Epilepsy is a central nervous system disorder that affects 0.5% to 1% of the population, with males and females of all races, ethnic backgrounds, and ages being equally affected. In the United States alone, about 2.5 million people have epilepsy.
One is diagnosed with the condition once they have had two seizures. A seizure is characterized by unusual electrical activity in the brain. Brain cells normally communicate by sending electrical signals. During a seizure, many brain cells signal at the same time. Symptoms vary from person to person and can be categorized based on where they start in the brain, whether a person’s awareness is affected, and whether the seizure involves other symptoms.
Focal seizures originate in one area of the brain and can be further classified as focal aware seizures or focal impaired awareness seizures. During the former, one remains conscious and can recognize they are having a seizure. They may experience motor or non-motor symptoms. Among motor symptoms are involuntary jerking movements, and among non-motor symptoms are a change in emotions, hallucinations, fear, anxiety, or déjà vu. During the latter, there is a change in consciousness, and one may experience unresponsiveness or exhibit repetitive movements called automatisms. They may blink, twitch, chew or swallow, rub their hands, or walk in circles.
Generalized seizures involve all areas of the brain and can be classified into six types. Absence seizures involve unresponsiveness and repetitive movements. Tonic seizures stiffen one’s back, arms, and legs, which can result in them falling to the ground. During atonic seizures, one loses muscle control in its entirety and can collapse. Clonic seizures are characterized by repetitive movements of the neck, face, and arms. In myoclonic seizures, there are sharp and detached jerks or twitches in the arms and legs. Tonic-clonic seizures cause sudden unconsciousness and stiffening and shaking.
Epilepsy is not a fatal condition, rather, those affected by epilepsy cope with it on a day to day basis. Self-management is encouraged among people with the condition, who can do so by taking medication accordingly, managing stress, and sleeping well. They must take precautions to prevent dehydration and overexertion, which can increase the probability of having a seizure. As is with other disabilities, people with epilepsy may be eligible to apply for benefits, and they cannot be denied employment due to their condition. In the United States, those prone to having seizures are not issued drivers licenses. Mental health disorders such as depression and anxiety are associated with the condition, which can be treated with counseling.
Epilepsy cannot be traced to a cause in the case of about half the people with the condition. On the other hand, it may be linked to factors having to do with abnormalities in the activity of the brain. These factors can be genetic—epilepsy can run in families, and genes may make one more prone to seizures. They can be associated with other conditions and diseases that damage the brain, namely stroke. Brain damage because of trauma or prenatal injury can cause epilepsy as well. Not to mention developmental disorders like autism.
Brain imaging in the form of an electroencephalogram (EEG) is used to evaluate seizures. The scan records the electrical activity of the brain in real time. Any abnormalities detected helps to diagnose the cause or type of seizure, be it focal or generalized. Evaluation of the seizure helps to determine whether medication would be beneficial to someone affected by epilepsy.
Epilepsy treatment helps to diminish the impact of epilepsy in day to day life. The condition is controlled with drug therapy, along with diet or surgery in some cases. One drug is prescribed, and a patient is recommended a low dosage when starting the medication. The dosage gets higher and higher until seizures under control and the optimal dosage is determined. Drug therapy may be accompanied by a ketogenic diet, which is high in fat and low in carbohydrates. If a patient doesn’t show any signs of subdued seizures after trying medication, or if their seizures are believed to originate from a distinct area of the brain, surgery may be an option for them.
Antiseizure drugs work by lessening the electrical activity of brain cells that cause seizures. As for patients going a ketogenic diet, consuming high fats allows for the body to produce chemicals called ketones, which reduce seizures. In the case of an epilepsy surgery, a lobectomy is usually carried out, in which the part of the brain where seizures originate is removed. On the other hand, incisions in the brain may be made so that in the event of a seizure, it does not spread to other parts of the brain. The corpus callosum connecting the halves of the brain may be severed in its entirety to prevent spreading as well. The outer layer of the brain may also be removed.
Among the side effects of antiseizure drugs are fatigue, dizziness, or weight gain. Depression may worsen or improve in some cases. Malnourishment may result from the ketogenic diet if not carefully adhered to. Epilepsy surgery may cause changes in memory or behavior.