Disease Topics:Epilepsy

Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. Many people with epilepsy have more than one type of seizure and may have other symptoms of neurological People with epilepsy tend to have recurrent seizures (fits). The seizures occur because of a sudden surge of electrical activity in the brain - there is an overload of electrical activity in the brain. This causes a temporary disturbance in the messaging systems between brain cells. During a seizure the patient's brain becomes "halted" or "mixed up".

Every function in our bodies is triggered by messaging systems in our brain. What a patient with epilepsy experiences during a seizure will depend on what part of his/her brain that epileptic activity starts, and how widely and quickly it spreads from that area. Consequently, there are several types of seizures and each patient will have epilepsy in his/her own unique way.

The word "epilepsy" comes from the Greek word epi meaning "upon, at, close upon", and the Greek word Leptos meaning "seizure". From those roots we have the Old French wordepilepsie, and Latin word epilepsia and the Greek words epilepsia and epilepsies.

problems as well.

Types of seizures

There are three types of diagnoses a doctor might make when treating a patient with epilepsy:

  1. Idiopathic - this means there is no apparent cause.
  2. Cryptogenic - this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
  3. Symptomatic - this means that the doctor knows what the cause is.

There are three descriptions of seizures, depending on what part of the brain the epileptic activity started:

Partial seizure

A partial seizure means the epileptic activity took place in just part of the patient's brain. There are two types of partial seizure:

  • Simple Partial Seizure - the patient is conscious during the seizure. In most cases the patient is also aware of his/her surroundings, even though the seizure is in progress.
  • Complex Partial Seizure - the patient's consciousness is impaired. The patient will generally not remember the seizure, and if he/she does, the recollection of it will be vague.

Generalized Seizure

A generalized seizure occurs when both halves of the brain have epileptic activity. The patient's consciousness is lost while the seizure is in progress.

Secondary Generalized Seizure

A secondary generalized seizure occurs when the epileptic activity starts as a partial seizure, but then spreads to both halves of the brain. As this development happens, the patient loses consciousness.

Symptoms of epilepsy

The main symptoms of epilepsy are repeated seizures. There are some symptoms which may indicate a person has epilepsy. If one or more of these symptoms are present a medical exam is advised, especially if they recur:

  • A convulsion with no temperature (no fever).
  • Short spells of blackout, or confused memory.
  • Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme tiredness.
  • For a short period the person is unresponsive to instructions or questions.
  • The person becomes stiff, suddenly, for no obvious reason
  • The person suddenly falls for no clear reason
  • Sudden bouts of blinking without apparent stimuli
  • Sudden bouts of chewing, without any apparent reason
  • For a short time the person seems dazed, and unable to communicate
  • Repetitive movements that seem inappropriate
  • The person becomes fearful for no apparent reason, he/she may even panic or become angry
  • Peculiar changes in senses, such as smell, touch and sound
  • The arms, legs, or body jerk, in babies these will appear as cluster of rapid jerking movements.

The following conditions need to be eliminated as they may present similar symptoms, and are sometimes misdiagnosed as epilepsy:

  • A high fever with epilepsy-like symptoms
  • Fainting
  • Narcolepsy (recurring episodes of sleep during the day and often disrupted nocturnal sleep)
  • Cataplexy (a transient attack of extreme generalized weakness, often precipitated by an emotional response, such as surprise, fear, or anger; one component of the narcolepsy quadrad)
  • Sleep disorders
  • Nightmares
  • Panic attacks
  • Fugue states (a rare psychiatric disorder characterized by reversible amnesia for personal identity)
  • Psychogenic seizures (a clinical episode that looks like an epileptic seizure, but is not due to epilepsy. The EEG is normal during an attack, and the behavior is often related to psychiatric disturbance, such as a conversion disorder)
  • Breath-holding episodes (when a child responds to anger there may be vigorous crying and subsequent apnea and cyanosis - the child then stops breathing and skin color changes with loss of consciousness).

Image result for epilepsy seizure

Treatments for epilepsy

When a diagnosis of seizures or epilepsy is made, the doctor will then discuss with the patient or the patient's family what the best treatment options are. If an underlying correctable brain condition was causing the seizures, sometimes surgery may stop them. If epilepsy is diagnosed (ongoing tendency to have seizures), the doctor will prescribe seizure-preventing drugs or anti-epileptic drugs.

If drugs do not work, the next option could be surgery, a special diet or VNS (vagus nerve stimulation). Trigeminal nerve stimulation may also be effective, according to this study.

The doctor's aim is to prevent further seizures from occurring, while at the same time avoiding side-effects so that the patient may lead a normal, active, and productive 

Here is a list of the most commonly prescribed anti-epileptic drugs (AEDs).

  • acetazolamide (brand name Diamox)
  • acetazolomide modified release (brand name Diamox SR)
  • carbamazepine (brand name Tegretol)
  • carbamazepine modified release (brand name Tegretol Retard)
  • clobazam (brand name Frisium )
  • clonazepam (brand name Rivotril)
  • ethosuximide (brand names Emeside - Zarontin)
  • gabapentin (brand name Neurontin)
  • lacosamide (brand name Vimpat)
  • lamotrigine (brand name Lamictal )
  • levetiracetam (brand name Keppra)
  • oxcarbazepine (brand name Trileptal phenobarbital)
  • perampanel (brand name Fycompa) tablets as an adjunctive treatment for partial onset seizures in epilepsy were approved by the FDA on Monday 22nd October, 2012. Fycompa is already approved in the European Union (27 sovereign states), Norway and Iceland, and is made and marketed by Eisai.
  • phenytoin (brand name Epanutin)
  • pregabalin (brand name Lyrica)
  • primidone (brand name Mysoline)
  • rufinamide (brand name Inovelon)
  • sodium valproate (brand names Epilim - Episenta)
  • sodium valproate modified release (brand name Epilim Chrono)
  • tiagabine (brand name Gabitril )
  • topiramate (brand name Topamax)
  • valproic acid (brand name Convulex)
  • vigabatrin (brand name Sabril)
  • zonisamide (brand name Zonegran)

Fatty acids for new epilepsy medications

Certain fatty acids may form the basis for new epilepsy medications in adults and children, scientists in London reported in Neuropharmacology. They explained that fatty-acid based drugs might provide similar symptom control as Ketogenic diets do.

They hope to identify the specific fatty acids in the Ketogenic diet that are effective in controlling seizures. The scientists, from University College London and the Royal Holloway Hospital expect their research will pave the way for new anti-epileptic therapies which have the same beneficial effects as the diet without having to make the patient suffer the severe side-effects.