Epilepsy

Epilepsy is a neurological disorder, which is characterized with reoccurring seizures that vary in its intensity. Epilepsy is not a seldom disorder of the brain. It afflicts as frequent as diabetes or rheumatoid arthritis. In the UK alone, one in every 131 people has epilepsy. This means that there are at least 456,000 people with epilepsy in the UK. The majority of these patients are diagnosed with Epilepsy during childhood or adolescence, which doesn't mean that epilepsy can't occur at any other age.

Not to be confused are epilepsy as a disorder and seizures. Having a seizure does not necessarily mean having epilepsy. Every human brain has the ability to produce a seizure. And this happens to nearly 5% at least once in their lifetime, because seizures can also be caused by specific circumstances such as high fever, fatigue or under alcohol. Fortunately these seizures usually disappear after the remission of the acute situation.

But, should seizures occur at least twice without being caused by a specific circumstance, there is a high chance the patient is suffering from epilepsy.

A seizure strikes in various ways. This concerns non-epileptic seizures and epilepsy seizures:

Focal Seizure

A focal or partial seizure derives from a partly affected brain and not the entire brain. The build-up of the seizure depends on the affected area. Symptoms can be: local myoclonus, automatic body movements, hallucinations, experiencing unusual feelings or sensations and a diverted sense of smelling or tasting. A focal can last from anything between seconds and a quarter of an hour.

A focal seizure is categorized in a simple partial seizure and complex partial seizure.

• Simple partial seizure: the person experiencing the seizure is conscious and remembers the attack afterwards.
• Complex partial seizure: the person experiencing the seizure in unconscious or semi-conscious with little remembrance of the attack.

A particular form of focal seizure is a so called aura. Those who sense an aura describe it as having a premonition of a soon arriving seizure. Certain sensations such as tingling, hallucinations and being highly emotional make up the premonition. However, an aura can be a seizure as well without necessarily being a forewarning of a seizure as described above.

Generalized Seizure

A generalized seizure describes a, from the beginning onwards partly or entire affection of the brain. In nearly all cases of generalized seizure, the patients suffer from a disordered consciousness or even a loss of consciousness.

Generalized seizure is also categorized in various seizure types:

• Tonic seizure

During a tonic seizure the muscles tense up extremely until they are stiff. This rigid state can last up to 30 seconds. Luckily, a tonic seizure usually occurs while the patient is asleep, otherwise the patient is due to fall and seriously hurt himself.

• Myclonic Epilepsy

Myclonic epilepsy is a severe or not so severe muscle twitching, caused by a sudden muscle contraction, mainly in the arms and head area.

• Tonic-clonic seizures

Tonic-clonic seizure is the most frequent type of generalized seizure and is therefore also known under the name of grand mal seizure. The patient, standing erect, may suddenly loose his consciousness, letting out a so called initial scream while falling. This tonic phase lasts 10 to 30 seconds and is then followed by the approximately 1 minute enduring clonic phase. The patient thereby usually bites his tongue and produces foamy spittle. After the seizure he will carry on sleeping deeply for a couple of hours.

• Atonic seizure

The muscles supporting the body suddenly lose their strength. The body inevitably sags under its weight and causes the patient to fall. The seizure does not last long and the patient is able to stand up by himself.

• Absence

Absence, or petit mal, is the sudden loss of consciousness for approximately 30 seconds. The patient stares into space and his face seems expressionless. The black-out can happen at any time and leaves behind a memory gap.

What happens in the brain during a seizure?

A healthy brain is able to coordinate the individual brain cells by sending out the proper mix of chemical and electronical signals, ensuring that the body follows the brains commands.

The brain of an epileptic is not able to coordinate the brain cells and the signals are unbalanced. Too many brain cells are active at the same time and cause irritations in the specific areas of the brain (focal seizure) or the entire brain (generalized seizure). Each specific area controls the movement of different body parts or emotions. The irritation makes the body react with unforeseen actions such as muscle twitching or hallucinations, depending on which part of the brain is irritated.

Two factors, individually or in combination, seem to be determining for the emergence of epilepsy.

• Heredity

Idiopathic epilepsy is the name of epilepsy based on genetic abnormalities. However, not the seizure itself is inherited, but the tendency of the brain to develop seizures.

• Injury of the brain

Causes for a brain injury can be a lack of oxygen at birth, infections of the brain, scars, tumors etc. Epilepsy usually derives from a brain injury and is then called symptomatic epilepsy.

However, these two factors still leave a cleft of 50% epilepsy patients, especially children and teenagers, whose causes are unknown. This form of epilepsy is referred to as cryptogenic epilepsy.

How does epilepsy develop?

The term epilepsy is a general term, standing for more than 30 different disease patterns. Therefore epilepsy is categorized into following types:

• Cause (Idiopathic, symptomatic, cryptogenic)
• Type of seizure (e.g. Tonic-clonic seizures, focal seizure)
• Age at diagnosis
• Result of electroencephalogram(EEG) (brain activity)
• Prognosis

In most cases all types of epilepsy can be successfully treated. An exception is the Status epilepticus. This state is reached, when the seizure does not seize or reoccurs in such short time frames that the patient is not able to regain full consciousness. In 10% of the cases the patient dies.

How to treat epilepsy?

Every epileptic has to follow an individually made up therapy. Then, the chances of living a normal life are high. Various therapy methods offer relief. The most important is medication. It not so severe cases the avoidance of seizure triggering subjects or situations can be sufficient to control and reduce the attacks. Is a therapy successful to the means that seizures do not occur anymore, that means the patient can be declared as cured.