BENGALURU: Epilepsy is the fourth most common neurological problem next to migraine, stroke, and Alzheimer’s disease. Epilepsy is a neurological disease that affects the nervous system. It is a non-contagious, non-infectious neurological disorder that occurs due to abrupt and uncontrollable electrical disturbance in the brain. It can affect people of all ages, everyone irrespective of gender.
Epilepsy is treatable if diagnosed early. However, if ignored it may cause multiple repetitive episodes that may damage the brain cells. With proper treatment, the condition can be managed effectively. The stigma associated with epilepsy and the lack of awareness among the general public has mostly delayed the diagnosis and treatment to manage the condition.
Identifying epilepsy
Epileptic seizures vary from brief uncons-ciousness or jerking of muscles to severe and prolonged convulsions (sudden rapid muscle contractions). It may occur multiple times a day or once a year. It results in short blackouts, loss of consciousness, fear, involuntary arrhythmic movements of the
limbs, etc.
Epilepsy is evident when two or more unprovoked seizures occur 24 hours apart. Diagnosis is made by clinical history and supportive investigations. Episodes of loss of consciousness with posturing of limbs, jerks with frothing, tongue bite or incontinence of bowel or bladder constitutes grand mal or generalised seizure. In rare cases, one can experience recurrent falls, marching sensory symptoms in limbs and visual problems.
The symptoms differ from the types of epileptic seizure but in most of the cases, it tends to exhibit similar symptoms.
Treatment
The main investigations needed for diagnosis of epilepsy include EEG (electroen-cephalogram), and MRI scan of brain. Various medications are available, which can be safely taken to control epilepsy. If an epileptic is seizure-free for 3-5 years, medications can be slowly tapered and stopped in some of the cases.
It is advisable to seek immediate medical attention if the epileptic seizures last for more than five minutes, second seizure occurs immediately after the first, if a person has underlying medical conditions such as diabetes, fever, pregnancy, etc.
Epilepsy surgery must be considered when drugs are unable to control epilepsy which happens in about 20-30 per cent of the patients. In such cases, who continue having seizures despite being on more than two medications, epilepsy surgery becomes a rational option. The additional tests needed before surgery include Video EEG, Single-Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) scan, functional MRI, WADA etc. In most cases, there is a visible abnormality on the brain MRI, which if proven to be responsible for epilepsy and removed successfully, helps in curing epilepsy and the quality of life.
(The writer is consultant - neurologist and epileptologist, Aster Hospitals Bangalore)