The epilepsies are a spectrum of disorders caused by excessive firing of the neurons from one or more part of the brain. In epilepsy, the patient may experience strange sensations, emotions, and behaviour or sometimes convulsions, muscle spasms, and loss of consciousness. The well recognized type of seizure in the community is generalized tonic clinic seizure in which patient falls unconscious, has twisting of arms and legs, jerky movements of limbs, stiffness of whole body, uprolling of eyes, frothing from mouth, tongue bite, head turning to one side and sometimes involuntary urination. One attack usually lasts a few minutes and patient slowly returns to normal over next few hours. An attack of seizure is traumatic, both physically and mentally, to the patient. The anxiety of having repeat attack and in situations beyond one’s control is tremendous. The label of epilepsy has a big social and occupational impact. It may be dangerous to drive, swim, work near fire or work at height when seizures are uncontrolled.
Some patients have seizures which are more subtle and may involve just one part of body, called focal seizures. Sometimes patient may just lose touch with surrounding for a few seconds to minutes without actually falling. These minor attacks also need medical attention however. The evaluation of patient generally includes either CT or MRI scan of the brain to look for any structural abnormality like a tumor, infection etc. Another common test is EEG which records electrical activity of the brain by putting a few wires over the head. One must remember that tests may be absolutely normal and still patient may be having epilepsy.
A tremendous amount of research has been done in last few decades and many new drugs with minimal side effects have been launched. Medications for epilepsy have to be taken for long time, generally 2-3 years. Medicines are started in a low dose and gradually increased for an optimum seizure control and tolerability. Any side effects observed by the patient should be reported to the treating doctor. Sticking to the schedule of medicines as advised is important. It’s a good idea to maintain seizure diary where timing of attacks should be recorded along with any triggers if noticed.
So having a diagnosis of epilepsy is not the end of road and there are many treatment options available for control of seizures. There certainly is proper medical aid.
Dr. Piyush Ostwal
Neurology Specialist
Email: piyush.ostwal@bsh.com.bh