Epilepsy is a central nervous system disorder thataffects 0.5% to 1% of the population, with males and females of all races,ethnic backgrounds, and ages being equally affected. In the United Statesalone, about 2.5 million people have epilepsy. One is diagnosed with the condition once they have hadtwo seizures. A seizure is characterized by unusual electrical activity in thebrain. Brain cells normally communicate by sending electrical signals. During aseizure, many brain cells signal at the same time.
Symptoms vary from person toperson and can be categorized based on where they start in the brain, whether aperson’s awareness is affected, and whether the seizure involves othersymptoms. Focal seizures originate in one area of the brain andcan be further classified as focal aware seizures or focal impaired awarenessseizures. During the former, one remains conscious and can recognize they arehaving a seizure. They may experience motor or non-motor symptoms.
Among motorsymptoms are involuntary jerking movements, and among non-motor symptoms are achange in emotions, hallucinations, fear, anxiety, or déjà vu. During thelatter, there is a change in consciousness, and one may experienceunresponsiveness or exhibit repetitive movements called automatisms. They mayblink, twitch, chew or swallow, rub their hands, or walk in circles.
Generalized seizures involve all areas of the brainand can be classified into six types. Absence seizures involve unresponsivenessand repetitive movements. Tonic seizures stiffen one’s back, arms, and legs, whichcan result in them falling to the ground. During atonic seizures, one losesmuscle control in its entirety and can collapse. Clonic seizures arecharacterized by repetitive movements of the neck, face, and arms. In myoclonicseizures, there are sharp and detached jerks or twitches in the arms and legs. Tonic-clonicseizures cause sudden unconsciousness and stiffening and shaking.Epilepsy is not a fatal condition, rather, thoseaffected by epilepsy cope with it on a day to day basis.
Self-management isencouraged among people with the condition, who can do so by taking medicationaccordingly, managing stress, and sleeping well. They must take precautions toprevent dehydration and overexertion, which can increase the probability ofhaving a seizure. As is with other disabilities, people with epilepsy may beeligible to apply for benefits, and they cannot be denied employment due totheir condition. In the United States, those prone to having seizures are notissued drivers licenses.
Mental health disorders such as depression and anxietyare associated with the condition, which can be treated with counseling.Epilepsy cannot be traced to a cause in the case ofabout half the people with the condition. On the other hand, it may be linkedto factors having to do with abnormalities in the activity of the brain. Thesefactors can be genetic—epilepsy can run in families, and genes may make onemore prone to seizures. They can be associated with other conditions anddiseases that damage the brain, namely stroke. Brain damage because of traumaor prenatal injury can cause epilepsy as well. Not to mention developmental disorderslike autism.
Brain imaging in the form of an electroencephalogram(EEG) is used to evaluate seizures. The scan records the electrical activity ofthe brain in real time. Any abnormalities detected helps to diagnose the causeor type of seizure, be it focal or generalized. Evaluation of the seizure helpsto determine whether medication would be beneficial to someone affected byepilepsy.
Epilepsy treatment helps to diminish the impact ofepilepsy in day to day life. The condition is controlled with drug therapy,along with diet, therapy, or surgery in some cases. One drug is prescribed, anda patient is recommended a low dosage when starting the medication. The dosagegets higher and higher until seizures are under control and the optimal dosageis determined. Drug therapy may be accompanied by a ketogenic diet, which ishigh in fat and low in carbohydrates. Vagus nerve stimulation is an alternativethat involves electrical stimulation of the brain. If a patient doesn’t showany signs of subdued seizures after trying medication, or if their seizures arebelieved to originate from a distinct area of the brain, surgery may be anoption for them. Antiseizure drugs work by lessening the electricalactivity of brain cells that cause seizures.
As for patients undergoing aketogenic diet, consuming high fats allows for the body to produce chemicalscalled ketones, which reduce seizures. Patients who go through with vagus nervestimulation have a stimulator implanted that connects to the vagus nerve. Thedevice regularly sends electrical stimulations to the brain through the vagusnerve. In the case of an epilepsy surgery, a lobectomy is usually carried out,in which the part of the brain where seizures originate is removed. On theother hand, incisions in the brain may be made so that in the event of aseizure, it does not spread to other parts of the brain. The corpus callosumconnecting the halves of the brain may be severed in its entirety to preventspreading as well.
The outer layer of the brain may also be removed. Among the side effects of antiseizure drugs arefatigue, dizziness, or weight gain. Depression may worsen or improve in somecases. Malnourishment may result from the ketogenic diet if not carefullyadhered to. Epilepsy surgery may cause changes in memory or behavior.