Epilepsy Treatment in Kolkata

What is Epilepsy?

Epilepsy is a neurological disorder that surfaces in the form of recurrent, unprovoked fits or seizures. A seizure is an abnormal reaction to the electrical wiring of our brain. It directly affects how a person behaves, feels, or moves in the long run. Some may experience these episodes occasionally, however, having two or more unprovoked seizures is a warning sign that often leads to the diagnosis of epilepsy.

So, who at risk of developing epilepsy? It is not restricted to a certain age, gender, or ethnicity. Some experience this in childhood, while others develop it later in life due to brain injuries or underlying health conditions. The important bit is that epilepsy is a manageable condition. And with the right diagnosis and treatment plan you can control and even prevent these episodes in the long run.

Types of Epilepsy

Depending on the part of the brain affected and the type of seizures experienced, these are the main types of epilepsy:

Focal Epilepsy: This happens when there is an abnormal electrical activity confined to one part of the brain. This can further be classified under:

Focal Aware Seizures: The person remains conscious but experiences tingling, visual changes, or hearing unusual sounds.
Focal Impaired Awareness Seizures: The person loses focus and awareness leading to confusion or difficulty in response

Generalised Epilepsy: These involve both sides of the brain and are more intense. Subtypes include:

Absence Seizures: Brief lapses in consciousness, especially in children, sometimes mistaken for daydreaming.
Tonic-Clonic Seizures: These involve convulsions, muscle stiffness, and rhythmic jerking.
Myoclonic Seizures: This can be seen as brief, sudden jerks or twitches of muscles, often in the arms or legs.

Unknown Onset Epilepsy : When the cause of the seizures remains unknown, the diagnosis is epilepsy with unknown onset. This may change later if more information becomes available.

Symptoms of Epilepsy

The primary symptom of all types of epilepsy is recurrent seizures. The way their seizures surface can give you the indications or signs to look out for:

Loss of Consciousness: Common for tonic-clonic or absence seizures.
Uncontrolled Jerking Movements: Movement affecting the arms, legs, or whole body.
Staring Spells: In case of absence seizures, patients often appear to stare into space for a moment and be unresponsive.
Confusion or Disorientation: After a seizure, confusion or disorientation gradually makes way for a postictal confusion phase.
Strange Sensations: One may feel unusual sensations, like numbness, dizziness, or tingling, right before or during a seizure.
Memory Loss: Complex partial seizures can directly affect our memory.

Note: All seizures don’t cause convulsions or loss of consciousness. Sometimes symptoms may be as subtle as a brief lapse in awareness.

Causes of Epilepsy

Epilepsy can develop for many reasons, though sometimes the cause remains unknown. Common causes include:

Genetic Factors: Epilepsy maybe hereditary, since our genes can influence our nervous system’s internal wiring.
Brain Injury: Trauma from accidents, falls, or other injuries often create a ripple effect, which ends up in epilepsy. The timing however, maybe far from the initial injury.
Infections: Meningitis, encephalitis, or neurocysticercosis of the brain can trigger epilepsy.
Stroke: Strokes in older people damage the brain tissue leading to epilepsy.
Developmental Disorders: Conditions such as autism or neurodevelopmental delays may increase the likelihood of epilepsy.
Brain Tumors: Tumors affecting the brain can provoke seizures and epilepsy.
Prenatal Injury: Injuries during birth, such as lack of oxygen supply to the brain, may lead to epilepsy later in life.

Risks and Complications of Epilepsy

Injury During Seizures: Falls, bumps, or accidents can occur if a seizure happens unexpectedly, leading to injuries like fractures or head trauma.
Sudden Unexpected Death in Epilepsy (SUDEP): Though rare, SUDEP can occur in individuals with poorly controlled seizures, particularly in tonic-clonic seizures.
Cognitive Impairment: Frequent or severe seizures can affect memory, learning, and cognitive functions.
Mental Health Issues: The anticipation of an episode and inability to contain it triggers anxiety, depression, or social isolation due to its unpredictability.

Diagnosis of Epilepsy

Diagnosing epilepsy involves a thorough examination and several tests to determine the type and cause of the seizures. The diagnostic process includes:

Medical History: A detailed history of seizures, including when they started, how often they occur, and the nature of the seizures, helps guide diagnosis.
Neurological Examination: A physical examination of the nervous system, checking for signs of neurological deficits, such as reflexes, muscle strength, and coordination.
Electroencephalogram (EEG): EEG tests measure the brain's electrical activity and can detect abnormal patterns that indicate epilepsy.
Brain Imaging: MRI or CT scans may be used to look for structural abnormalities in the brain that could be causing seizures, such as tumors or scar tissue.
Blood Tests: These can help identify underlying conditions, such as infections or genetic disorders, that may contribute to epilepsy.

Treatment Options for Epilepsy

Epilepsy treatment aims to control seizures and improve the quality of life. The treatment plan is personalized, depending on the type and severity of seizures, as well as the patient's overall health. Common treatment options include:

Antiepileptic Medications (AEDs): AEDs are the first line of treatment for controlling seizures. There are several types, and a doctor will prescribe the one best suited to the individual's needs. Some common AEDs include valproate, lamotrigine, and levetiracetam. It's essential to take medications as prescribed to reduce seizure frequency.
Ketogenic Diet: For some individuals, particularly children, a ketogenic diet—high in fats and low in carbohydrates—can help reduce seizures.
Surgery: In cases where medication is not effective, surgery may be considered. This typically involves removing the area of the brain causing the seizures or implanting devices that help control seizures, such as vagus nerve stimulators.
Lifestyle Changes: Getting enough sleep, managing stress, and avoiding seizure triggers, such as flashing lights or certain foods, can help reduce the likelihood of seizures.
Supportive Therapies: Occupational therapy, counseling, and support groups can help individuals manage the psychological and social aspects of living with epilepsy.