Epilepsy: Abnormal Brain Activity

 

 

What is Epilepsy?

Epilepsy is a neurological disorder caused by abnormal electrical activity in the brain, resulting in seizures. It can occur in both children and adults and stems from various causes.

 

• Abnormalities in brain tissue, such as Stroke, abnormal masses, scarring, or brain hemorrhage.
• Patients with liver disease, kidney disease, electrolyte imbalances, drugs, or toxins.

 

 

 

 

What are the Symptoms of Epilepsy?

There are several types of seizures. Symptoms vary depending on the part of the brain being stimulated, such as:

 

1. Focal Impaired Awareness Seizures

     Symptoms include stopping current activities and losing awareness of surroundings. There may be involuntary, aimless movements such as walking around, rubbing hands, or repeating words. The patient may appear confused. These episodes usually last 2-4 minutes and may progress to a generalized tonic-clonic seizure.

 

2. Absence Seizures (Staring Spells)

     These seizures are very brief, starting and ending abruptly. The patient stares blankly for about 5-10 seconds, which may be mistaken for daydreaming. There may be eye fluttering, blinking, or facial twitching. The patient is unaware of the episode. Most common in children aged 6-14 years.

 

3. Atonic Seizures (Drop Attacks)

     This type involves a sudden loss of muscle control, causing the patient to collapse or fall down abruptly.

 

4. Generalized Tonic-Clonic Seizures (Grand Mal)

• Tonic Phase: Rapid loss of consciousness, falling, involuntary vocalization, body stiffness, upward eye rolling, clenched teeth, and temporary cessation of breathing.
• Clonic Phase: Rhythmic jerking of arms and legs, possible biting of the tongue or cheek, foaming at the mouth, and cessation of breathing for 2-3 minutes (the patient may turn blue).
• Postictal Phase: Resumption of breathing, gradual return to consciousness, temporary confusion, fatigue, or sleep. Vomiting or loss of bowel/bladder control may occur.

 

 

 

 

 

 

 

What to do if Epilepsy is Suspected?

You should consult a Neurologist for a history review and physical examination. Additional tests may be required to differentiate the disease and identify the cause, including:

 

• Blood tests; some cases may require a Lumbar Puncture
• CT Scan of the brain
• MRI Scan of the brain
• Electroencephalogram (EEG)

 

How is Epilepsy Treated?

     If a cause is identified, treatment focuses on addressing that cause alongside seizure control. If no specific cause is found, patients must avoid seizure triggers. Neurologists will determine the best course of action, which may include anti-epileptic medication or surgery, depending on the individual case.

 

When do Seizures Occur?

     Epileptic seizures can occur during both sleep and wakefulness, with varying frequency. They often occur when triggered by factors such as sleep deprivation, fever, alcohol consumption, stress, intense exercise, flashing lights, loud noises, or menstruation.

 

 

 

 

 

 

Self-Care for People with Epilepsy

• Take all prescribed medications strictly as directed. Do not miss doses or stop medication without consulting a doctor.
• Avoid triggers such as sleep deprivation, stress, alcohol, irregular medication, flashing lights, and loud noises.
• Avoid hazardous work involving machinery, sharp objects, heights, or being near water.
• Witnesses are encouraged to observe and remember the seizure characteristics to provide useful information for diagnosis and treatment.
• Even if seizures are well-controlled, do not stop medication unless instructed by a doctor, as the condition may return.
• Inform your doctor if you are pregnant or have other co-existing illnesses.
• Ensure adequate sleep and rest.

 

 

Once a seizure starts, it usually lasts 1-5 minutes. If it lasts longer than this, the patient should be taken to the hospital immediately.

 

 

First Aid for Seizures

• Do not pry open the mouth or insert anything between the teeth, such as spoons or chopsticks. This causes more oral injury than the seizure itself. If possible, provide a soft cloth or object for the patient to bite on at the start, but never use hard objects.
• Prevent injury by protecting the patient from falls or impact. Gently lay the patient on their side to keep the airway clear. Remove glasses, loosen tight clothing, and remove dentures if possible.
• Do not restrain the patient. Seizures will stop on their own, and restraint can cause injury.
• Do not leave the patient alone to find help. Stay with them at all times to provide reassurance when they regain consciousness.
• Do not give the patient anything to eat or drink during or immediately after a seizure, as it may lead to choking.

 

 

Last Updated: Nov 08, 2024