What is Epilepsy?
Epilepsy is defined as a disorder occurring due to the disturbance in the normal flow of electrical signals in the brain. Epilepsy is also termed with the name of seizures and convulsions.
Epilepsy is a neurological disorder, in which there occur disturbance of the nervous functions. Epilepsy is a term used for a disorder in which a person suffers from repeated attacks of seizures (convulsions).
A seizure is a term used due to disturbed electrical impulses of the brain person shows abnormal behavior and attention.
In seizures due to disturbed electrical impulses in the brain, the neurons or nerve cells send deranged signals to different parts of the body. Due to these deranged signals, the part affected reacts abnormally such as people showing strange behaviour, emotions, and strange sensations.
Some people may lose normal conscious or have a violent muscle spasm.
These deranged abnormal signals by the brain are created due to some underlying disease or illness of the brain such as trauma to brain tissue, or abnormal brain development of fetus due to the ill health of the mother, or any other disease condition of brain as a tumor.
PATHOPHYSIOLOGY
Seizures are the deranged manifestation of cerebral cortex part of the brain.
Cortical neurons present in cerebral cortex part of the brain have a set of electrical signals which help a person to perform his daily routine work.
Due to some sudden excitation force from the outside body or any disease condition of the brain the network of signals gets disturbed. When this sudden imbalance affects the excitatory and inhibitory forces present in the network of cortical neurons leads to the formation of seizures.
Clinical manifestation in epilepsy depends on the area of the brain involved.
Superficially there are mainly two types of seizures focal -onset-seizures and generalized-onset-seizures.
Mechanism working in the brain to produce focal-onset-seizures is traveling of focal interictal epileptiform spike or wave in a wrong way. This charge of electrical impulse travels in a single cortical neuron through PDS (paroxysmal depolarization shift) process.
In epilepsy when the visual area of the cortex show derangement then epileptic attack involves visual instability.
In epilepsy, when or pharyngeal area( i.e. mouth, jaw, tongue) of the cortex shows derangement then an epileptic attack shows sudden changes in these organs as clenched teeth, twisting of the tongue, or salivation excessive.
In cases of generalized seizures, the mechanism of travelling of defective impulses is the same but in this type of epilepsy multiple areas of the cortex are involved at a time and the patient reflects multiple body deficits during an attack.
Defected impulses travel through multiple cortical neurons and whichever neuron is involved in that particular part is deranged.
Who is more prone to get affected with Epilepsy?
Epileptic attacks can occur at any age group. The age group can involve from newborn infant to an old age person. Any age group and any gender can suffer from this disorder.
Epilepsy is prevalent in 1 out of 100 persons.
35% of the cases of epilepsy show complex partial seizures. Countries where cysticercosis is more prevalent show history of more prevalence of partial seizure. Partial seizure cases are more prevalent in higher age groups.
What are the causes of Epilepsy?
• Neoplasm of the brain.
• Cortical malformations.
• Vascular malformation in the vessels of the brain.
• Infections of the central nervous system.
• Hypoxic-ischemic brain injury due to embolism in vessels supplying blood to the brain.
• CNS inflammation due to immune response.
• Trauma to head.
• Stroke.
• Malformations in the cortical part of the brain.
• Hippocampus sclerosis is also included as one of the cause.
• Inherited defects of the cortex.
What are the signs and symptoms of Epilepsy?
• Clinical signs and symptoms of epilepsy depend upon the area of cerebral cortex affected.
• The onset of an attack of seizure starts with some particular signs which reflect that attack is going to occur and that collection of early signs are known as an aura.
• Aura includes a particular visual effect or a particular smell.
• After the attack of seizure, the patient is tired and have a lot of weakness unable to perform work after the attack and wants rest. Some patients do not even remember what happened during the attack.
• Signs and symptoms depend on the area of brain deranged.
• Partial seizures
• Simple partial seizures
• Consciousness is not lost.
• Jerking affects an arm or leg.
• Disturbance at a visual plane that is flashing of lights.
• Abnormal smells during an attack.
• Facial tic.
• This type of seizure starts in the face or hands.
• Complex partial seizures
• Loss of consciousness is present in this type or there may be a slight alteration in consciousness.
• The patient makes sounds that have no meaning.
• Jerking of one limb or both limbs.
• Patient memory suddenly vanishes as where he was 5 minutes ago.
• Even after the attacks, the patient is lost in his own world unable to answer the questions.
• A patient star at a particular thing with suspicion.
Generalized seizures include any type of seizures explained below-
• Febrile seizures
• A very common type of seizure in children who are below the age of five.
• The cause of the seizure is the fever.
• The epileptic attack is associated with fever.
• Meningitis to find out if present because if meningitis is present in the child then the condition is critical.
• Infantile spasms
• Occur in babies.
• Babies suddenly bend forward on the neck.
• An infantile seizure occurs only for a few seconds but attacks are repeated.
• Baby cries after an attack.
Atonic seizure
• Also called with the name of drop attacks.
• It is called drop attacks because there is a sudden loss of muscle tone.
• The patient does not lose consciousness but falls to the ground due to loss of muscle tone.
Myoclonic seizure
• In this type of epilepsy, there are small attacks of body jerks.
• There is no loss of consciousness but the patient cannot hold the things in hand during the attack
Absence seizure (petit mal)
• Occur in children and there is loss of consciousness lasting for 30 seconds.
• There is fluttering of eyelids.
• Children are not aware of their surroundings during the attack.
• Patient forgets what happened in the attack.
• Tonic-clonic seizure (grand mal)
• Muscle spasm is seen throughout the body, loss of consciousness and falling.
• Attack last for 2 minutes.
• The patient is tired and confused about.
What are the complications of Epilepsy?
• If the patient falls during an attack fracture of the bone can occur or injury to the part on which the patient falls.
• If the patient is suffering from epilepsy and performs swimming, the possibility of drowning is increased.
• Car accidents can occur if the patient suffers from an attack during driving.
• Epilepsy causes complications during pregnancy.
• Stress level increases during epilepsy.
• Some threatening conditions are status epilepticus; sudden unexplained death due to epilepsy is also seen.
What investigations are advised in cases of Epilepsy?
• Neurological examination of the patient. History taking plays an important role in getting a type of seizure and the severity of the attack.
• Blood tests are done that is
Serum calcium.
Serum potassium.
Hb%
Serum glucose
• Other investigations include diagnostic tools i.e.
EEG (electroencephalogram)
CT (computerized tomography) scans.
MRI
Single photon emission computerized tomography.
Neuropsychological test.
What treatment is advised in cases of Epilepsy?
Antiepileptic drugs are helpful.
The increase of dosage depends on the severity and recurrence of the attack.
These epileptic drugs show some side effects and that is
• Decrease in bone density.
• Skin rashes.
• Weight Gain
• Dizziness all the time.
• Loss of coordination.
• Speech problems.
Depression and inflammation of some organs like the liver are rare complications but are very dangerous for patients.
What Homeopathic remedies are advised to manage cases of Epilepsy?
-Cuprum metallicum
-Artemisia vulgaris
-Hydrocyanicum acidum
-Silicea
-Calcarea Arsenicum
What diet and management are advised in cases of Epilepsy?
• Yoga and meditation helps to keep calm
• Take enough sleep
• Always take proper medication such as anticonvulsants etc.
• Talk to the patient to make them emotionally stable and stress-free
• Don’t skip meals, balanced diet helps in healthy living
• Avoid using heavy machinery or heavy activities in cases one is epileptic
• Avoid alcohol
• Wear a medical alert bracelet in case of emergency personnel know how to treat you correctly.
