Epilepsy

• Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures due to abnormal electrical activity in the brain.

• Seizures can vary in type and severity, ranging from brief lapses in attention or muscle jerks to severe and prolonged convulsions.

Epilepsy with electric activity

Causes

1. Genetic Factors: Certain types of epilepsy are linked to genetic mutations.

2. Structural Brain Abnormalities: Brain injuries, tumors, or congenital anomalies.

3. Infections: Meningitis, encephalitis, or neurocysticercosis.

4. Metabolic Disorders: Conditions like hypoglycemia or electrolyte imbalances.

5. Developmental Disorders: Such as autism or neurofibromatosis.

Types of Seizures

1. Focal Seizures:

• Originating in a specific area of the brain.

• Simple Focal Seizures: Affect a small part of the brain and do not cause loss of consciousness.

• Complex Focal Seizures: Affect a larger part of the brain and can alter consciousness.

2. Generalized Seizures:

• Affecting both hemispheres of the brain.

• Absence Seizures (Petit Mal): Brief, sudden lapses in attention.

• Tonic-Clonic Seizures (Grand Mal): Involve both tonic (stiffening) and clonic (jerking) phases.

• Myoclonic Seizures: Sudden, brief jerks or twitches.

• Atonic Seizures: Sudden loss of muscle tone.

• Tonic Seizures: Stiffening of muscles.

• Clonic Seizures: Repeated jerking movements.

Symptoms

1. Temporary confusion

2. Staring spells

3. Uncontrollable jerking movements of arms and legs

4. Loss of consciousness or awareness

5. Psychic symptoms such as fear or anxiety

Diagnosis

1. Electroencephalogram (EEG): Records electrical activity in the brain.

2. Magnetic Resonance Imaging (MRI): To identify structural abnormalities.

3. Computed Tomography (CT) Scan: To detect lesions or abnormalities in the brain.

4. Blood Tests: To check for underlying conditions or infections.

Pathophysiology of Epilepsy

Pathophysiology of Epilepsy

1. Abnormal Electrical Activity: Epilepsy involves excessive and abnormal electrical discharges in the brain's neurons.

2. Neuronal Hyperexcitability: Imbalance between excitatory and inhibitory neurotransmitters, often involving glutamate and GABA.

3. Structural Abnormalities: Can result from brain injuries, tumors, congenital malformations, or scarring.

4. Genetic Factors: Certain mutations can predispose individuals to epilepsy

Treatment

1. Medications: Antiepileptic drugs (AEDs) like carbamazepine, valproate, and levetiracetam.

2. Surgery: For patients with drug-resistant epilepsy; includes resective surgery or implantation of a vagus nerve stimulator.

3. Dietary Therapy: Ketogenic diet, especially in children with refractory epilepsy.

4. Lifestyle Adjustments: Avoiding seizure triggers, ensuring adequate sleep, and stress management.

5. Neuromodulation: Devices like responsive neurostimulation (RNS).