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Epilepsy: Causes, Symptoms, Diagnosis, and Treatment

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According to the Epilepsy Foundation, epilepsy is a chronic central nervous system disorder in which the clusters of neurons in the brain behave irregularly or are disrupted causing periods of strange sensation, seizures, abnormal behaviour and sometimes loss of consciousness and awareness.

The Central Nervous System (CNS) is a part of the nervous system that comprises the brain, brain stems and spinal cord. Epilepsy is the fourth most common neurological disorder that is characterised by recurring seizures.

According to the Hopkinsmedicine, a quick rush of electrical activity in the brain cell is called seizure. People from epilepsy also suffer from some major psychological disorder such as depression, anxiety, and suicidal thoughts. An uncontrolled and extended seizure can lead to brain damage.

Let's understand the causes, symptoms, diagnosis and treatment options of epilepsy in detail.

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Epilepsy: Signs & Symptoms 

Symptoms experienced during epilepsy depend upon the part of the brain affected. Epilepsy occurs in both males and females of all ages. However, it is more common in young children below the age of 2 and older adults.

The most common symptom of epilepsy is a seizure and may differ from person to person depending on the type of seizure. According to the US NIH, there are basically different types of seizures with two broad categories of focal and generalized seizures.

  • A simple focal seizure which is characterised by dizziness, change in sense of taste or smell, tingling, twitching of limbs, jerking of the body parts such as arms or limbs.

  • A complex focal seizure characterised by loss of consciousness or awareness, unresponsiveness to the environment, repetitive movements such as rubbing of hands, chewing, smacking of lips, making random noises or fiddling with objects.

  • Tonic seizure which is one of the 6 generalised seizures, is characterised by muscle stiffness, affecting the muscles of the back which may lead to a fall.

  • Atonic seizures cause loss of muscle control and may result in a sudden collapse.

  • Absence seizures often occur in children and are characterized by subtle body movements such as blinking or staring into space.

  • Clonic seizures are associated with rhythmic or repeated jerky muscle movement of the face, neck and arm.

  • Myoclonic seizure causes twitches in arms and legs.

  • Tonic-clonic seizures are the most dramatic epileptic symptom and may cause stiffening of the body, shaking, loss of consciousness, loss of bladder control and biting of the tongue.

Epilepsy: Causes

According to the Epilepsy Foundation, epilepsy affects around 70 million people worldwide. People with epilepsy are 11 times more likely to have premature death as compared to the rest of the population. Overall 1% of the epileptic patients die of sudden unexpected death.

The causes of epilepsy may include head trauma resulting from an accident or other traumatic events. Infectious diseases such as AIDS, meningitis can also cause epilepsy.

The leading cause of epilepsy in people older than 35 years is stroke. Serious illness or very high fever, lack of oxygen to the brain, some inherited genetic factor can make people more prone to epilepsy.

A brain injury before birth, which could be due to poor nutrition, infection in mother, deficiency of oxygen, can also cause epilepsy. Some developmental disorder such as autism or neurofibromatosis can also be a major cause of epilepsy.

Epilepsy: Diagnosis 

According to Mayo Clinic, in diagnosing epilepsy the following procedure may be carried out:

  • A blood test to check the levels of glucose and functioning of liver, kidneys or traces of any infections

  • Brain scans which may help to find the reasons of the seizures. The two common ones are CT scans and MRI.

  • PET or Position Emission Therapy that visualizes the active area of the brain and can detect abnormalities. In this procedure, a small amount of low dose radioactive substance is injected in to the brain.

  • Electroencephalogram (EEG) is the most common procedure in diagnosing epilepsy. In this procedure a paste like substance is used in attaching electrolydes in your scalp to measure the electrical activity of your brain.

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In case where MRI and EEG do not pinpoint the location in the brain where the seizure is occurring, SPECT (Single Photon Emission Computerised Tomography) may be recommended which shows the blood flow activity in the brain during a seizure.

Epilepsy: Treatment 

In treating epilepsy, medication is the first approach. In cases where medications can't treat the condition surgery or another type of treatment may be proposed.

The first line of medication is the anti-seizure medicines that are used to reduce the severity and frequency of seizures. Depending on the type of seizure you are experiencing, doctor may prescribe a single drug or combination of drugs.

When it comes to surgeries, resection is the most common surgical process carried out. This involves removing the part of the brain that is causing the seizure.

It can only be performed if the doctor has confirmed that seizure is occurring from a small, well-defined part of the brain and the surgery may not affect the vital motor functions, speech, walking, vision and hearing.

It's important to consult doctors and get proper diagnosis of your condition and best treat options for you and you loved ones.

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