Everything You Need To Know About Epilepsy

According to the Indian Epilepsy Society, India carries an enormous burden of epilepsy affecting ten million people every year. Epilepsy is one of the world’s oldest recognized conditions, but fear and misunderstanding have created a social stigma around it. Therefore, there is an urgent need to spread awareness and talk about the disease for reducing the burden.

Understanding epilepsy

Epilepsy is a non-communicable condition which leads to seizures affecting mental and physical functions. It can be categorized into focal (or partial) epilepsy and generalized epilepsy. In focal epilepsy, the epileptic seizure starts from a specific part of the brain and spreads across the entire brain. In the case of generalized epilepsy, there are no single foci of the origin of seizures.

Warning signs When a person has two or more unprovoked seizures, they can be said to have epilepsy. One should look out for symptoms such as convulsions (jerking in various body parts), short spells of a blackout, sudden bouts of blinking without apparent stimuli and the person may seem dazed and unable to communicate for a short duration.

Risk factors

There are several factors that trigger seizures, including lack of sleep, severe stress, heavy consumption of alcohol, use of recreational drugs (cocaine, ecstasy), nutritional deficiencies, and in some cases, even menstrual cycle. Missed medication, prescription drugs, and some antibiotics may also trigger epileptic seizures. Usually, a seizure does not last for more than 1 or 2 minutes. Although an episode tends to end spontaneously, it is not a voluntary action, i.e. a person cannot control the seizure.

Management of epilepsy

Epilepsy can be diagnosed through High-quality MRI and video EEG. The duration for the treatment is between 3 to 5 years in most patients. In some cases, patients may only require treatment up to one year (neuro-cysticercosis), while on the other hand, some patients may need long term treatment for many years (even lifelong) like in the case of juvenile myoclonic epilepsy. The most important precaution is to take medication on time as discontinuation of the same can result in seizure relapse.

One should keep the following points in mind to help someone who is having a seizure:

· Remove or move objects out of the way so the person does not get injured

· Reposition or place a pillow under their head

· Lay the patient on one side once the seizure is over

· Time the seizure duration

· Reassure the patient and stay with them until recovery

· No one should hold the person down during the seizure

· In case the person turns blue or stops breathing, try to position their head in such a way that they can breathe

· CPR or mouth-to-mouth breathing is rarely needed and should especially not be performed during the seizure

· In case, the seizure lasts longer than five minutes, or the person gets injured during the episode or is unconscious, it is advisable to rush to the nearby hospital

Epilepsy is treatable in the majority of the cases. Significant improvement can be seen in people on a single drug (though some may require the addition of another drug). In recent years, there are several new and effective antiepileptic drugs available which have lesser side effects. In extreme cases, where seizures are non-responsive to medication, surgery is an option. In fact, if seizures are identified to be starting from a single point of the brain, then it can possibly be treated by removing that part of the brain.

Dr Atma Ram Bansal

Guest Author The author is Senior Consultant, Institute of Neurosciences at Medanta, The Medicity.