Epilepsy: symptoms and what to do (and not to do) in case of crisis

Epilepsy is a disorder of the brain characterized by seizures. It is in practice a neurological condition.It is a neurological disease that involves the nervous system. Epilepsy, on the other hand, is a disease that is expressed through recurrent epileptic seizures, lot of loss of consciousness and violent convulsive movements of the muscles.

Signals and symptons

– Muscle contractions and involuntary movements
– Loss of consciousness
– Torpor
– Attention lapses

Risk factors

– Having suffered head trauma or severe blows to the head
– Family history
– Congenital malformations in the brain
– Cardiac arrhythmias

What is the incidence of epilepsy in the world?

Epilepsy affects several mental and physical functions and is a very common condition, occurring in approximately 65 million people worldwide.In the United States, epilepsy is the fourth most common neurological disease, second only to migraine, stroke and Alzheimer’s disease.In Portugal, it is estimated that epilepsy affects 4 to 7 thousand inhabitants. However, the number of people who, not being epileptic, may have a seizure during their lifetime is about 1 in 20.Epilepsy is more common in very young or very old people, although it can occur at any age.Although treatment allows many patients to live with this disease, for others, seizures are not controllable, affecting quality of life in all its aspects.

 

How does epilepsy manifest?

Epilepsy does not manifest itself in the same way in all patients, and simple or complex crises can occur. In addition, the manifestations depend on the location of the discharge focus in the brain, which can affect gait, the face, specific activities, or cause different types of alteration of the state of consciousness, being often accompanied by unreasonable automatic movements (dressing or undressing) , walk, chew or swallow).

 

  • Seizures can occur during sleep and the patient can either be conscious during the crisis or not remember anything afterwards.
  • The seizures themselves can be of different types, and the muscles can be relaxed, contracted or show spasmodic movements.
  • Some epileptic seizures show signs that precede them (aura) while others install themselves without warning.

 

What causes epilepsy?

As mentioned, in a large number of cases it is not possible to determine a cause for epilepsy.

 

Any injury that reaches the brain can cause an injury or “scar” that is a potential starting point for epileptic seizures.

 

How is epilepsy diagnosed?

This diagnosis is a complex process that involves several steps.

 

  • Clinical history, neurological examination and laboratory tests are, in general, the first steps and allow the exclusion of seizures not related to epilepsy.
  • The electroencephalogram, magnetic resonance or computed tomography allow to explore possible causes for epilepsy.
  • Finding a cause for epilepsy is very important because it will allow for a better selection of the most appropriate treatment.

 

How is epilepsy treated?

The treatment of epilepsy has to be highly personalized, taking into account the risks of the treatment itself and the risks of seizures.

It is, therefore, important to consider the patient’s age, the characteristics of the crises, the associated factors and the social and professional context. Many antiepileptic drugs have important side effects and this risk requires proper consideration.

In some cases, the use of one type of medication is enough, but for other patients, it may be necessary to combine several drugs. As a rule, treatment is started with a reduced dose of the selected drug, making a gradual adjustment depending on the clinical response.

The goal of treatment is not to cure epilepsy but to control the occurrence of seizures. For this treatment to be successful, good collaboration on the part of the patient is essential. In some cases, treatment may be stopped after some time without the seizures recurring again.When drugs are not effective, alternatives such as the ketogenic diet or surgery can be considered:

– Ketogenic Diet

The ketogenic diet uses a high proportion of fat, few proteins and carbohydrates and a total suppression of sugar. This diet creates a metabolic state called “ketosis”, which seems to reduce the attacks of epilepsy.

– Surgery

Surgery aims at removing the brain areas responsible for electrical discharges or interrupting the transmission of the electrical signal.

The stimulation of the vagus nerve is done by means of a small device surgically implanted under the skin, just under the clavicle, and allows to desynchronize the convulsive activity in the brain.

For each case, the neurologist will decide which way to go.

How to prevent epilepsy?

Seizures are often associated with specific triggering factors or changes in daily routines.

Examples of events that can lead to a seizure in susceptible patients:

  • Stress
  • Anxiety
  • Excessive alcohol consumption
  • Tobacco
  • Changes in sleep rhythm
  • Tiredness
  • Changes in ongoing medication
  • Very intense stimuli (bright lights, television, video, computer)
  • Hormonal changes in women

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