Epilepsy: What It Is, Causes, Symptoms, Diagnosis & Treatment

Epilepsy is a chronic brain disorder in which groups of nerve cells, or neurons, sometimes send abnormal signals that cause seizures. These seizures vary widely, from mild lapses in awareness to severe convulsions. Understanding the causes of epilepsy, recognising epilepsy symptoms, and getting the right epilepsy treatment can help individuals manage this condition effectively.

Understanding Epilepsy

Epilepsy is characterised by repeated, unprovoked seizures. Neurons in the brain typically communicate via carefully regulated electrical and chemical signals. In epilepsy, however, many neurons may fire all at once or in an uncontrolled manner, which can trigger movements, sensations, emotions, or a combination of these symptoms. Although it can affect people of all ages, epilepsy is more common in older adults and can arise from a number of underlying conditions, including genetic factors, head injuries, and infections.

Despite its often unpredictable nature, epilepsy is not always life-threatening. Many individuals with epilepsy can lead full, active lives, especially when their condition is well-managed. Importantly, one single seizure does not necessarily mean a person has epilepsy. The condition is typically diagnosed after two or more unprovoked seizures occur, separated by at least 24 hours.

Types of Epilepsy

Epilepsy is sometimes referred to as “the epilepsies” due to its diverse causes and seizure types. Understanding these types can help individuals and healthcare providers tailor an appropriate management plan.

Focal (Partial) Epilepsy

Focal Onset Aware Seizures (Simple Partial Seizures): People remain conscious but may experience unusual sensations, such as intense déjà vu or strange tastes and smells.

Focal Onset Impaired Awareness Seizures (Complex Partial Seizures): People may have a change in consciousness and perform repetitive movements (automatisms) like blinking, chewing, or walking in circles.

Generalised Epilepsy

Absence Seizures: Brief lapses in awareness, often described as staring spells.

Tonic-Clonic Seizures: Involve stiffening (tonic phase) and repeated jerking (clonic phase) of the arms, legs, or entire body.

Myoclonic Seizures: Quick, jerk-like movements of the upper body or limbs.

Atonic Seizures: Sudden loss of muscle tone, causing the person to fall.

Tonic Seizures: Persistent muscle stiffening, often in the back or limbs.

Other Syndromes

Certain epilepsy syndromes are specific to certain ages or genetic profiles, such as absence epilepsy which often begins in childhood, or temporal lobe epilepsy, which is linked to focal seizures originating in the temporal lobe.

Because epilepsy manifests in different ways, diagnosis and treatment approaches can also vary significantly.

Epilepsy Symptoms

Epilepsy symptoms can differ widely between individuals, but the most recognisable signs of epilepsy are seizures. Whether mild or severe, the signs and epilepsy symptoms to look out for include:

• Seizures: These can range from subtle staring spells to sudden convulsions or loss of consciousness.
• Convulsions: Muscles contract repeatedly, sometimes causing a person to collapse or fall.
• Sensory Disturbances: Strange smells, tastes, or sudden feelings of déjà vu.
• Automatisms: Uncontrollable repetitive actions such as blinking, fidgeting, or lip-smacking.
• Brief Lapses in Awareness: Common in absence seizures, where a person may stare blankly and then quickly resume normal activity.

More subtle signs of epilepsy (signs of epilepsy) can include brief confusion, unusual mood changes, or repeated episodes of memory lapses. After a seizure, some people recover immediately, while others may feel tired, confused, or weak for minutes to hours.

What Causes Epilepsy

Despite extensive research, the causes of epilepsy can sometimes remain unknown. However, a number of factors are known to contribute:

• Genetic Factors

Genetic alterations (particularly in the JAK2 gene for blood-related conditions, though in epilepsy’s case, different genes may be involved) can predispose individuals to certain forms of epilepsy. Sometimes these gene variants are inherited; other times, they appear spontaneously.

• Structural Brain Abnormalities

Conditions like brain tumours, stroke, head trauma, or infections (such as meningitis, encephalitis, or HIV-related infections) can disrupt normal brain activity, leading to seizures. Birth defects or developmental issues (e.g., cerebral palsy) can also play a role.

• Metabolic Disorders

Issues with metabolism or hormone levels might lower the brain’s seizure threshold, causing episodes of abnormal electrical activity.

• Triggers

Seizures can be provoked by triggers like stress, sleep deprivation, intense flashing lights, fever, or even changes in blood sugar. These do not necessarily cause epilepsy but can spark seizures in those already susceptible.

• Other Risk Factors

1. 1. Age: While epilepsy can occur at any age, it’s more common in children and adults over 60.
   2. Stroke or Heart Problems: Conditions that deprive the brain of oxygen can lead to lasting changes in neuronal signalling.

Alcohol Withdrawal: Abruptly stopping heavy alcohol use can trigger seizures.

Epilepsy Treatment

Epilepsy treatment focuses on preventing seizures, managing underlying causes, and improving the person’s quality of life. Most often, treatment is effective, especially when started early.

• Epilepsy Medication

1. 1. 1. Doctors typically prescribe antiseizure medications that help reduce or prevent seizures.
      2. The choice of medication depends on seizure type, the person’s age, and other health considerations.
      3. Many individuals respond well to a single drug, while others may require a combination.

• Lifestyle Adjustments

1. 1. 1. Adequate Sleep: Sleep deprivation is a powerful seizure trigger. A regular sleep schedule can help manage the frequency of seizures.
      2. Stress Management: Techniques such as yoga, meditation, or counselling can reduce stress-related triggers.
      3. Diet: Some people benefit from specific diets like the ketogenic diet, particularly in certain types of childhood epilepsy.

• Surgical Interventions

If epilepsy medication fails to control seizures, brain surgery to remove or isolate the seizure focus may be considered. Temporal lobe resection and lesionectomy are examples of surgical procedures that help reduce or eliminate seizure occurrences.

• Neurostimulation Devices

In cases where surgery is not an option, devices such as a vagus nerve stimulator (VNS) or responsive neurostimulation (RNS) may be used. These devices help regulate abnormal electrical activity in the brain.

• Complementary Therapies

Techniques like biofeedback, acupuncture, or even music therapy can provide additional support, though they should complement, not replace, standard medical interventions.

When to See a Doctor?

• Multiple Unprovoked Seizures: If you or a loved one experiences multiple unprovoked seizures, it’s crucial to consult a neurologist for diagnosis and treatment.
• Persistent Uncertainty: Sometimes, events that look like seizures might actually be related to fainting, mental health conditions, or cardiac issues. A thorough evaluation helps rule out other causes.
• Medication Queries or Side Effects: People already on epilepsy medication should check in regularly with their doctor to monitor side effects and ensure the treatment remains effective.

If you’re based in Bangalore, consider a visit to SPARSH, a well-known neurology hospital in Bangalore. You can consult some of the best neurologists in Bangalore who will provide personalised treatment and care for the best outcome.

Conclusion

Epilepsy is a complex neurological condition with diverse signs of epilepsy, from mild lapses of awareness to severe convulsions. Understanding the potential triggers, the various types of epilepsy, and different treatment approaches empowers individuals and families to manage the condition effectively. While epilepsy may not always be curable, it is highly treatable, and many people lead full lives once their seizures are under control.

Early diagnosis and tailored management are key. If you suspect you or someone you know has epilepsy, don’t delay seeking professional advice. Appropriate treatment, whether through medication, surgery, or lifestyle adjustments, can significantly improve the outlook for those living with this condition.

Frequently Asked Questions

What is the main treatment for epilepsy?

The primary treatment is epilepsy medication, also known as antiseizure drugs. Many types are available, and they’re chosen based on the person’s seizure type and overall health.

What is the most common epilepsy diagnosis?

Focal (partial) epilepsy, where seizures originate in one area of the brain, is one of the most common forms.

Is epilepsy 100% curable?

While there’s no guaranteed cure, many people achieve long-term seizure control through medication or surgery. Others may outgrow epilepsy or experience fewer seizures over time.

What is the first treatment for epilepsy?

Doctors often start with a low dose of an antiseizure medication. The dose or medication may be adjusted until seizures are under control. Surgery or other options may be considered if medication alone is not effective.