Epilepsy is a neurological disease characterized by seizures that impair the nervous system. The seizure may be defined as an interruption in the electrical conductivity in the brain
WHAT ARE THE CAUSES, RISK FACTORS AND SYMPTOMS OF EPILEPSY?
Cause and risk factors
The exact cause of epilepsy in many sufferers remain unidentified . Approximately two-third of the epilepsy cases present no cause. Children are more susceptible relative to adults to suffering from epilepsy with unknown cause. There are risk factors that may predispose some individuals to epilepsy and include damage to the head or brain, tumor of the brain, Alzheimer’s disease, brain infections such as meningitis, and lack of oxygen during birth .
There exist two categories of epilepsy seizures that may be focal or generalized. Focal or partial seizures that occur in specific regions involve symptoms such as dizziness, jerky motions, confusion and emotional fluctuations. Generalized seizures take place globally in the brain and symptoms include falling down, twitching movements, impairment of bladder control, biting of tongue and tightening of the body
WHAT ARE THE DIAGNOSTIC TESTS, PROGNOSIS AND TREATMENT STRATEGIES USED TO TREAT EPILEPSY?
Centre for Disease Control (CDC) reports that nearly 150,000 new cases are diagnosed annually . Accurate diagnosis is critical for effective treatment. The first phase in the diagnosis is for the physician to gauge whether the symptoms are caused by a seizure in the first place. Once this is confirmed, the category of seizure and the cause need to be identified.
The doctor will interrogate thoroughly to obtain a comprehensive medical history, that could aid the doctor eliminate certain conditions unrelated to epilepsy and investigate into other underlying medical problems . The patient or a family member is questioned about the occurrence of exact events prior to, during and after a seizure took place. Laboratory techniques conducted include complete blood count (CBC) to examine occurrence of infections or imbalance of electrolytes or understand genetic disorders or issues with the kidneys that may have resulted in seizures. A toxicology screening procedure may be performed to evaluate consumption of any poisons or drugs in the blood that could have potentially led to seizures. Lumbar puncture can be conducted to rule out infections. This is performed by obtaining cerebrospinal fluid from the patient’s lower back by inserting a needle in the middle of certain bones of you. The most crucial diagnostic test for epilepsy is an electroencephalogram (EEG), which counts the brain’s electrical activity and tracks for any aberrant spikes or patterns. Different types of epilepsy may be diagnosed based on the profiles. Videography EEG may also be utilized during seizures to record the events in the brain prior to, in the process of after a seizure. Magnetic resonance imaging (MRI) and computed tomography (CT) scans may aid in recognizing the exact location of abnormal activity in the brain. Occurrence of any tumors or other irregularities may be ruled out using imaging tests.
Once an exact diagnosis of epilepsy is made, treatment methods are investigated . Drugs are a crucial aspect of epilepsy treatment. Anticonvulsants or Antiepileptic drugs are may be effectively employed to control seizures in many patients. The various kinds of seizure drugs include clonazepam, topiramate, primidone, gabapentin. These drugs may exhibit certain side effects such as stomach discomfort, blurred vision or dizziness and should be taken after recommendation from the physician . Surgery may be performed on patients that do not respond to the medications, even after two weeks of treatment and patients with unrestrained seizures for over a year. Dietary modifications may be important in the management of epilepsy. The physician may recommend a more ketogenic diet, rich in fats and low in carbohydrates. patient’s response to treatment and act accordingly .
Treatment and management of epilepsy often involves a multidisciplinary team of doctors such as primary physicians, neurologists, pediatricians and epileptologist . An epileptologist is a neurologist who has expertise in treatment of epileptic patients.
In the course of treatment of epilepsy, it is of crucial importance to closely monitor the occurrence of consequent seizures, after one unprovoked seizure has occurred, or the potential for accomplishment of a seizure free status or terminal reduction after a pattern pf frequent seizures has been recognized. It is now established that about 70% of people suffering from epilepsy will enter remission, typically in the preliminary years of the condition . While deliberating on the prognosis of epilepsy, many aspects have to be taken into consideration, which include: possibility of recurrence after a single seizure, likelihood of seizure reduction after surgery or recurrence after the stoppage of medications, repercussions of early verses late treatment .
The chances of achieving seizure freedom is typically high in those with idiopathic generalized epilepsy and normal neurological evaluation. For patients in whom seizures continue to occur despite multiple relevant treatments, there is a four-fold likelihood of surgery for epilepsy to impart a seizure freedom rather than sole utilization of medical treatment
Herndon, Jaime. Healthine.com. 30 October 2014. http://www.healthline.com/health/epilepsy. 20 April 2016.
Neligan, A. "The prognosis of epilepsy." 2015. epilepsysociety.org. https://www.epilepsysociety.org.uk/sites//Chapter36Neligan2015.pdf.
Schachter, S C. Epilepsy.com. July 2013. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-medicines/side-effects. 20 April 2016.