Seize the day

In the throes of... On Epilepsy Awareness Day today, Satkam Divya suggests that better awareness can make a difference to the lives of people affected by epilepsy

Epilepsy is a central nervous system (neurological) disorder which brings about abnormality, causing seizures or periods of unusual behaviour, sensations, and sometimes loss of awareness. It can happen to anybody at any age. Epilepsy can affect both mens and women.

Symptoms of epilepsy

Epilepsy symptoms can vary widely. These can include symptoms wherein an individual with epilepsy may simply stare blankly for a few seconds before having a seizure, while others repeatedly twitch their arms or legs. Single seizure does not mean that a person has epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Some of the signs and symptoms of seizure may include:

Uncontrollable jerky movements of the arms and legs.

Loss of consciousness or awareness.

Temporary confusion.

A staring spell.

Psychic symptoms such as fear, anxiety or déjà vu.

However, symptoms may vary depending on the type of seizure. At times, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors basically classify seizures either as focal or generalised based on how the abnormal brain activity begins.

Focal seizures

Seizures appearing in just one area of the brain are called focal or partial seizures. These fall into two categories.

Focal seizures without loss of consciousness: These seizures don’t cause a loss of consciousness but they may alter emotions or change the way things look, smell, feel, taste or sound. It may also result in involuntary jerking of a body part, such as an arm or leg, spontaneous sensory symptoms such as tingling, dizziness and flashing lights.

Seizures with impaired awareness: These seizures involve a change or loss of consciousness or awareness. An individual may stare into space and not respond normally to the environment during a complex partial seizure. They may perform repetitive movements such as hand rubbing, chewing, swallowing or walking in circles.

Some of the symptoms of focal seizures could be confused with other neurological disorders such as migraine, narcolepsy or mental illness.

Only through tests and an examination can a doctor distinguish between epilepsy and other disorders.

Generalised seizures

Generalised seizures are those which appear to involve all areas of the brain and listed below are six types of generalised seizures:

Absence seizures: Previously known as petit mal seizures, they often occur in children and are characterised by staring into space or subtle body movements such as the blinking of the eye or lip smacking. These may occur in clusters and cause a brief loss of awareness.

Tonic seizures: These seizures usually affect muscles in the back, arms and legs and may also lead to falls.

Atonic seizures: These are also known as drop seizures which cause a loss of muscle control, leading to a sudden collapse.

Clonic seizures: These seizures are repeated or rhythmic, jerking muscle movements. These usually affect the neck, face and arms.

Myoclonic seizures: They usually appear as sudden brief jerks or twitches in the arms and legs.

Tonic-clonic seizures: Previously known as grand mal seizures, these are the most dramatic type of
epileptic seizures and can cause an abrupt loss of consciousness, body stiffening and shaking, and at times loss of bladder control or biting of the tongue.

Cures

Of late, epilepsy can be treated with medication. However, drugs do not cure epilepsy but can help in controlling seizures very well. There are other treatment options that are available if the prescribed medications do not work.

Ketogenic diet

A strict meal plan like opting for a Ketogenic diet can help children, especially after working closely with a doctor and a dietician.

The diet usually starts with a fast that lasts for about 24 to 48 hours.

Foods that are high in fat and low in carbohydrates are introduced. If the diet is strictly adhered to, studies showed that two-thirds of kids who follow it are able to stop their seizures.

However, there are side effects you need to watch out for like dehydration, constipation, or the formation of kidney stones or gall stones.

Surgery

Recently new surgical techniques have improved the outcomes. Depending on the type of seizure or if the patient has tried several medications without success, doctors may recommend surgery.

Vagus nerve stimulation or VNS

A Vagus nerve stimulator works like a pacemaker. This is surgically implanted in the chest and it delivers short bursts of energy to the brain. Scientists have discovered that this reduces seizures by about 40% to 50% but does not work for everyone.

Dos

Keep a cool head under pressure and try to keep the person safe till the seizure stops.

Gently try to put the person onto a flat surface so he does not fall and remove the individual’s eyeglasses, tie or scarf.

Place something soft and flat under the head.

Note the time when the seizure begins. They will only last for about two to three minutes.

Don’ts

Don’t restrain the person or you could injure the person or yourself.

Don’t offer even a sip of water as that could cause choking.

Attempting to put an object in the individual’s mouth could be dangerous for you and him.

Don’t attempt artificial respiration unless the person is not breathing when the seizure has stopped.

(The author is CEO, KlinicApp)