Living with Epilepsy

November is observed as Epilepsy Awareness Month. Here is everything you need to know about the central nervous system disorder   

What is epilepsy?

Epilepsy is a neurological disorder in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behaviour, sensations and sometimes loss of consciousness. A treatable brain disease, epilepsy can develop at any age, however it is diagnosed mostly before the age of 20 and after 60. A single seizure doesn’t mean you have epilepsy. At least two unprovoked seizures are required for an epilepsy diagnosis. Even mild seizures may require treatment because they can be dangerous during activities such as driving or swimming. Treatment with medications or sometimes surgery can control seizures in about 80 per cent of patients. Some children with epilepsy may also outgrow their condition with age

Risk factors 

Age: The onset of epilepsy is most common during early childhood and after the age of 60, but the condition can occur at any age

Family history: If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder

Head injuries: These are responsible in some cases. You can reduce your risk by wearing a seat belt while driving and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury

Stroke and other vascular diseases: Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet and exercising regularly

Seizures in childhood: High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won’t develop epilepsy, although the risk is higher if they have a long seizure, other nervous system conditions or a family history of epilepsy

Causes 
 

• Peril-natal brain injury
• Infections
• Traumatic brain injury
• Stroke

All of these conditions are preventable. But, epilepsy has no identifiable cause in 30 per cent of those with the condition. In the other, the condition may be traced to various factors such as genetic influence, brain tumours and developmental disorders of the brain

Triggers 

• Flickering lights
• Lack of sleep
• Tiredness
• Stress
• Excitement
• Missed meals
• High temperature
• Menstrual periods
• Missed/late medication 

Symptoms 

• Temporary confusion
• Staring spell
• Uncontrollable jerking movements of arms/legs
• Loss of consciousness/awareness 
• Psychic symptoms 

When to see a doc?

• If the seizure lasts more than 5 mins minutes
• If breathing/consciousness doesn’t return after the seizure stops
• A second seizure follows immediately
• If you have a high fever
• If you are pregnant
• If you’ve injured yourself during the seizure

Diagnosis

• Good description of the event, a home video recording of the event 
• EEG test, MRI of the brain

Bear in mind 

Dos

• Stay calm
• Protect the head 
• Loosen tight clothing, remove glasses
• Once the seizure ends, aid breathing by gently placing the child in the recovery position
• Allow the person a period of rest/sleep 

Don’ts

• Do not panic 
• Do not insert spoon or any such articles into the mouth
• Do not restrict convulsive movements as it may cause fracture
• Do not try to gag the patient 
• Do not crowd around the patient
• Do not give water or any other liquid till he is fully consciousness
• Do not try and physically hold the person

Surgery 

• Epilepsy surgery involves removing the abnormal or damaged part of the brain without affecting the normal function. This major brain surgery is performed by specialised centres
• Vagus nerve stimulation is a relatively new type of treatment for epilepsy. It aims to reduce the number, length and severity of seizures. It is a treatment for epilepsy where a small generator is implanted under the skin below the left collar bone

(Dr Sita Jayalakshmi, consultant neurologist and epilepsy specialist, KIMS Hospitals, Secunderabad)