EPILEPSY

Epilepsy

Epilepsy is recurrent seizures (fits) because of a sudden surge of electrical activity in the brain. During a seizure, different parts of brain will experience seizure and it may spread from one area to another.

Types:

  • Idiopathic – no apparent cause.
  • Cryptogenic – there may be a cause. However, cannot pinpoint it.
  • Symptomatic – the doctor knows the cause.

There are three descriptions of seizures:

  • Partial seizure
  • Simple partial seizure
  • Generalised seizure
  • Secondary generalized seizure

Symptoms of epilepsy:

  • Convulsion
  • Confused memory
  • Tiredness
  • Fainting
  • Stiffness
  • Patient suddenly falls
  • Blinking
  • Patient becomes fearful
  • Peculiar changes in senses
  • Loss of consciousness or awareness
  • A staring spell
  • Psychic symptoms

Causes:

  • Genetic influence
  • Head trauma
  • Infectious diseases
  • Prenatal injuries
  • Brain injury
  • Developmental disorders

Risk factors:

  • Age – early childhood or after 60 years
  • Family history
  • Head injuries
  • Stroke
  • Dementia
  • Brain infections

Complications:

  • You may fall during seizures and injure yourself.
  • Patients with epilepsy should not swim.
  • A patient should not drive a two wheeler or car: This may cause injury to him, the occupants of the vehicle and road users.
  • Complications during pregnancy
  • Sudden unexplained death

Tests & Diagnosis:

  • Neurological examination
  • Blood tests
  • Electroencephalogram (EEG)
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Functional MRI

Treatments for epilepsy:

  1. Anti-epileptic drugs (AED)
  2. Surgery

Epilepsy surgery is recommended only when:

  • A single area of only one side of the brain is causing seizures
  • Tests show that your seizures originate in a small, well-defined area of your brain that does not interfere with vital functions, viz, speech, language, motor function, vision or hearing.


Investigations done for pre-surgical evaluation:

 

Video-EEG monitoring:

In this procedure, the EEG is recorded for a prolonged period, accompanied by continuous closed-circuit video observation. The digitized EEG and recorded behavior are displayed simultaneously. This shows point-to-point correlations of recorded events and any accompanying electrographic changes.

Video-EEG is very helpful to determine whether seizures with unusual features are actually epilepsy. It identifies all types of seizures and pinpoints the region of the brain where seizures begin. Locating the exact region is very essential if epilepsy surgery is contemplated.

Continuous video-EEG monitoring can help establish the diagnosis of epilepsy.

 

Is epilepsy fatal?

  • Many people with epilepsy lead a full life span. However, the risk of premature death.
  • Sometimes epilepsy is a symptom of a more serious condition like stroke or tumour.
  • Prolong seizures called ‘status epilepticus’ can be life-threatening.

Head doctors

  • Dr.Rajesh Shankar Iyar

    Dr.Rajesh Shankar Iyar

    Epileptologist and Neurologist
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