Health Care

Epilepsy : Causes, Risk factor, Diagnosis and Treatment

Epilepsy

Epilepsy is a neurological disorder in which there is abnormally excessive neuronal discharge (series of active membrane potential) that result in seizures (due to abnormal, involuntary muscular contraction). Epileptic patients present with sudden phase of seizures followed by aura during normal daily tasks. The abnormal electrical functioning of brain is temporary. This abnormality lead to sudden temporary change in behaviour in a patient. The imbalance in brain activity may causes many complications in patient and may lead to death if duration of seizures is prolonged and dyspnea persist due to jaw lock.

Pathophysiology

It as simple as the disturbance in balance between excitatory (glutamate) and inhibitory (GABA) neuronal activity (neurotransmission). When the neurotransmitters are released, in synaptic cleft by presynaptic membrane, neurotransmitters are taken up by neurotransmitters receptors present on the surface of post synaptic membrane. The response produce in post synaptic membrane is according to the type of neurotransmitter released. The results will be excitation (active membrane potential) in post synaptic membrane if neurotransmitters are glutamate, epinephrine and norepinephrine while if GABA, serotonin, glycine are released the results will be inhibitory (resting membrane potential) in nature. In epilepsy the inhibitory Impulses are blocked where as excitatory impulses are conducted forward excessively that result in seizures.

Epilepsy

Types of seizures

Seizures are of many types classified in two major classes i.e.,

  • Partial seizures (effecting the brain partially)

Partial seizures are further of many types out of which the most common are focal seizures, complex focal seizures and secondary generalised seizure. Focal seizure effects the small part of brain. Secondary focal seizures are type of partial seizures in which initially only small portion of brain is involved but the condition progress and involve multiple area of brain.

  • Generalised seizure (both cortexes are involved)

The types of seizures in which entire brain is involved. Such seizure attacks are lethal. The further types of generalised seizures include, absence seizure, tonic seizure, clonic seizure, tonic-clonic seizures, myoclonic, febrile seizures.

risk factors

the risk factors for epilepsy includes,
age, family history because of genetic basis of epilepsy, head injury result in abnormality in brain function and one of the abnormalities in the function can be epilepsy, dementia, brain infection, stress, sleep disturbances, insufficient food intake malnutrition also result in brain damage that in turn result in episodes of seizure, difficulty breathing and altered consciousness. All of these risk factors have potential to cause seizures in person hence the person should avoid all the above-mentioned risk factors in order to live healthy life.

Sign and symptoms

Sign and symptoms of epilepsy include,
altered consciousness, confusion, muscles stiffness, fear, anxiety, depression, sparing spell, strange feelings, jerking movements and ultimately collapsing. All these signs are corresponding to the brain damage. That result in decline in function but increase in electrical activity. These signs and symptoms are followed by the first stage of epilepsy that is aura. Aura is felt before the seizures start. So the patient is aware that he is about to suffer with epileptic seizures.

Epilepsy

Causes

The major causes of epilepsy include, stress, brain damage BY stroke or severe head injury, drug abuse, alcoholism, brain infection, delay cry or ischemic injury to brain during birth. When an area in the brain is damage, the function it performs is also impaired. When the function is not performed, the impulses continue to discharge to stimulate the damage area that result in hyperactivity of brain and ultimately resulting in tremors.

Complications

One of the major complications of epilepsy include the jaw lock. In with the TMJ is forcefully closed and sometimes it makes the breathing difficult for patient, but the temporomandibular joint should not be forcefully opened manually by attendant as it may result in TMJ fracture or dislocation. Its better for wait for the seizure to be over. It will lose on its own after seizure. During this seizure episodic attacks, any food or drink orally should be strictly forbidden as anything can result in patient choking and may prove to be lethal as it can cause sudden death.

Diagnosis

EEG (electro encephalography) is widely used to diagnose or investigate epilepsy. This test is used to study the electrical activity of brain. During EEG test, number of electrodes are placed on the scalp that detect the electrical activity of brain. If it detect excessive brain electrical discharge, the person is diagnosed with epilepsy.

Treatment

antiepileptic drugs such as barbiturates, benzodiazepine carbamazepine, phenytoin, etc. these are the anti-psychotic group of drugs that increase the inhibitory activity of brain to balance the excitatory activity of brain with inhibitory activity to maintain the dynamic balance. Due to their effect of inhibiting excitatory impulses and passing on inhibitory (GABA mediated) impulses, help minimize epilepsy. But the drawback of such medicine is decline in normal brain activity due to excessive release of inhibitory action on effectors even when excitatory impulses are required.

Research

Researchers claim that the most common form of epilepsy is childhood epilepsy moreover they have successfully found because it is mutation in gene ask SCN1A gene. This Mutation is most common in genetic epilepsy. Other research studies are trying to find the proper cure for the seizures with minimum side effects.

Epidemiological Study

Epidemiologists through their study prove that about 50 million people are suffering with epilepsy globally. That make epilepsy one of the most common neurological disorders around the globe in present.

Conclusion

Like any disease epilepsy is also a condition that primarily effect the brain and later on effect the total functioning of body. The severe epileptic patient during episode of seizure fell to ground unconscious and sleep afterwards and wake up normal like nothing happens. It’s a scary condition to see someone in his seizure attack.

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