By Dr. Rachna Pande
Epilepsy is a condition, where one has recurrent seizures. A seizure is any abnormal involuntary movement. Normally there are multiple neuronal circuits in the brain which work together for synchronous activity.
In epilepsy this circuit is disturbed because of various reasons. This is manifested in the form of abnormal movements of parts of body depending on the part of brain affected.
Seizures may be generalized involving the whole body. These are the best known by lay people. The affected person may suddenly fall down while standing or doing some work followed by involuntary outward movement of limbs. Tongue may be put out and bitten, accompanied by frothing from mouth. There may be respiratory arrest in severe cases.
The epileptic may become unconscious. After regaining consciousness, he may have no memory of the preceding event.
He can get exhausted and may sleep for hours following the attack. Mostly it comes instantly, giving no time for the person to avoid it or call somebody. Sometimes an attack of epilepsy may be followed by paralysis for few moments or hours.
Partial seizures involve only a part of the body maybe a limb or face. In absence seizures, the person may suddenly start staring blankly or making rhythmic smacking or grimacing movements of the lips. All this happens in few minutes. Absence seizures need high degree of suspicion for diagnosis as there are no outward manifestations.
Overall it is a very scary situation for the sufferer as well as the observer. Due to ignorance, the common belief is that, the concerned person is possessed by evil spirits. Well wishers may go for witch craft for cure. Observing a man having a seizure one would think him to be mad or intoxicated. If not attended urgently, he may sustain injury, develop permanent paralysis or even die due to aspiration of secretions.
There are many causes for epilepsy. It may be genetic and run in families. In children it may be due to head injury, high fever. Metabolic disturbances such as low sugar in blood may cause seizures. Any trauma, infection or tumor of the brain can cause epilepsy. In alcohol addicts, withdrawal can result in seizures.
Strokes are the commonest cause of epilepsy in elderly, followed by degenerative diseases like Parkinsonism and Alzheimer’s disease.
Diagnosis of epilepsy is based on a history of recurrent seizures and electroencephalogram (E.E.G which shows the electric activity of the brain). Imaging of the brain would show an underlying cause if present. In between seizures, these people are mostly normal.
Certain factors trigger the attacks in susceptible people. These are bright flickering lights, loud music or sounds, high fever especially in children, looking down from heights and stress. Excess consumption of alcohol can also precipitate a seizure. Pregnancy aggravates epilepsy.
Once epilepsy is diagnosed treatment is by antiepileptic medication and treatment of cause if possible. Antiepileptic drugs, invariably produce side-effects on long term use.
A person suffering from epilepsy should always be very careful. Bright lights, loud sounds, alcohol or stress should be avoided.
Careful driving is needed with permission from the doctor. The person’s family and friends also have to be vigilant. In case of youngsters their epileptic status should be disclosed to the school authorities and friends so that in case of emergency they can help.
If one sees a person having an epilepsy attack, he/she should be immediately put in a lateral position with head flexed forward so as to avoid aspiration of fluid in lungs in case of frothing. A gag should be placed in the mouth to avoid any injury because of tongue bite. The person should be rushed to emergency.
Women on anti-epileptic medication should be careful while taking contraceptive pills. Anti epilepsy pills reduce the effectiveness of contraceptive pills . With certain precautions and medicines, an epileptic can lead a normal life.
Dr. Rachna Pande, Specialist internal medicine. E-mail – email@example.com
- SOURCE: OoReporters
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