Epilepsy

What is Epilepsy ?

Epilepsy is a condition of the brain characterized by a susceptibility to recurrent seizures. It's also known as seizure disorder. Seizures are paroxysmal events associated with abnormal electrical discharges of neurons in the brain. In most patients, this condition doesn't affect intelligence. Epilepsy usually occurs in patients under age 20. About 80% of patients have good seizure control with strict adherence to prescribed treatment.

Causes of Epilepsy

About half the cases of epilepsy are idiopathic. No specific cause can be found, and the patient has no other neurologic abnormality. Nonidiopathic epilepsy may be caused by:

• genetic abnormalities, such as tuberous sclerosis and phenylketonuria (PKU)
• perinatal injuries
• metabolic abnormalities, such as hypocalcemia, hypoglycemia, and pyridoxine deficiency
• brain tumors or other space-occupying lesions
• infections, such as meningitis, encephalitis, or brain abscess
• traumatic injury, especially if the dura mater was penetrated
• ingestion of toxins, such as mercury, lead, or carbon monoxide
• cerebrovascular accident.

Researchers also have detected hereditary EEG abnormalities in some families, and certain seizure disorders appear to have a familial incidence.

Signs & Symptoms of Epilepsy

Symptoms may be motor, sensory, psychic (states of consciousness), and/or autonomic (involuntary activity controlled by the autonomic nervous system). There is no impairment of consciousness in simple partial seizures. However, each individual may experience symptoms differently. Symptoms may include:

• headache
• changes in mood or energy level
• dizziness
• fainting
• confusion
• memory loss

Some people may also experience an aura - sensations that indicate a seizure is imminent just prior to onset. The symptoms of epilepsy may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnostic Tests

EEG can be used to identify paroxysmal abnormalities which may confirm the diagnosis of epilepsy by providing evidence of the continuing tendency to have seizures. A negative EEG doesn't rule out epilepsy because the paroxysmal abnormalities occur intermittently. The EEG also helps guide the prognosis and can help to classify the disorder.

Magnetic resonance imaging (MRI). An MRI scan uses a powerful magnetic field and radio waves to produce images of your brain. Like CT scans, MRI images may reveal abnormalities in brain structure.

Computed tomography scanning and magnetic resonance imaging provide density readings of the brain and may indicate abnormalities in internal structures.

Blood tests. Your doctor may want to take samples of your blood to be tested for chemical imbalances that may be the cause of your seizures.

Treatment

Typically, treatment for epilepsy consists of drug therapy specific to the type of seizure. The most commonly prescribed drugs include phenytoin, carbamazepine, phenobarbital, and primidone administered individually for generalized tonic-clonic seizures and complex partial seizures. Valproic acid, clonazepam, and ethosuximide are commonly prescribed for absence (petit mal) seizures. Lamotrigine is also prescribed as adjunct therapy for partial seizures. Fosphenytoin is a new I.V. preparation that is effective in treatment.

If drug therapy fails, treatment may include surgical removal of a demonstrated focal lesion to attempt to bring an end to seizures. Surgery is also performed when epilepsy results from an underlying problem. such as intracranial tumors, a brain abscess or cyst, and vascular abnormalities.

Prevention Tips

Generally, there is no known way to prevent epilepsy. However, adequate diet and sleep, and abstinence from drugs and alcohol, may decrease the likelihood of precipitating a seizure in people with epilepsy.