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Causes of Seizure & Epilepsy
There is a fine balance in the brain between factors that begin electrical
activity and factors that restrict it, and there are also systems that limit
the spread of electrical activity. During a seizure, these limits break down,
and abnormal electrical discharges can occur and spread to whole groups of
neighboring cells at once. This linkage of electrical discharges creates a
"storm" of electrical activity in the brain. This is a seizure. When a person
has had at least two of these seizures, that's called epilepsy.
The reasons why epilepsy begins are different for people of different ages. But
what's true for every age is that the cause is unknown for about half of
everyone with
epilepsy.
Children may be born with a defect in the structure of their brain, or they may
suffer a head injury or infection that causes their epilepsy. Severe head
injury is the most common known cause in young adults. In middle age, strokes,
tumors, and injuries are more frequent. In people over 65, stroke is the most
common known cause, followed by degenerative conditions such as Alzheimer's
disease.
Often seizures do not begin immediately after a person has an injury to the
brain. Instead, a seizure may happen many months later. We do not have a good
explanation for this common observation, but scientists are actively
researching this subject.
Risk factors for epilepsy & Seizure
Risk factors for epilepsy & Seizure are following:-
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Babies who are small for their gestational age
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Babies who have seizures in the first month of life
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Babies who are born with abnormal brain structures
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Bleeding into the brain
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Abnormal blood vessels in the brain
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Serious brain injury or lack of oxygen to the brain
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Brain tumors
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Infections of the brain: abscess, meningitis, or encephalitis
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Stroke resulting from blockage of arteries
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Cerebral palsy
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Mental handicap
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Seizures occurring within days after head injury ("early posttraumatic
seizures")
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Family history of epilepsy or fever-related seizures
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Alzheimer's disease (late in the illness)
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Fever-related (febrile) seizures that are unusually long
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Use of illegal drugs such as cocaine
Other Risk factors for epilepsy & Seizure
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Missed medication
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Lack of sleep
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Illness (both with and without fever)
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Severe psychological stress
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Heavy alcohol use
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Use of cocaine and other recreational drugs such as Ecstasy
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Over-the-counter or prescription medications or supplements that decrease the
effectiveness of seizure medicines
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Nutritional deficiencies: vitamins and minerals
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The menstrual cycle
Epilepsy and the Brian
Epilepsy is a disorder of the central nervous system, specifically the brain. In
simple terms, our nervous system is a communications network that controls
every thought, emotion, impression, memory, and movement, essentially defining
who we are. Nerves throughout the body function like telephone lines, enabling
the brain to communicate with every part of the body via electrical signals. In
epilepsy, the brain's electrical rhythms have a tendency to become imbalanced,
resulting in recurrent seizures.
If you have seen a picture of the brain before, it probably looked like this
one, which illustrates the outer surface of the upper brain. This outer surface
contains numerous folds that increase the surface area and allow more cerebral
cortex to be packed into the skull, giving us more "brain
power."
The brain is an extraordinarily complex organ. When it comes to understanding
epilepsy, there are several concepts about the brain you'll need to learn.
The first is that the brain works on electricity. Normally, the brain
continuously generates tiny electrical impulses in an orderly pattern. These
impulses travel along the network of nerve cells, called neurons, in the brain
and throughout the whole body via chemical messengers called neurotransmitters.
A seizure occurs when the brain's nerve cells misfire and generate a sudden,
uncontrolled surge of electrical activity in the brain.
Another concept important to epilepsy is that different areas of the brain
control different
functions.
If seizures arise from a specific area of the brain, then the initial symptoms
of the seizure often reflect the functions of that area. The right half of the
brain controls the left side of the body, and the left half of the brain
controls the right side of the body. So if a seizure starts from the right side
of the brain, in the area that controls movement in the thumb, then the seizure
may begin with jerking of the left thumb or hand.
Sleep and Epilepsy
We all know that we think more clearly, react more quickly, and generally
perform better after a good night's sleep. And while a good night’s sleep plays
a key role in the overall well-being and health of all people it is even more
vital in people with epilepsy. One reason why is because a lack of sleep or
poor quality of sleep can in turn increase frequency of seizures. The reasons
why sleep deprivation provokes seizures are unclear. However, what we do know
is that the sleep-wake cycle is associated with prominent changes in brain
electrical activity, so seizures and the sleep-wake cycle are often clearly
related. We also know that most types of seizures are affected by sleep,
although the degree varies greatly from type to type and patient to patient.
Further, there are hormonal changes during sleep that could possibly be related
to seizures. Finally, the effects of seizures and seizure medicines on the
quality of your sleep can make the relationship even more complicated. In this
section we will explore all the different aspects of the sleep-epilepsy
connection. Let’s get started with an introductory look at how sleep and
epilepsy are connected.
Diagnosis
Usually it is easy for a doctor to tell whether a patient has epilepsy. But
sometimes other disorders can cause sudden changes in behavior that may be
confused with epilepsy. The patient's treatment depends on an accurate
diagnosis: does the patient have epilepsy or some other disorder? If the
diagnosis is epilepsy, the choice of treatment also depends on accurately
identifying the specific type (or types) of seizure. Different types respond
best to different seizure medicines. Some types can even be made worse by
particular medicines.
The doctor seldom gets to see the patient have an actual spell, so the
information provided
by the patient and family members or other witnesses is extremely important. No
matter how accurate and complete the information, however, some episodes are
difficult to diagnose correctly, even for experts. Every epilepsy specialist
has had patients whose spells were so confusing that the first diagnosis was
incorrect. This is one reason that follow-up care, and the additional
information it can provide, is so important.
The diagnosis of epilepsy depends largely on your medical history. Because your
doctor will probably never see one of your seizures, an accurate description of
what happens, either from you or from someone who witnesses your seizure, is
essential. Additional tests will help to confirm the diagnosis and to determine
which type of epilepsy you have.
EEG
An EEG (electroencephalogram) measures the electrical activity in your brain.
The presence of abnormal electrical activity, or "spikes," can help to
determine if you have epilepsy, and help to identify the region of the brain
where your seizures begin. Longer EEG recordings over several days, known as
ambulatory EEG or video-EEG monitoring may show abnormal activity even when the
first EEG was normal.
Brain imaging
Brain images are pictures of your brain that are taken in order to look for
areas of abnormality that might account for the seizures. The most common type
of brain scan is CT (computerized tomography). A more sensitive type of scan is
MRI (magnetic resonance imaging), which produces a high-quality image of your
brain. Most patients with partial seizures will have brain imaging.
Blood tests
A blood sample may be taken to look for any medical conditions that may be the
cause of the seizures.
Treatment
First aid for a seizure as it's occurring is certainly an important part of
treating epilepsy. But taking a longer view, we see that the real objective of
treatment for epilepsy is not to extend life or relieve pain. Instead, the goal
is to enable people with epilepsy to lead full and unrestricted lives according
to their own wishes.
"No seizures, no side effects" is the motto for epilepsy treatment. Not every
person with epilepsy is able to reach that goal right now, but with research,
more achieve it every year. Doctors keep working with the others to help them
achieve the best possible quality of life—measured not by the number of
seizures but by how close they come to achieving their own individual aims.
For some people, the treatment of epilepsy consists of taking a pill once or
twice a day for a few years. No seizures, no side effects.
Others take many pills year after year. Lots of seizures, plenty of side
effects. They may move on to other kinds of treatment. Sometimes they work well
and sometimes they do not. People in this situation can get help from a team of
health professionals who not only will help them find the most effective
treatment to stop seizures, but also will help them to live as well as they can
while the search continues.
Who needs medication?
Not all patients with seizures require treatment with antiepileptic drugs, and
some patients need only one or two years of drug therapy. Most patients with
epilepsy, however, will require one or more drugs for many years. Overall,
there is about a 60 percent chance of good seizure control with a single drug,
and about 75 percent with additional drugs.
Other Treatments
Vitamin therapy. Unfortunately, when it comes to epilepsy, high doses of
vitamins do not usually do any good. This is often a disappointment to people
who would like to have what they think of as a more "natural" kind of treatment
than taking medicines every day. Special diets (except for the ketogenic diet)
don't seem to have any antiseizure effects, either.
Help with how you feel. Some people with seizures may need other kinds of
treatment -- like counseling for emotional problems or help with anxiety or
depression, help with finding jobs, or special education services. This type of
treatment may help you cope with this disorder and get on track to a more
normal life. But the first priority is to get up-to-date medical care and the
best seizure control possible.
Other Treatment Options
About 20 to 25 percent of patients will continue to have seizures despite
treatment with antiepileptic medications. For these patients, several other
therapies are available, including:-
Ketogenic diet
This is a high-fat, low-carbohydrate, no-sugar diet that is effective for some
children with hard-to-control seizures. The diet is very strict, can be
difficult to follow, and does not work for every child. It must be monitored
closely by your doctor and nutritionist. The diet seems to be more effective
for children than adults.
Vagus nerve stimulation
This treatment involves electronic stimulation of the brain using an implanted
device, like a pacemaker. Placement of the stimulator has been shown to reduce
the frequency of seizures by about 50 percent in carefully selected patients.
Epilepsy surgery
Some patients with frequent partial seizures may be candidates for brain
surgery. This procedure removes the part of the brain that is causing the
seizures or prevents the spread of seizure activity from one part of the brain
to another. Epilepsy surgery has its own risks and benefits, and is not
appropriate for every patient with epilepsy.
Conclusion
Epilepsy is a common neurological disease. If it isn't adequately treated, it
can be disabling. Frequent seizures can lead to social isolation, poor school
or job performance, restriction of driving privileges, family stress, and loss
of independence and self-esteem. Exciting advances in the past 10 years,
however, offer many new
options for the treatment of epilepsy, including new medications, the ketogenic
diet, vagal nerve stimulation, and epilepsy surgery. If you or someone you know
has epilepsy, talk to a doctor about treatment options. Most
patients can achieve acceptable seizure control with one or more of these
treatments.
References:-
http://abcnews.healthology.com
http://www.epilepsyfoundation.org
http://www.epilepsy.com
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