Epilepsy is a neurological disorder in which brain activity becomes abnormal causing seizures, inactivity, unusual sensations or movements, and loss of consciousness.
Epilepsy is a chronic disorder characterized by recurrent seizures.
A seizure is an occasional, an excessive and a disorderly electrical discharge of cerebral neurons.
Types of seizures
There are 2 main types of seizures:
- Partial seizure
- Generalized seizures
In simple seizures consciousness is not affected and small part of brain is affected.
For instance if part of brain controlling hand movements is involved , then only the hand may show rhythmic or jerky movements.
In complex seizures consciousness and awareness is affected.
The person may become confused and lost after few minutes of seizure.
In generalized type of seizures the person may become stiffen for few seconds to minutes with jerky movements of arms and legs.
Eyes are generally open; the person may have difficulty breathing and turn blue.
The person stay confused for some time after regaining consciousness
- Absence seizure (Petit mal)
It is brief loss of awareness (5-20 sec), usually occurs many times a day accompanied by eyelid fluttering, lip-smacking, chewing movements.
2- Myoclonic seizures
These are sudden jerky or shock like contractions of different muscle and lasts for a fraction of a second, or for one second at most.
3- Atonic seizures
It cause loss of muscle control, which may cause you to suddenly collapse or fall down and often result in head injury.
It typically lasts for a few seconds.
4- Tonic seizures
Tonic seizures cause sudden stiffness of muscles in your back, arms and legs and may cause you to fall to the ground.
It usually ends after 5-10 seconds.
5- Clonic seizures
It involves repeated or rhythmic, jerking muscle movements affecting the neck, face and arms.
It usually lasts for between 30 second 1-2 minutes.
6- Tonic clonic (grandmal)
It is the most complicated type of epileptic seizure and cause abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue.
It typically lasts for 1-3 minutes. It occurs in a condition called Eclampsia.
What Causes Epilepsy?
1. Birth injury (mishandling during birth): Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies.
This brain damage can result in epilepsy or cerebral palsy.
2. Brain damage: Head trauma as a result of a car accident or other traumatic injury can cause epilepsy.
3. Infections: Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy.
4. Cerebrovascular diseases: Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy.
5. Tumors: Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy.
Stroke is a leading cause of epilepsy in adults older than age 35.
6. Neurodegenerative disorders: Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis.
Dementia can increase the risk of epilepsy in older adults.
Memory and temporal lobe lesions :
Performance on psychological tests
- Decreased ability to learn and recall
- Poor immediate recall and learning capacity
- Language difficulties and organizational problems
- Lower verbal I.Q
- Cognitive decline
- Epileptic dementia
- Impaired on tests of languages
- High frequency of partial seizures cause poor performance on WAIS
Psychological response to epilepsy
5. Locus of control
Ways to Manage Your Epilepsy
Anti-seizure or anticonvulsant medications like Neurontin and Clonotril change the way your brain cells work and send messages to each other.
Drugs that work for one person might not work for another. You might have to try more than one.
Trileptal is another drug, used to treat seizures and brain disorders.
- Counseling about regular medication
- Pill reminders
- Keep a record of your seizure (seizure diary)
- Most types of epilepsy are fairly easy to control with treatment
Side Effects of Drugs
- Change in appetite (usually but not always)
- Behavioral problems in children
- Weight gain or weight loss
- Mood changes
Psycho-educate the client or attendants, guide them that other problems could arise
(fore warn) if untreated.
- Enhance self-esteem by the use of Coping statements e.g I am not the only one with the problem
- Deal with anxiety by exposing the client to anxiety provoking situation
Practice deep breathing and progressive muscle relaxation exercise to relax the muscles and reduce stress.
Ketogenic diet – high in fats and low in carbohydrates
The super high-fat, super low-carb ketogenic diet is strict and complicated.
The ketogenic diet has been curbing seizures since it was first developed in the 1920s.
As many as 1 in 7 stop having seizures completely.
Most kids who stay on the ketogenic diet for at least 2 years have a good chance of becoming seizure free.
In the ketogenic diet, about 80% to 90% of calories come from fat.
First Aid for Epilepsy
1. Be understanding and talk gently
2. If there is no danger, let the seizure take its natural course
3. Protect the person from injury by moving furniture or other hard objects out of his way if possible
4. Protect head from injury e.g by putting a cushion, pillow or folded-up sweater or coat underneath it, or by using your hands and arms
5. Don’t leave the patient alone until he is fully recovered
6. Let a person fall asleep after a seizure
Calling an ambulance (Crisis Intervention )
Emergency medical care should be obtained in the following circumstances:
- This is the first seizure you have ever had
- If two seizures, involving loss consciousness occur within 10 minutes of each other, whether or not consciousness is regained between the seizures
- If the convulsive part of the seizure is lasting longer than usual, and certainly if it lasts longer than 10 minutes
- If you have any injuries that occurred during the seizure, e.g. cuts requiring stitches
- If for any other reason someone is worried or concerned either during or after seizure ….. Talk with some near one i.e who can grieve you better
Share Feelings, talk to families and friends
- Encourage the client to talk about his feelings
- Talk about patient’s concern
- To subside the feelings of fear, client need to give himself the opportunity to grieve for his loss and accept it
- Client may join various epilepsy discussion and support groups, if possible
- Educate the client’s family and friends
- “Confidence boosting” of client to tell colleagues, teachers, friends about the problem.
- Evaluate cost-benefit ratio and inform your social circle
Things You Must Know If You Have Epilepsy
1. Safety in the house
2. Remember to take pans rather than carry saucepans containing boiling liquids
3. A microwave oven would be a safer option than a conventional stove
4. Best to avoid free standing heaters
5. Move as much furniture as possible away from the middle of the room, especially in rooms used regularly where the furniture is solid and has sharp edges
6. Try to make sure that you only bath when someone else is in the house, and leave the bathrooms unlocked
7. Choose a shower fitting with an efficient heat- control
8. Make sure that any shower screens are made from safety glass or plastic and have warm rather than hot shower to reduce the risk of skin burn if you fall unconscious in the shower
- You can buy water-proof mattress covers or sheets
- Incontinence pads and other form of protection from a pharmacy/ use cotton at home
- Make your doctor aware of this problem
If you want to have a safe, successful and active career, then your employer needs to know about your problem.
Exactly what should you tell your employer:
- What your seizure look like?
- How long the seizure last?
- How long a rest you need after a seizure?
- What first-aid may be required?
- What action you would like the staff to take if there is an emergency?
Driving with epilepsy means balancing the need for independence against the need for safety.
You should carry your identity card or address written somewhere with you.
In case you have epileptic attack in public your family may be contacted and safety measures taken.
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- Photo-sensitivity, which means that watching television might cause you to have a seizure i.e flashes of light or blinking light, video games, parties with much lightening
- The closer you get to the television, the greater the risk
- Identify triggers: stress, smelly area, flashing light hat is on long roads with trees and shades … people with epilepsy cannot control much fluctuations
What is onset age of epilepsy?
The onset of epilepsy is common in children and older adults, but it can occur at any age.
About 3.4 Million people in the United States have epilepsy.
Is epilepsy curable?
A 2017 study found that less than two thirds of patients with newly diagnosed epilepsy are seizure-free after 1 year.
Can surgery cure epilepsy?
Surgery may be an option when medicines fail to effect.
In epileptic surgery, area of your brain that’s causing seizures is removed (corpus callosum).
Doctors usually perform surgery when tests show that:
– Your seizures originate in a small area of brain
– The area in your brain to be operated on doesn’t interfere with vital functions such as speech, language, motor function, vision or hearing
Sometimes medication (low doses) is required even after surgery.
However, in some cases, surgery can cause complications such as decline in cognitive abilities.
Epilepsy can cause death?
People with epilepsy have a risk of sudden unexpected death (SUDEP).
Some researches show that it may occur due to heart or respiratory conditions.
People with frequent tonic-clonic seizures are at higher risk of SUDEP.
About 1 percent of people with epilepsy die due to SUDEP.
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