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Epilepsy: Signs, symptoms, cause, diagnosis and treatment
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Epilepsy: Signs, symptoms, cause, diagnosis and treatment

Epilepsy can affect anyone irrespective of age or gender

Epilepsy Illustration

Epilepsy is a non-communicable neurological condition in which there is excessive electrical discharges from a group of brain cells. It is characterized by frequent episodes of seizures.
Seizures are brief episodes of uncontrolled movement of a body part (partial) or entire body (generalized), sometimes accompanied by loss of consciousness or loss of control of bowel or bladder function. 

According to WHO, epilepsy is one of the oldest-known medical conditions with a written record dating back to 4000 BCE. Epilepsy can affect anyone irrespective of their age and gender. 

Signs and symptoms 

Seizures are the classical sign of epilepsy, but a single episode of seizure does not manifest epilepsy. For a person to be diagnosed with epilepsy, they must have had two or more unprovoked episodes of seizures. Though symptoms vary depending on the type of seizures, some common signs include: 

  • Temporary confusion 
  • A staring eye 
  • Muscle stiffness or twitching 
  • Uncontrolled jerking of arms and legs (fits) 
  • Loss of consciousness or awareness 
  • Phobia or anxiety 

Cause 

The exact cause of epilepsy is still unknown, but it is believed that excessive electrical discharges by a group of brain cells are responsible. Think of it as a disruption in the nerve cells of the brain just like a disruption of the wiring in a complex electrical circuit of a house. This can happen due to: 

  • Imbalance in the neurotransmitters or natural chemicals in the brain that helps in electrical conductivity of nerve cells 
  • Changes in the membrane covering of the nerves cells which leads to inefficient electrical conductivity through nerve cells 
  • Damage or changes in the junction of two successive nerve cells (proteins or ions) leading to improper electrical conductivity between nerve cells 

Apart from these, there are several other factors that can cause epilepsy such as a head injury, brain infections (meningitis, encephalopathy), ischemic stroke (damage of brain cells due to lack of oxygen), certain genetic syndromes, brain tumors, high fever, high blood sugar levels, alcohol or withdrawal of drugs. 

Diagnosis 

Evaluating the location of the affected brain cells, type of seizures and their severity can be established by various imaging techniques. A collaborative inference from imaging and physical exams can help make a confident diagnosis. Some of the diagnostic methods are: 

  • MRIs help in detecting the affected area of the brain or presence of any hindrance 
  • CT scans can help in detecting any structural changes of scalp 
  • Electroencephalographs (EEG) measure the electrical activity of the brain for a more specific diagnosis of affected area of the brain or nerve cells 

Individuals are advised to note down the date and year, signs and symptoms, time and duration of seizure episode. If possible, a bystander should make a video of the episodic event, noting down pulse and breathing rate of the person suffering from seizures to show to a doctor and improve the accuracy of diagnosis. 

Treatment 

There are many anti-epileptic medications used alone or in combination to treat epilepsy. These include Phenobarbitone, Phenytoin, Clonazepam, Diazepam, Lorazepam, 

Carbamazepine, Valproate, Lamotrigine, Gabapentin, Pregabalin. Some of the newer medicines are Topiramate, Levetiracetam, Vigabatrin and Lacosamide. 

Also, surgical treatments exist and can be performed in case a person with epilepsy develops resistance to medications. 

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