Cortical Resection is for seizures in the temporal, parietal, frontal or occipital lobes may be treated by this method if the seizure-producing area can be safely removed without damaging vital functions
Temporal lobectomy is done for Complex partial seizures typical for temporal lobe epilepsy , unilateral hippocampal sclerosis
Hemispherectomy is done in cases of progressive disease affecting one whole hemisphere of the brain and in cases of children born with conditions that cause excessive damage to one side of the brain, such as bleeding in the brain prior to birth
Multiple Sub-Pial Transection seeks to control seizures by cutting nerve pathways. It is used when the seizure focus is located in a vital area of the brain that cannot be removed, such as the speech area. Instead of taking out the affected tissue, the surgeon severs the parallel connections between cells in the affected area
Corpus callosotomy: in which the major connection between the two sides of the brain is severed in order to lessen the severity of some types of seizures.
Vagus nerve stimulaton: in which a small wire electrically shocks the vagus nerve in the neck. This surgery is also performed to limit the severity of seizures.