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Epilepsy |
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In epilepsy there are repeated attacks of 'fits' or seizures, with jerky movements of limbs and other parts of the body. The attack is a result of sudden abnormal activity in brain cells. One type of epilepsy usually begins at a younger age and no cause for it has been found. (Note: Seizures can occur due to reasons other than epilepsy.) In some other types the cause can be identified, e.g. trauma, metabolic problems, infections, high blood pressure, reduced blood supply to the brain, and degeneration or tumors in the brain. In some epileptics the attacks may be triggered by factors like stress, exhaustion, menstrual periods, hunger, use of alcohol and fever. Sometimes even sensory stimuli - like certain smells, sounds or sights - may provoke fits. In some types of epilepsy the seizures affect a small part of the brain, with less widespread symptoms and usually no loss of consciousness. In others a minor attack spreads to become a generalized seizure. The more generalized seizures are grand mal and petit mal. Epileptic attacks more often occur at any time, without apparent links to any specific situation. That is one of the dangers of the disease. Some patients may get warning symptoms hours before an attack -like headache, mood changes or small jerky movements. Just before an attack there may be a premonitory aura, a strange 'psychical' feeling, at times as if a breeze is passing through the body. Symptoms may include brief loss of consciousness and stoppage of breathing, rapid jerky movements, biting of the tongue, tingling, numbness, abnormal visual or other sensations (like flashing lights or a buzzing sound), frothing from the mouth and uncontrolled urination or passing of stools. Unconsciousness may be followed by longer, peaceful sleep. At times one epileptic attack may follow another and even (in status epilepticus) without the patient gaining consciousness in between. That is an emergency. Petit mal symptoms, mild compared to those of grand mal, are called 'absence' attacks. It usually occurs in children and often stops by the time they reach youth. The attacks last a few seconds and are characterized by 'staring' and transient loss of awareness. Neither the patient nor the onlooker may realize anything was wrong. In another type of epilepsy symptoms similar to petit mal occur more gradually and last longer, and may be accompanied by unusual actions like a chewing movement of the jaws. Investigations to confirm the diagnosis include lab tests, EEG, and imaging methods like MRI. What you can do Consult. Medications to prevent attacks depend on the type of epilepsy. Treatment continues at least till the person is free of attacks for 3 years; and the medications should only be tapered off gradually and one drug at a time. The patient's activities are carefully organized. Work involving machinery or driving vehicles and situations where life may be endangered by a sudden attack are to be avoided. In some patients factors provoking attacks can be identified and avoided. In an attack take care to see that the patient does not cut his tongue, that he is in a safe position and his breathing is not obstructed. Some cases benefit from surgery; but it involves highly specialized techniques.
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