A disorder of the central nervous system, epilepsy causes repeated episodes of unprovoked seizures or fits. It affects people of all ages and backgrounds and is triggered by the disturbance of your brain’s normal cell activity.
Fits are a fairly common occurrence. It is estimated that one in every thousand people will experience an attack of seizure at least once in his life time. Primarily every one of the millions of neurons in the brain continuously discharges electrical signals.
These signals travel through nerve fibers and reach various parts of the body resulting in electrochemical reactions that enable the brain to control every activity including thoughts and behavioral processes. Given the nature of this activity, electrical upsurges do happen occasionally leading to a “short circuit” that may shut down a normal process temporarily. This usually manifests itself as a sudden cry accompanied by loss of consciousness and jerky movements of the limbs which ease up gradually recovery.
There are several kinds of fits each with its typical manifestations. Epilepsies whose cause cannot be pinpointed are described as “idiopathic epilepsy”. At other times, Epileptic seizures could be an indicator of serious underlying diseases like brain tumors and stroke. Therefore every single incident of epilepsy needs to be evaluated by a neurologist to identify its type and pattern.
Unfortunately, there are several myths and social taboos associated with epilepsy that continue to hold sway despite the increasing awareness and knowledge about the disease. Over years a variety of anti-epileptic drugs which can control these attacks effectively have been developed. They act like spike arrestors and suppress abnormal electrical discharges in the brain. With time the abnormality completely disappears.
Till that happens it is mandatory for patients to continue the drugs without fail. Patient compliance is extremely critical and missing doses can not only prolong the duration of the illness but can also make epilepsy resistant to medical treatment. It’s a myth that drugs are like sleeping pills and can harm brain function.
The benefits of controlling seizures far outweigh the side effects that these drugs may produce. Therefore, these drugs have to titrated by an epileptologist to suit individual requirements and to protect brain functions. Uncontrolled epilepsy can lead to progressive brain damage. In addition, they can make them susceptible to accidental falls leading to injuries.
In spite of adequate medical treatment, one in three epileptics do not respond and continued to have attacks (refractory epilepsy). They require careful evaluation by a team to identify the right course of management, which might include surgery. Epilepsy surgery aims primarily to remove the abnormal electrogenic area of the brain (focus). If there is an underlying disease like a tumor, surgery might become unavoidable.
If the focus is not identified, surgery can be directed to prevent the spread of abnormal electrical activity within the brain, which can minimize the severity of the attacks. Stereotaxy, deep brain stimulation, and vagal nerve stimulation are some of the palliative procedures. Accurate diagnosis can be made with Electroencephalogram, Video EEG, depth electrode study, electrocorticography, brain mapping, and MRI.
Comprehensive Epilepsy Care Clinics are very few in our country despite the magnitude of the problem. The Global Institute of Neurosciences at the BGS Global Hospitals in Bangalore offers one such state-of-the-art comprehensive clinic for epileptics with a dedicated team that offers diagnostics, medical management, surgical treatment, and supportive therapies.