- Diseases, Disorders & Conditions
What is Epilepsy?
Epilepsy is a neurological disorder that results in abnormal generation and conduction, and uncontrolled cellular electrical stimulation in one or more areas of the brain.
The most common causes of the disease are associated with genetic, traumatic or tumor factors. This disease has many forms and varying severity of clinical presentation. It is estimated that there are about 50 million people with epilepsy worldwide.
It is considered the onset of epilepsy as two or more episodes of sudden onset and unexpected. The crisis are not an isolated epilepsy; so the crisis arise in the course of an acute process (fever, infection, etc) are labeled as occasional crises, and epilepsy are not.
Many people know epilepsy as a disease in which the patient suffers from crisis, causing falls, uncontrollable convulsions, mouth foaming and loss of urine. In ancient Greece it was believed that these people were possessed by the devil. From here derives the origin of the word Epilepsy is the Greek term for "getting caught or attacked." German was called the "disease of the falls." An inappropriate designation because not all people with epilepsy fall during a crisis. Similarly convulsions and release of saliva in the mouth foam are not always present. Fortunately, these symptoms are not always so serious.
Of course, during a crisis (sometimes called a epileptic seizure), the patient loses control over many bodily functions: some lose control of the muscles, others on thought or on the bladder. The cause is a disturbance in the brain.
What is a crisis?
An epileptic seizure can be described as a "sudden storm" in the brain. There is a temporary failure of the network connections between the millions of brain cells. These brain cells exchange information continuously. Usually this occurs in a wonderfully structured way. In the case of people with epilepsy, large groups of brain cells begin to exchange information with each other at the same time. This chaos results in a seizure. Fortunately, the brain is able to restore order itself - consequently the crisis ends. In some people the crisis may take longer than others.
Do you know someone with Epilepsy?
The focal seizures begin with the activation of a small number of neurons, usually in the cerebral hemispheres, which may remain localized or extended secondary (become generalized) through the brain. It is believed that the generalized seizures are the consequence of the activation of neurons in both cerebral hemispheres. These differences in the origin of the crisis are the basis of classification of epileptic seizures International League Against Epilepsy (initial rating in 1981) scheme.
Basically there are two types of crises:
• Crisis originated in a particular area of the brain; doctors designate it as focal seizures or focal onset seizures;
• Crisis that originate simultaneously in all brain cells are known as generalized seizures. An important feature of these are usually being accompanied by loss of consciousness. However, this does not mean that invariably happen. Brief moments of absence may exist, often unnoticed by bystanders. This type of seizure is also known as "absence".
Epilepsy in children can disappear completely. Often, this is also true for adults, but even when they continue to suffer from epilepsy his disease is usually controlled in an acceptable manner, with medication.
Seizures, although lush are controlled effectively with preventive medication, since the disease is pharmacologically controllable and adequate by the doctor.
If it's a child, parents should communicate the disease at school, to teachers and people who live daily with the child.
Preventive measures are for fulfill with prescribed medication and do not drink alcohol because it may trigger an attack.
Symptoms of an epileptic seizure
Initially, the person may experience sensory changes as auditory, visual, olfactory and gustatory. There is a sudden loss of consciousness, sustained contraction of every muscle, followed by contraction-relaxation of alternating groups of muscles (convulsions), noisy ventilation, abundant salivation and loss of sphincter control.
The person should avoid some activities during a crisis that can be dangerous such as driving, cycling, swimming, bathing, mountain climbing, etc. Epilepsy also affects other important aspects of life as relationships, work and leisure activities.
For many, crisis emerges without warning. The severity of these crisis varies from person to person. Some crisis are rarely obvious, others require hospitalization.
10 Truths About Epilepsy
Once diagnosed, it's complemented with auxiliary diagnosis exams that helps to detect the origin of the crisis. The most important are the X-ray computed tomography, Magnetic resonance imaging and the Electroencephalography. The first two are useful to see the structure of the brain and can detect the presence of tumors, scars, cysts, brain malformations, etc. On the other hand, with the EEG you can obtain the recording of the brain electrical activity, indicative of some possible brain excitability and its location. On some occasions it is necessary to record the crisis through a closed-circuit video-EEG to be able to safely diagnose epilepsy to determine the location of the brain where the seizures are originated.
Patients with epilepsy can be grouped into four prognostic categories:
• Those who have a mild disease that remits shortly;
• Those who have seizures that are controlled quickly with medication, is likely to remitam with time;
• Those who suffer from seizures that only partially control with current antiepileptic drugs, presenting a continuing tendency to relapse;
• Those who suffer from seizures that, mostly, do not respond to treatments, being the remission improbable. This group includes approximately 30% of people with epilepsy.
Epilepsy Treatment: Epilepsy and medication
Nowadays, there are a whole range of drugs (antiepileptic) for epilepsy. These counteract excessive and uncontrolled activity of brain cells. Some drugs does not seem to work and some people suffer from side effects or intolerable side effects. However, each patient should be treated with medication that is best for him/her. If none of them are effective, surgery can sometimes be a solution to the focal seizures.
Forgetting medication carries, as an immediate result, a decrease in plasma levels of the same. This explains that forgetting even a single dose of medication or abandonment are the most common causes of recurrence of seizures (50%). Therefore the patient must be careful with the medication.
In some cases, people need to take antiepileptic medication throughout life. If there is no crisis over two or four years, the patients may discuss with their doctor the possibility to gradually discontinue the medication. However, it can never be completely sure that crises disappeared for good.
The first historical references to epilepsy disease are immemorial, already known in Ancient Egypt (3000 BC) references. The initial links with hysteria and other disease states related in time with the deployment of the uterus, was succeeded by the "sacred" nature of the disease, much developed by the Greeks who believed it was possible to communicate with the gods of the priestesses when they uttered their oracles amid convulsions.
It was Hippocrates, in his monograph about "the sacred disease", that first identified as the seat of the disease the brain itself, in this as in other aspects of medicine, established scientific principles of pathology.
As a final comment, it seems essencial to me to remember the basic mechanisms and clinical research capacities and the better control of the patient with epilepsy, the decrease of classically associated side effects, bringing to the patients a significant improvement in their quality of their personal, family, social and professional life, which result in saving other resources and an increase in productivity as active elements of a social fabric.
One of the reasons that I made this hub, is because I have Epilepsy. The other reason is to make others understand what epilepsy really means and in that way people know how to help it's patients.
© 2014 Tiago Damião