Watching a person have epileptic seizures can be more frightening than the condition itself. Seizures, called ‘Fits’, occur when the nerve cells or neurons of the brain generate abnormal electrical activity which gets propagated along the brain, and results in the person having unexplained behavioural changes.
Types of Epilepsy: Epileptic seizures are of two types. A typical symptom of an epileptic seizure is when the person falls to the ground, contracts the body, frothing at the mouth. However, this type actually accounts for about 30- 40 percent of seizures. The second and more common types of seizures are sudden explained behavioural changes where the person seems to lapse into a trance lasting seconds to minutes.
Many of these attacks may be unnoticed leading to a delay in diagnosis and appropriate treatment. Rohit (name changed) could never go to school like other children his age.
Wracked by seizures from when he was only six months old, he was pulled out from school by his parents when his seizures made it impossible for him to play and study like other children.
A surgery to ‘disconnect’ the seizure-causing part from the rest of his brain was all that it took to restore Rohit’s childhood.
Today the boy is a topper at school and his seizures have vanished. Decoding the brain: “The boy had a developmental malformation of the brain which was causing seizures”, Dr S Raghavendra, Consultant Neurologist and Epileptologist at Vikram Hospital’s Epilepsy Care Centre.
A Video EEG on Rohit revealed to the neurologist’s trained eye that the young boy was having seizures originating from the right side of the brain and due to a developmental malformation in the brain.
“The boy was having 50- 100 attacks a day, sometimes unnoticed by his parents or teachers because the symptoms are not visible”, informs the neurologist.
“Through the Video EEG, I could record the slightest abnormality in the brain and convince his parents that he was suffering from Epilepsy”, he adds.
An MRI too showed the same symptom. The PET scan during a period when there are no seizures showed reduced blood flow in the region of the abnormality.
Disconnecting the abnormality: Although epilepsy surgery is complex, the treating team of neurologists and neurosurgeons follow a straightforward set of principles. The strategy is to identify the area of abnormally discharging neurons or the “seizure focus”, and to remove it when possible.
In certain patients without a well detain patients without a well defined epilepsy focus, surgery can sometimes help, by disconnecting or isolating the abnormal area so that seizures no longer spread to the neighbouring normal brain.