Epilepsy

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Epilepsy

What is epilepsy?

Epilepsy is a medical condition where a person has recurring, unprovoked seizures. Having a single seizure does not mean that a person has epilepsy. Seizures are short episodes when a person does not function normally because of abnormal electrical discharges in the brain. During a seizure, these impulses become overactive or occur at the same time which leads to irregular brain activity. This can cause changes in behaviour and body function.

What causes epilepsy?

Epilepsy does not have a single cause. In fact, for many people with epilepsy, no cause is ever found.

Some known causes include:

  • Developmental abnormalities in the brain
  • Infections that injure the brain
  • Lack of oxygen to the brain
  • Disturbance in blood circulation to the brain (stroke and other vascular problems)
  • Tumours of the brain
  • Previous trauma (such as brain injury)
  • Genetic causes

What are the symptoms?

  • Convulsions (uncontrollable muscle stiffening and shaking)
  • Brief staring spells
  • Repetitive, automatic behaviour such as chewing movements
  • Decreased awareness of what is going on

How is epilepsy diagnosed?

Your neurologist will ask you and your family members or other observers about any seizure-like episodes you may have experienced. Your neurologist will need to understand your family's medical history to see whether you have an inherited form of epilepsy. Your neurologist will also determine whether you have other risk factors for epilepsy and perform a neurological examination.

It is likely that your neurologist will perform several tests, including:

  • Electroencephalography (EEG) which records brain wave patterns
  • Magnetic resonance imaging (MRI) of the brain
  • Blood tests

What are the treatment options?

The most common treatment to prevent seizures is the daily use of medications. Nearly 70% of people with epilepsy can have good control of their seizures using medications. Most people whose seizures are controlled with drugs have few restrictions on their activities. Many medications are available. Some of them work better for one type of epilepsy than another. Talk to your neurologist about the choice of medication, how often it is taken and any side effects.

Side effects may vary from one drug to another and from one person to another. Your neurologist will make sure that the prescribed drug is the best medication for you.

In some cases, medication does not work. Then surgery or vagus nerve stimulation may be an option. In vagus nerve stimulation, a device similar to a pacemaker is implanted under the skin in the chest. It reduces seizures by delivering electrical signals to the brain via the vagus nerve in the neck.

Epilepsy surgery usually involves identifying and removing the seizure focus. It can be very effective and even curative for some people, even when medications have failed. It is not a 'last resort'. Talk to your neurologist about the best treatment for your seizures.

Living with epilepsy

Epilepsy is different for everyone. Some people have seizures that are easily controlled; their epilepsy doesn’t have much effect on their daily lives. Others may find that their seizures will have a bigger impact on their lives; they may affect the way they work, socialise or complete daily activities.

Diet: Do not fast or skip meals. Eat solids.

Rest: Adequate rest is essential.

Exercise: is a must but do not overdo

Stress: should be avoided

Controlling seizures

To help control your seizures:

  • Take your medication as prescribed.
  • Maintain regular sleep patterns.
  • Avoid excessive alcohol use or use of illegal drugs.
  • Work to reduce and manage stress.
  • Talk to your neurologist about any changes in symptoms or new symptoms.
  • Exercise to maintain your overall health.

Driving and safety

  • Driving should be avoided.
  • Talk to your neurologist about this issue and your overall safety.
  • People with epilepsy also need to avoid sports or activities that could be hazardous if they were to lose consciousness or become unable to control their movements.
  • Working at a height should also be avoided, along with swimming alone.

Women and epilepsy

Women with epilepsy should talk to their neurologist before becoming pregnant. Most pregnancies in women with epilepsy have a happy outcome and a healthy baby. But both seizures and the drugs that treat seizures can be harmful to the developing baby. Women need to be under close medical care to make sure the epilepsy is under the best control possible.

Partnering with your neurologist

  • Inform the neurologist about all symptoms and medical history.
  • In a diary, record the dates, frequency and severity of your seizures.

Epileptic seizure first aid

When a person is having a seizure:

  • Stay calm and remain with the person.
  • If there is food or fluid in the mouth, roll him / her onto the side immediately.
  • Keep the person safe and protect them from injury.
  • Place something soft under their head and loosen any tight clothing.
  • Do not restrain while having fits.
  • Reassure the person until they recover.
  • Time the seizure, if you can.