Epilepsy is one of medical condition. it is one of the seizures disorder. it is common chronic neurological disorder. it is characterized by the recurrent unprovoked seizures. it effects nearly 50 million people throughout the world. it is not cured but can be controlled. it is usually treated with medical treatment. in some cases surgery is preferred, not all epilepsy syndromes are life long . in children it may disappear in later years.
Classification of Epilepsy:-
Epilepsy are classified as follows:
1. by the patients first cause, or etiology.
2. by observing the manifestations of seizures.
3. on the basis of where the seizures originates in the brain.
4. As a part of discrete, identifiable medical syndrome.
5. on the basis of event that triggers the seizures.
the international league against epilepsy proposed a classification scheme for individuals in 1981. Since 1997, the ILAE have been working on a new scheme that has five axes: ictal phenomenon, seizure type, syndrome, etiology and impairment.
The patient should be thoroughly evaluated to diagnose the disease in the proper manner. it is important to physician to collect careful history such as birth, childhood, family medical history, any neurological history, treatment regimen etc. history of nervous system, thorough history of drugs, alcohol intake, should be taken.
the detailed history about seizure is very important to distinguish the type of seizure. the significant events are as follows:
1. the events that occurs with seizures.
2. nature of the onset of the seizure
3. presence of triggers such as sleep deprivation etc.
4. at what time the seizure occurs in the day.
5. whether the seizure occurs during work or sleep.
6. whether the awareness recovers fast or it is prolonged.
The thorough physical examination and neurological assessment should be done. the blood test, urine test reveals any kidney diseases or liver disorders. augment adverse effects of anti epileptic drugs and rule out or identify certain underlying causes. These results also establish a baseline for monitoring kidney and liver function while the patient is on anti-epileptic medication. The kidney and liver metabolize most of these medications.
It is important to identify and treat any trauma or injury or any diseases that causes seizures.
1. head trauma
3. drug intoxication
Conditions that produce symptoms similar to those that occur during seizures must be ruled out, such as the following:
1) Breath-holding spells: bluish tint to the skin, loss of consciousness, loss of muscle tone
2) Meniere’s disease: vertigo, visual phenomena, speech impairment, altered consciousness
3) Migraine: aura, loss of consciousness, nausea, photo-phobia , muscle weakness
4) Movement disorder: tics, chorea, tremor
5) Syncope: sudden loss of muscle tone and posture, loss of consciousness, vertigo, nausea, muscle spasm
-it is the important test used to diagnose the seizure disorder. It identifies abnormal electrical activity in the brain, provides information about the type of seizure disorder locates the area in which area the seizures occurs.
-Some of the findings on EEG are specific to particular disorders and subtypes of epilepsy. Activity during a seizure can be identified by a pattern on the graph, called epileptiform, which indicates epilepsy. Correlating this type of data with clinical symptoms of seizures often helps make an accurate diagnosis. Additionally, the EEG recording between seizures is often abnormal in patients with epilepsy.
-the other tests conducted by the doctors are neurological exam that tests your reflexes, muscle tone, muscle strength, sensory function, gait, posture, coordination and balance. Your doctor may also ask questions to test your thinking, judgment and memory.
-Blood tests may be needed to check for problems — such as infections, lead poisoning, anemia or diabetes — that could be causing or triggering your seizures.
before sending a person to the EEG the doctor should inform to avoid elaborate hair styling,greasy hair dressing or metallic hair dressing. avoid taking caffeine 6 hours before the procedure. the procedure is painless and it last for 30 minutes.
it is the procedure of computerized scanning . it is the special type of x-ray , which obtains the image of cross section of the brain in different angle. scan reveals the abnormality in the brain, such as cyst,tumor,strokes or strangled blood vessels.
Magnetic Resonance Imaging:-
It provides the detailed image of the brain using radio waves and strong magnetic field. it also reveals the abnormalities in the brain.
Signs and symptoms of Epilepsy:-
epilepsy is due to the abnormal activity of the brain. so the seizure can effect any process of our brain carries. the seizures can produce, short term mental confusion, uncontrollable jerking movements of the extremities, complete or partial loss of consciousness. seizure can begin in one part of the brain and it can spread to the other part. on the basis of abnormal activity of brain the seizures can be classified as partial or generalized.
Epilepsy without seizures; Is this possible?
-Epilepsy is a complex brain (mental) disorder. Although epilepsy is primarily characterized by seizures, the nature of the seizures can vary depending on the type of seizure and the individual person.
-In older adults, especially, seizures tend to be more subtle than in younger people and may appear as brief memory lapses or episodes of confusion. In some cases, seizures may cause little or no change in consciousness. Also, involuntary shaking is a less common feature of seizures in older adults. To someone nearby, a person having this type of seizure may simply appear to be staring into space and be unresponsive for a few seconds.
-Although it can occur at any age, the onset of epilepsy is quite common after age 65. So it is possible that your sister only recently developed epilepsy. The good news is that epilepsy can be treated. Appropriate treatment of epilepsy is important because recurrent seizures may put your sister and others at risk of physical harm — for example, if your sister has a seizure while driving and loses control of the car.
Complications of Epilepsy:-
The suspected complications are head injury, any accidents, falls, fractures,etc . the seizures person may fall to the water, touch fire etc. totally the seizures person is susceptible for all type of injuries.
Treatment of epilepsy:-
The anti epileptic drugs are effective treatment for the control of seizures in epileptic patient. some of the other drugs can reduce the intensity and duration of the seizures. the minimum dosage and duration has to be maintained. the minimum period of anti-epileptic drugs usage is two to three years.
prescribing the right medication and dosage can be complex. Your physician likely will first prescribe a single drug at a relatively low dosage, and may increase the dosage gradually until your seizures are well controlled. If the client have tried two or more single-drug regimens without success, the physician may recommend trying a combination of two drugs. the drugs to be taken regularly at correct time, and correct dosage.
All anti-seizure medications or anti epileptic drugs have some side effects. which may include mild fatigue, dizziness,general weakness and weight gain. In some cases more severe side effects include depression, skin rashes, loss of coordination, speech problems and extreme fatigue.
if medical treatment is not effective, surgery is indicated such as vagal nerve stimulation etc.
Self care for Epilepsy:-
The epileptic patient should follow certain measures to avoid complications, injuries,and to manage the seizures effectively. the client should have a small record with him as it contains the drugs using, referring doctor,address, vital statistics etc.the client should avoid alcohol and smoking, as they triggers the seizures.
As with number of chronic conditions, maintaining your overall health is an important step in controlling epilepsy. Sleep deprivation is a powerful trigger of seizures. Be sure to get adequate rest every night, and make a conscious effort to eat a balanced diet, exercise and manage stress effectively. meditation keeps the body and mind fresh and free.
Excessive alcohol consumption may worsen the condition. get advice by the doctor to avoid alcohol. ..