Epilepsy is a neurological disorder affecting children as well as adults. There are episodes of various body movements medically termed as seizures. These seizures are spasmodic, irregular body movements, affecting various muscle groups of body. It may present with varying intensity and duration, and different groups of muscles in different individuals, at different times. It is due to abnormal electrical activity in the brain which is reflected on different groups of muscles. Epilepsy is a chronic disease having a tendency to relapse periodically and for many years to life time, if not adequately treated.
The following are some of the symptoms of Epilepsy: The most common symptoms or signs are seizures or convulsions. Seizures are involuntary movements, like jerking or thrashing, or experiencing unusual feelings or sensations, which can be associated with loss of consciousness or being unaware of things happening around. Following are subjective experiences of seizures: • Before appearance of seizure may be hours or days ago, person can notice various changes in his behavior or mood. • History can be obtained from friend or patient himself. • Patients experience aura before the seizure attack, something like “déjà vu” phenomenon in which the patient feels that he has seen this before or lived this before or can smell strange things or see flashes of lights. • After a partial seizure there may be temporary weakness of the affected limb. • After generalized seizure the patient may feel awful with headache, myalgia, confusion, and a sore tongue. Generally seizures can also be caused due to decrease in sodium ,calcium ,magnesium ,hypoglycemia (decreased blood glucose level ) from the body, or due to high fever or even due to hypoxia (decrease oxygen content in the blood). Not everything that twitches is epilepsy; but tongue biting is very suggestive of epilepsy Causes of epilepsy: There are several possible causes for epilepsy: They may be grouped as: Physical causes: • Trauma • Space occupying lesion • Stroke • Very raised blood pressure • Tuberous sclerosis Metabolic causes: • Hypoglycemia (low sugar level) • Hyperglycemia (high sugar level) • Hypoxia (low oxygen level) • Uremia • Hyponatraemia (low sodium level) • Hypernatraemia (high sodium level) • Hypocalcaemia • Liver diseases • Alcohol withdrawal • Drugs-phenothiazines,cocaine,benzodiazepines Infections: • Encephalitis • Syphilis • Cysticercosis • HIV Classification of epilepsy: The seizures that the patient experiences are of various forms, they are classified as below: Partial epilepsy: patient looses consciousness, there may be twitching or jerking of one single part like twitching of finger or fingers, or twitching of facial muscles. It happens because of the pausing of the electrical activity in the brain, which could be in one part, or can move to another part or may stay in one area until the seizure is over. Generalized seizure: Electrical disturbances occurring all over brain at same time are generalized seizures. They are further classified as follows: a) Petit mal: the conversation is associated with brief pauses e.g.: suddenly stops talking in middle of the sentence, and then carries on where he left off. Usually seen in childhood. b) Grand mal: has sudden onset, with loss of consciousness, limbs stiffened, and then they jerk and can feel drowsy post seizure. c) Myoclonic jerk: sudden fall on the ground or giving up of the limb. d) Atonic: becoming flaccid e) Akinetic: usually associated with less motility of limbs like in infantile spasms Diagnosis of epilepsy: • Obtaining authentic history from the patient and the witness • Establishment of the cause • Past medical history or family history • Blood glucose both fasting and post-food • CBC • Calcium and phosphorus levels • Imaging: CT scan, and MRI (also MRI angiography) is indicated to evaluate the structural changes in brain • Electroencephalogram (EEG) is suggested for non conclusive status.
a. Conventional treatment: Carbamazepine: Usually used as a first line of treatment in partial seizures. Toxic effects: rash, nausea, diplopia, dizziness, fluid retention, Hyponatraemia, blood dyscrasias Sodium valproate: Usually used as a first line of treatment in generalized seizure. Toxic effects: sedation, tremors, increased weight, hair thinning, ankle swelling, hyperammonaemia, liver failure. Phenytoin: No longer used as a first choice of drug in partial a swell as generalized epilepsy Due to its toxicity: nystagmus, diplopia, tremors, dysarthria, ataxia. Toxic effects: decrease intellect, depression, impaired drive, polyneuropathy, acne, Gum hypertrophy, blood dyscrasias. c. Surgical treatment : There is surgical intervention also where the affected part of the brain causing seizure is removed. This is called as seizure surgery. Usually the surgery is done to get rid of sezures which do not respond to medicinal line of treatment. d. Homeopathic treatment: Homeopathy is much effective than conventional treatment, in most cases. As per the cause, types of seizures and constitutional make up the case is evaluated and treated.
