EPILEPSY

EPILEPSY

·         Epilepsy is a group of neurological diseases characterized by unpredictable seizures and can cause other health problems.

Epileptic seizures are episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking.

·         Epilepsy is the fourth most common neurological disorder and affects people of all ages.

·         Epilepsy means the same thing as "seizure disorders"

SEIZURE Vs EPILEPSY

A single epileptic attack is described as seizure.

The term epilepsy is coined when seizures are recurrent and long standing.

CAUSES

·         The cause of most cases of epilepsy is unknown.

·          Brain injury, Stroke, Brain tumor.

·         Birth trauma, Prolonged and difficult labor.

·         Meningitis, Encephalitis.

·         Cysticercosis.

·         Hereditary - a small percentage of cases.

DIAGNOSIS

A person is diagnosed with epilepsy if they have had at least two seizures occurring greater than 24 hours apart that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.

CLASSIFICATION

Based on manifestations,

1. Grand mal

2. Petit mal

3. Complex Partial

4. special verities like Reflex Epilepsy

The layman is aware of Grand mal seizure which is characterized by generalized convulsive 

movements with rolling up of eyes, heralded by the epileptic cry along with falling and later frothing 

from the mouth. This lasts for 3-4 minutes during which the patient is unconscious. He may injure 

himself during the episode and at times may bite his tongue.

Petit mal affects young children between 5-10 years and is noticed as brief spells of unconsciousness 

during which the child does not fall but may blink or stare vacantly. He will not respond if he is

called by name at the time of the episode. The whole episode may lasts less than a count of ten. 

Many such episodes 25-100, can occur daily. It may be the teacher in the class who notices this first, 

through inattentiveness shown by the student.

Complex Partial Seizure as the name itself suggests has complex symptomatology. It may manifest 

as repetitive motor acts like opening and shutting the door, crushing of whatever the person see by

hand, inappropriate uttering of meaningless words etc for short periods during which he is unaware of the surroundings.

Unlike petit mal, this can occur during any age groups but the number of attacks per day is one or two

only. The complex seizure may be followed by grand mal seizure at times.

Reflex Epilepsy is a rare type precipitated by extraneous stimuli like sunlight, some music etc. A 

type of reflex epilepsy called Hot Water Epilepsy is seen in south India. It occurs when a person takes hot water bath.

WHAT A BYSTANDER SHOULD DO WHEN A PERSON DEVELOPS SEIZURE?

Remove all the hard objects that can harm himself around the patient.

People should not crowd around as it will affect the oxygenation.

Put the patient on his side to avoid aspiration.

Do not feed the patient, as he may vomit.

Admit the patient if more than one seizure occurs.

INSTRUCTIONS TO PATIENT

Take medicine regularly. A doctor may attempt to reduce the dose if the person doesn’t develop for a minimum of 2 years or more.

Avoid sleep deprivation as well as not take alcohol.

Occupation involving tackling of machinery is best avoided, except for these guides he can lead a normal life.

Driving is possible on specific instructions of the doctor only.

Care of epileptic patient during dental treatment

Expert opinion from doctor treating him is needed.

He should not stop or miss the anti-epileptic drug

Should be accompanied by a bystander.

Future developments in epilepsy

Research is in the offing for the development of the software to be implanted in the brain that can detect the excitation stimulus as it originates which can lead to production of seizure and to nullify it, before it spreads in the brain.

Brain stimulation in particular parts of brain by putting a permanent electrode may help in abolishing the epileptic attacks.

Thus, the future prospects for an epileptic holds good.

BY,

DR.RENJU T GEORGE,

INDIA.