Epilepsy

The brain operates through locally generated electric currents.During normal function,the currents occur in a controlled and organized manner.  Seizures occur due to a sudden but transient excessive electrical currents in the brain.

The seizure manifests as an abnormal experience or behavior that varies depending on where the abnormal current starts off in the brain. Accordingly there are different types of seizures. Grand mal seizure

The classical "grand mal" seizure occurs when the  current invades the entire brain.In this type of seizure the person falls to the ground and becomes stiff and then shakes all over. There may be frothing at the mouth,the person may pass urine and also bite his tongue.After the attack the person may be confused for several minutes.

When the abnormal current involves only a portion of the brain,the symptoms may vary with the location of the current.

• Simple partial seizure :
  The person may be fully aware and may have an unusual feeling or jerking of his limbs, and recollect this event later.
• Complex partial seizure:
  He or she may be partially aware and exhibit some irrelevant automatic behavior, called a complex partial seizure.

Epilepsy may occur due to a variety of reasons that have damaged the superficial areas of the brain called the cerebral cortex.A brain tumor,   brain stroke,  head injury due to an accident or damage to the baby's brain during birth can  all cause seizures.
Alternately, epilepsy may also occur because of abnormalities in the function of the neurons without any brain damage.

Epilepsy can start at any age, but it commonly starts at extremes of age, that is, in small children and in the elderly.
A large percentage of children with epilepsy outgrow the problem with age.

There have been major breakthroughs in epilepsy treatment in the last few years.
Over 70% of the people with epilepsy have a good control of their seizures with medications. Several new medications available over the last decade have very few side effects. At present there are over 15 different types of medications available for the treatment of fits.
But Epilepsy can be of different types, due to different causes,and can greatly vary in severity as well.  This variability makes it difficult to generalize its treatment and its outcome in different persons. The correct choice of medication has to be made, with the careful consideration of the specialist doctor who treats epilepsy.A neurologist or an epilepsy expert.
With the right medication and right advice, most people with epilepsy can lead normal lives.

Medications suppress seizures and keep the patient seizure free,but they do not remove the tendency to seizures. A significant proportion of patients outgrow the tendency to more seizures with age, and can come off antiepileptic medications.

Each patient's problem is unique and it is not easy to generalize.Usually medications are prescribed for a period of 2-5 years, before a consideration to stop medicines is made. Some patients may need medications for longer, that may mean several years.

About 20-30% of people with epilepsy continue to have seizures despite medications. When two or three correctly selected medicines have failed to control the fits, the chances that a fourth medicine will cure the epilepsy is extremely low.
Some of these patients may be  helped with  brain surgery. Patients have to be carefully selected for epilepsy surgery with some detailed testing.In correctly chosen patients, surgery is safe and  can cure epilepsy. The person can become free of seizures  and may even be able to gradually stop all medications, thus be "cured" of the epilepsy
The one time cost of epilepsy surgery may offset the life long cost and inconvenience of medications.

If you see someone having a seizure

• Don't panic
• Lay the person on the ground and turn him over to his side.Remove anything that may injure the person, so that he/she does not choke on his saliva.
• Do not force any object into the mouth during the seizure
• Smelling onions, chappals or holding keys does not stop an epileptic seizure
• Most seizures stop in 2-3 minutes, after which the person may be confused or sleepy
• Call for help if the seizure continues beyond 3 minutes
• Do not feed the person food or water until he is awake

Little children under the age of 5 years can have a seizure with high fever.This happens to one in 20 children and it is not epilepsy.This is not dangerous,unless the seizure lasts for more than 15 minutes. Please consult the pediatrician or neurologist if your child has had a febrile seizure

Febrile convulsions only happen with children when they have fever.Sometimes febrile convulsion can recur in another episode of fever.Most children with febrile convulsions outgrow the problem by their sixth birthday and do not develop epilepsy.

Seek out the correct medical help from the expert doctor.
Regularity with medications  is of utmost priority, even when there are no fits.
Sleep and meal times have to be regular. Lack of sleep is known to precipitate seizures.
Avoid driving motorized vehicles, swimming, cooking on open fires or working with heavy machinery if the epilepsy is active.
A person with epilepsy can study, work, play marry and have normal children. Epilepsy need not be a barrier to achieving the highest goal.

Most seizures last between 1-3 minutes. Such short duration seizures do not cause brain damage. However repeated frequent seizures or those that last for several minutes to hours can damage the brain.

Epilepsy is a medical problem, just like diabetes or asthma.
A lot of ignorance and misconceptions about the disease makes life for people with epilepsy difficult. Epilepsy is not a sin or a curse  or possession by evil spirits. It is not a mental illness, and a person with epilepsy is not mentally subnormal.

Unfortunately a lot of misconceptions has about this condition has been carried through the ages.It makes people resort to irrational practices during a seizure,like smelling onions/leather or holding a key during a seizure. It also leads people to seek help from quacks and witch craft.
A little more understanding of the disease can improve our attitudes and make life a lot easier.