Overview – What is it?
Epilepsy is a neurological disorder in which the brain’s activity becomes abnormal causing recurrent seizures, periods of unusual behaviour and sensations, even loss of awareness. Seizures are abnormal, disorderly discharging of the brain’s nerve cells which result in temporary disturbance of motor, sensory or mental function.
Epilepsy can be caused by genetic influence, brain conditions and infectious diseases, among other factors. Some of the other symptoms of this condition, apart from seizures, are temporary confusion, anxiety and having a staring spell.
It can be diagnosed by carrying out a neurological exam, blood tests and testing for brain abnormalities.
To prevent epilepsy, try living a healthy lifestyle which involves eating a healthy diet, exercising and maintaining good hygiene, among other things.
Causes – What causes it?
The common causes of epilepsy are:
- Head trauma: This can be due to an accident or other traumatic injuries that can cause epilepsy.
- Brain conditions: Conditions that cause damage to the brain such as stroke can also lead to epilepsy.
- Genetic influence: Some people inherit genes that make them more sensitive to environmental conditions that can trigger seizures or make them more likely to get epilepsy.
- Infectious diseases: Certain infectious diseases such as meningitis, viral encephalitis and HIV/AIDs can cause epilepsy.
- Development disorders: Some disorders such as autism and neurofibromatosis can also lead to epilepsy.
- Prenatal injury: This refers to brain damage that occurs during birth due to infection in the mother, oxygen deficiency or brain malformation, among other reasons, that can lead to epilepsy.
Other risk factors for this condition include:
- Brain tumours or cysts: Having a brain tumour or cyst can increase your risk of having epilepsy.
- Family history: Having a close family member who has epilepsy also increases your risk of developing the same condition or developing seizures.
- Dementia: This condition, which is common in older adults, can increase the risk of having epilepsy.
- Childhood seizures: Some children may experience seizures due to high fevers and if the seizures last for long periods or if the child has another nervous system condition, that can increase the child’s risk of developing epilepsy.
Symptoms – What do you feel?
When a person has epileptic seizures, they can suffer the following symptoms:
- Staring blankly
- Temporary confusion
- Loss of consciousness or awareness
- Having feelings of anxiety, fear or déjà vu
- Uncontrollable jerking movements of the arms and legs
- Twitching limbs
- Stiffening of the body
- Biting of the tongue
- Loss of bladder or bowel control
Diagnosis – How do you diagnose it?
After a doctor has found out what symptoms you have, and found out your medical history, the tests and exams the doctor uses to make the diagnosis include:
- Neurological exam: This is done to test your behaviour, motor abilities and mental function to diagnose the condition and determine which type of epilepsy you have.
Types of seizures
- Focal seizures: Result from abnormal activity in one area of the brain. Some people can suffer loss of consciousness while others experience loss of awareness.
- Generalised seizures: These involve all areas of the brain.
- Blood tests: These are done to check for liver and kidney function, signs of infectious diseases and blood glucose levels to determine the presence of any condition that can be associated with seizures.
- Electroencephalogram (EEG): This is the most common test used to diagnose epilepsy by recording the brain’s electrical activity using electrodes that are attached to the scalp with a paste-like substance.
- High density EEG: In this test the electrodes are spaced more closely than in conventional EEG helping to make a more precise determination of the areas of your brain that are affected by the seizures.
- Imaging tests: These tests are done using CT (computerised tomography), MRI (magnetic resonance imaging) and PET (positron emission tomography) scans to give detailed images of your brain which can help in determining whether there are any abnormalities in the brain such as tumours, cysts or bleeding, that may be causing the seizures.
- Neuropsychological tests: These involve having your thinking, memory and speech skills assessed which can help in determining which areas of your brain are affected.
- Statistical parametric mapping (SPM): Used to compare areas of the brain that have increased metabolism during seizures to normal areas, which can help the doctor in determining where the seizures begin.
- Magnetoencephalography (MEG): Used to measure the magnetic fields produced by brain activity to identify potential areas where the seizures may be starting from.
Treatment – How do you treat it?
Epilepsy has no cure, but there are treatments offered to people with this condition to reduce, prevent or stop some seizures from occurring. These treatments include:
- Medication: Anti-epileptic or antiseizure drugs are taken to reduce the number of seizures you get and in some people the seizures may be eliminated. However, for the medication to be effective:
- They have to be taken as prescribed and their use not stopped abruptly,
- You have to talk to your doctor about any developments such as migraines and before switching medications.
- Surgery: Epilepsy surgery is performed when medication does not provide adequate control over the seizures, when the seizures originate from a small well-defined area of the brain and if the area to be operated on will not affect brain functions such as speech and vision.
- Therapies: These include:
- Ketogenic diet which involves following a strict diet comprising of high fats and low carbohydrate levels. This enables the body to break down fats instead of carbohydrates to produce energy.
- Vagus nerve stimulation which is done using a device similar to a pacemaker that is implanted underneath the skin in the chest area. Wires from the device are then connected to the vagus nerve in the neck. The device sends electrical energy to the brain from the vagus nerve reducing the seizures by 20 to 40%.
- Deep brain stimulation which is done using electrodes that are implanted into a specific part of the brain and connected to a generator that is implanted in the chest or skull sending pulses to the brain and may reduce seizures.
Prevention – How do you prevent it?
There is no specific way to prevent epilepsy, however there are measures you can take to reduce your risk of getting the condition or reduce the frequency of the seizures. These measures can also be taken to manage the condition and prevent it from becoming more severe. These include:
- Living a healthy lifestyle is one of the major ways to manage epilepsy by eating healthy (a diet low in saturated fats and added sugar) and exercising regularly.
- Getting treated for any cardiovascular diseases, infections, hypertension, neurological disorders and any other health complications that can lead to epilepsy.
- Practising good hygiene by washing your hands regularly to avoid infections like cysticercosis that have been linked to epilepsy.
- Staying healthy during pregnancy to keep your baby healthy.
- Not smoking to reduce your risk for stroke which can lead to epilepsy.