What is Epilepsy?

Epilepsy is a long-term condition that causes repeated seizures. These seizures happen because of unusual electrical activity in damaged brain cells. A spasm of electrical discharge within the brain cells results in a seizure. It can affect awareness, muscle power (your muscles may twitch or jerk), feelings, emotions, and behavior.

Epilepsy is also known as a seizure disorder.

What are the types of epilepsies and seizure symptoms?

Healthcare professionals classify epilepsies by type of seizure. Seizure groups are divided based on where a seizure begins in the brain, whether awareness is maintained during a seizure, and whether muscle activity occurs.

There are two major kinds of seizure categories:

Focal onset seizures

Focal-onset seizures arise from a single region or network of cells on one side of your brain. Earlier known as partial onset seizure, there are two types of focal seizures:

A focal onset aware seizure is characterized by being awake and aware during the seizure. Considered earlier as a simple partial seizure, the manifestations may include the following:

You may notice changes in your senses, like how things taste, smell, or sound. You might also experience changes in your emotions. Sometimes you may experience uncontrolled muscle jerking, usually in your arms or legs. You might see flashing lights, feel dizzy, or experience tingling.

A focal onset impaired awareness seizure means you may feel confused or lose awareness during the seizure. This type was previously known as a complex partial seizure. Symptoms can include:

• A blank stare or looking off into space
• ​Repetitive movements like eye blinking, lip-smacking, chewing, rubbing your hands, or moving your fingers.

Generalized onset seizures

Generalized onset seizures involve many cells on both sides of the brain simultaneously. There are six types of generalized seizures.

• Absence seizures: A person may stare blankly or "zone out" for a short time. During these seizures, minor muscle movements may occur, such as blinking, lip-smacking, or rubbing the fingers. Absence seizures usually last less than 10 seconds and are more common in children. They are often mistaken for daydreaming. These seizures used to be called petit mal seizures.
• Atonic seizures: Atonic means "without tone." An atonic seizure happens when you lose muscle control or your muscles become weak. During this short seizure, which usually lasts less than 15 seconds, parts of your body may droop or drop. This can include your eyelids or head, and you might fall to the ground. This type of seizure is also known as a "drop seizure" or "drop attack."
• Tonic seizures: Tonic means "with tone." A tonic seizure means that your muscle tone has increased dramatically. Your arms, legs, back, or whole body may be stiffened or tensed, causing you to fall. You may be aware of, or have a slight change in awareness, during this brief seizure, which lasts less than 20 seconds.
• Clonic seizures: "Clonus" refers to quick, repetitive stiffening and relaxing of a muscle ("jerking"). A clonic seizure occurs when muscles jerk rhythmically for seconds to a minute, or muscles stiffen and jerk in rhythm for seconds up to two minutes.
• Tonic-clonic seizures: A tonic-clonic seizure involves a combination of muscle stiffness (tonic phase) and repeated, rhythmic muscle jerking (clonic phase). Healthcare providers may refer to this type of seizure as a convulsion, and it was previously known as a grand mal seizure. Tonic-clonic seizures are what many people envision when they hear the term "seizure." During this type of seizure, you typically lose consciousness and may fall to the ground. Your muscles will stiffen and jerk for 1 to 5 minutes. It's also possible to bite your tongue, drool, and lose control of your bowels or bladder, which can result in urination or defecation.
• Myoclonic seizures: This is a seizure that causes brief, shock-like jerks or twitches of muscles ("myo" for muscle, "clonus" meaning muscle jerking). Myoclonic seizures usually only last a couple of seconds.

As your doctor gets more information, your seizure type may become a focal or generalized onset seizure.

What are seizure triggers?

Seizure triggers are events that occur before the onset of your seizure.

Normally reported seizure triggers include:

• Stress.
• Sleep disorders include poor sleep, inadequate sleep, excessive sleepiness, sleep disruption, and sleep disorders such as sleep apnea.
• Substance use, substance withdrawal, substance abuse.
• Hormonal changes or menstrual hormonal changes.
• Illness, fever.
• Flashing lights or patterns.
• Poor eating habits, balanced diet, hydration, vitamin and mineral deficiencies, missing meals.
• Physical overexertion.
• Certain foods (such as caffeine) are common triggers.
• Dehydration.
• Certain times of the day or night.
• Certain medications. Diphenhydramine, a component of many over-the-counter cold, allergy, and sleep preparations, is a common trigger.
• Missing doses of anti-seizure medication.

How can I identify my seizure triggers?

Some people find that their seizures occur predictably at the same time each day or around the same events or other variables. You might want to monitor your seizures—and the circumstances surrounding your seizures—to look for a pattern.

In your seizure diary, note the time of day at which each seizure happened, events or exceptional circumstances happening around the time of the seizure, and how you felt. If you suspect you have identified a trigger, monitor it to see if it is. For example, if you suspect that caffeine triggers your seizures, do you experience a seizure every time you consume caffeinated foods or beverages? Or is it only after consuming a certain number of caffeinated items, or at specific times of the day after consuming caffeine? A detailed examination will help clarify whether caffeine is indeed the trigger.

What are the symptoms of epileptic seizures?

The main symptom of epilepsy is having seizures that happen repeatedly. The way seizures affect people can vary based on the type of seizure they have.

Signs and symptoms of a seizure can include:

• A temporary loss of awareness or consciousness.
• Uncontrolled movements, muscle jerking, or a loss of muscle tone.
• A blank stare or looking like you are “staring into space.”
• Short periods of confusion, slow thinking, and trouble speaking or understanding.
• Changes in your senses, such as hearing, vision, taste, or smell, as well as feelings of numbness or tingling.
• Difficulty talking or understanding.
• An upset stomach, feelings of heat or cold, or goosebumps.
• Lip-smacking, making chewing motions, rubbing hands, or finger movements.
• Feelings of fear, dread, anxiety, or déjà vu.
• A racing heart or fast breathing.

Most people with epilepsy experience the same type of seizure each time, so their symptoms tend to be similar at each event.

What causes epilepsy?

In up to 70% of cases, the cause of seizures is often unknown. Known causes include:

• Genetics: Some types of epilepsy, like juvenile myoclonic epilepsy and childhood absence epilepsy, can be passed down in families. Researchers think certain genes may increase the risk of epilepsy. Other factors also play a role. Some types of epilepsy happen because of issues that affect how brain cells communicate, which lead to abnormal signals in the brain and seizures.
• Mesial temporal sclerosis: This condition involves a scar forming in the inner part of the temporal lobe, located near your ear, which can cause focal seizures.
• Head injuries: Head injuries can happen due to car accidents, falls, or any impact to the head.
• Brain infections: Infections that can affect the brain include brain abscess, meningitis, encephalitis, and neurocysticercosis.
• Immune disorders: Conditions that cause the immune system to attack brain cells, known as autoimmune diseases, can also lead to epilepsy.
• Developmental disorders: Brain malformations present at birth are a common cause of epilepsy, especially in people whose seizures are not controlled with anti-seizure medication. Some birth defects that can cause epilepsy include focal cortical dysplasia, polymicrogyria, and tuberous sclerosis. Many other types of brain malformations can also lead to epilepsy.
• Metabolic disorders: A metabolic condition (how your body obtains energy for normal functions) is a cause of epilepsy. Many of these disorders are detectable through genetic tests your healthcare provider may use.
• Brain conditions and brain vessel abnormalities: Other possible causes of epilepsy include brain conditions such as tumors, strokes, dementia, and abnormal blood vessels in the brain, such as arteriovenous malformations.

How is epilepsy diagnosed?

Technically, if you have two or more seizures that were not due to a known medical condition-for example, alcohol withdrawal or low blood sugar-you have epilepsy. Your doctor or epilepsy specialist will examine you and review your medical history. They may also order blood tests to check for other potential causes. They will also ask you about your symptoms during the seizure and perform different tests.

Your health care provider will ask you or your family member (who's seen you having a seizure) whether you experienced any of the following during a seizure:

• Muscle jerks.
• Muscle stiffness.
• Lost control of the bowel or bladder (you peed or pooed during the seizure).
• Had a change in breathing.
• Skinned out and pale.
• Had a blank stare.
• Lost consciousness.
• I could not speak, and I didn't understand what someone said to you.

What tests are going to be used to diagnose this disorder?

Tests:

• EEG: This procedure measures the electrical activity in your brain. Some abnormal electrical patterns are associated with seizures.
• Scans of the brain: MRI is applied to look for tumors, infections, or abnormalities in blood vessels.

How is epilepsy treated?

Different therapies to control seizures are anti-seizure medications, special diets, normally in conjunction with anti-seizure medications, and surgery.

Anti-seizure medications

Anti-seizure medications can help control seizures in about 60% to 70% of people with epilepsy. Treatment with these medications is personalized. The U.S. Food and Drug Administration (FDA) has approved over 20 anti-seizure medications for treating epilepsy. Your doctor may try different medications, change the doses, or combine medicines to find the best way to control your seizures.

The choice of an anti-seizure medication depends on:

• Type of seizure.
• Your previous history of response to anti-seizure medication
• The other diseases you have.
• How prone would you be to interact with other drugs that you take?
• The side effects of the anti-seizure drug, if any
• Your age
• Your overall health.
• Cost.

Since some anti-seizure drugs are associated with birth defects, advise your doctor if you are pregnant or you're planning to become pregnant.

If your anti-seizure medications don’t control your seizures, your doctor will talk to you about other treatment options. These options may include special diets, medical devices, or surgery.

Diet therapy

The two most common diets that sometimes are recommended for patients with epilepsy are the ketogenic diet and the modified Atkins diet — diets that are high in fat, moderate in protein, and low in carbohydrates. Diets are usually recommended to children whose medications are not effective and are not good candidates for surgery. Low glycemic index diets also help to reduce seizures in some patients with epilepsy.

Surgery and devices

Your doctor may recommend surgery if anti-seizure medications do not control your seizures and if your seizures are severe and disrupt your life. Epilepsy surgery can be a safe and effective option if you have tried more than two types of anti-seizure medications without success. It’s important to get evaluated at an epilepsy center to see if you qualify for surgery.

Surgical options include removing abnormal tissue (surgical resection), cutting connections between different areas of your brain (disconnection), using targeted rays to destroy abnormal brain tissue (stereotactic radiosurgery), or placing devices that send electrical impulses to your brain to help reduce seizures over time.

Can epilepsy be prevented?

Although many causes of epilepsy are beyond your ability to control and prevent, some potentially causative conditions may be prevented by reducing the chances for their development, including:

• To lower your risk of a traumatic brain injury from head impacts, always wear your seatbelt while driving and practice defensive driving. Wear a helmet when biking. Keep your floors clear of clutter and power cords to prevent falls and avoid using ladders.
• To lower your risk of stroke, eat a healthy diet like the Mediterranean diet, maintain a healthy weight, and exercise regularly.
• Get help for drug addiction. Alcohol and illegal drugs can harm your brain and may lead to epilepsy.

Is there a cure for epilepsy?

There's no cure for epilepsy. But there are many treatments for epilepsy.

How long will I have to take anti-epileptic medications?

It depends on the type of epilepsy you have and how responsive you are to medication. Some people who are seizure-free for several years might be able to discontinue the medication. It is a decision that your healthcare provider has to make. He or she will consider several factors when making that decision, including whether or not you have brain lesions on your MRI, the EEG readout, and your medical history. In some cases, you will need lifelong medication.

What happens in the brain during an epileptic seizure?

When you have epilepsy, your brain's cells send and receive messages to and from your body. They do this through continuous electrical signals that flow from one cell to another. In epilepsy, this smooth flow gets interrupted. Instead of regular signals, there are sudden bursts of electrical activity in one or more areas of your brain, similar to a lightning storm. This disruption can change how you think, feel, and move, and it may even cause you to lose consciousness.

Living With

When should I see my doctor? When should I go to the emergency room?

See your primary care provider if you have never had a seizure and suspect you've just had one - or others in your life have told you you're "out" or have "lost consciousness". You might be referred to a neurologist for further evaluation and testing.

Why Choose Tender Palm Super-Speciality Hospital for Epilepsy Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Epilepsy treatment in Lucknow, India, at an affordable cost. We have a team of experienced neurologists and epilepsy specialists who provide accurate diagnosis and both non-surgical and surgical treatment options including anti-epileptic medication management, EEG monitoring, and epilepsy surgery procedures. Our Neurology and Epilepsy Care team has decades of experience in successfully treating Epilepsy in Lucknow, India.

To seek an Expert Consultation for Epilepsy Treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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