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Epilepsy Conditions

Epilepsy is a neurological disorder in which abnormal activity in the brain causes seizures or periods of unusual behaviour, sensations, and sometimes loss of awareness.

Seizure symptoms can vary widely and may include:

  • Temporary confusion
  • A staring spell
  • Uncontrollable jerking movements of the arms and legs
  • Loss of consciousness or awareness
  • Psychic symptoms such as fear, anxiety or deja vu

Symptoms vary depending on the type of seizure but in most cases, a person with epilepsy will tend to have the same type of seizure each time.

Seizures as classified as either focal or generalized, based on how the abnormal brain activity begins.

Focal (or partial) seizures appear to result from abnormal activity in just one area of the brain. Symptoms of focal seizures may be similar to other neurological disorders, such as migraine, narcolepsy or mental illness. 

Focal seizures may occur without loss of consciousness (simple partial seizure). Symptoms may include:

  • alteration in emotions or sensations such as vision, smell, touch, taste or sound
  • involuntary jerking of a body part, such as an arm or leg

Focal seizures may occur with a change or loss of consciousness or awareness (complex partial seizure). Symptoms may include:

  • staring into space and not respond normally to your environment  
  • performing repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles

Generalized seizures appear to involve all areas of the brain. Six types of generalized seizures exist.

  • Absence seizures (petit mal seizures) often occur in children, sometimes in clusters and cause a brief loss of awareness. Symptoms include staring into space or subtle body movements such as eye blinking or lip smacking. 
  • Tonic seizures involve stiffening of muscles, especially in the back, arms and legs which may result in falling to the ground.
  • Atonic seizures (drop seizures) cause a loss of muscle control, which may cause a sudden collapse or fall.
  • Clonic seizures are associated with repeated or rhythmic, jerking muscle movements, usually affect the neck, face and arms.
  • Myoclonic seizures usually appear as sudden brief jerks or twitches of the arms and legs.
  • Tonic-clonic seizures (grand mal seizures) are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or tongue biting.

Seek immediate medical help if:

  • The seizure lasts more than five minutes or a second seizure follows immediately
  • Breathing or consciousness does not return after the seizure stops.
  • The seizure is associated with a high fever or heat exhaustion.
  • An injury occurs during a seizure
  • Seizure during pregnancy
  • Seizure of a diabetic person

If you experience a seizure for the first time, seek medical advice.

Epilepsy has no identifiable cause in about half of cases. In some cases, the condition may be associated with various factors, including:

  • Genetic factors
  • Traumatic head injury
  • Brain tumours or strokes
  • Infectious diseases, such as meningitis, AIDS and viral encephalitis
  • Prenatal brain damage which may be caused by poor nutrition, infection or lack of oxygen in the womb
  • Developmental disorders, such as autism and neurofibromatosis.

Your doctor will assess your medical history and symptoms.

Having a single seizure does not mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis.

Tests may include:

  • Neurological examination to test motor abilities and mental functioning
  • Blood tests to check for signs of infections, genetic conditions or other conditions that may be associated with seizures
  • Electroencephalogram (EEG) to record the electrical activity of your brain
  • CT scans can reveal abnormalities in your brain that might be cause seizures, such as tumours, bleeding and cysts
  • An MRI may be able to detect lesions or abnormalities in the brain that could be the cause of seizures
  • Positron emission tomography (PET) scans use a small amount of low-dose radioactive material that is injected into a vein to help visualize active areas of the brain and detect abnormalities.
  • Single-photon emission computerized tomography (SPECT) test uses a small amount of low-dose radioactive material that is injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures.

Advanced techniques such, statistical parametric mapping (SPM) and magnetoencephalography (MEG) can help pinpoint where in the brain seizures start:

Accurate diagnosis of the type and origin of seizures give the best chance for finding an effective treatment.

Anti-seizure medications are usually the first line of treatment. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. 

Finding the right medication(s) and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors, such as other medications you are taking, when choosing which medication to prescribe. 

Benefits of medication must be weighed against potential side effects, such as fatigue, dizziness or, more rarely, increased risk of depression or liver inflammation.

It is important to take medications exactly as prescribed and notify your doctor if you experience side effects.

If anti-epileptic medications do not provide satisfactory results, your doctor may suggest surgery or other therapies. 

Apart from medications and surgery, therapies such as vagus nerve stimulation or deep brain stimulation may be helpful.

First Aid

If you witness someone having a seizure, do not try to restrain them or put your fingers or anything else in their mouth.

You can help by remaining calm and:

  • Carefully rolling the person onto one side
  • Placing something soft under his or her head
  • Loosening tight neckwear
  • If the person is moving, clearing away dangerous objects
  • Staying with the person until medical personnel arrive
  • Observing the person closely so that you can provide details on what happened
  • Timing the seizures.

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