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According to the Epilepsy Foundation, epilepsy (meaning "seizure disorder") is the fourth most common neurological disorder in the world. It affects people of all ages and cultures. (1) Currently, 65 million people worldwide have epilepsy, including 3 million children and adults living in the United States. About one in 26 people in the United States will develop epilepsy at some point in their lives, with 150,000 new cases diagnosed each year.
Epilepsy is not just one disease, but a term for a spectrum of neurological disorders that share common symptoms. Seizures, the hallmark of epilepsy, occur when there is a sudden change in the way brain cells communicate with each other. These changes in communication cause abnormal signals and transient changes in sensation, behavior, motor control, movement, and awareness.
While much remains unclear about the causes of seizures due to epilepsy, triggers appear to include certain environmental factors, recent brain injury, and genetics/family history of seizures. The treatment of epilepsy always depends on the severity of the symptoms and the individual response to different therapeutic approaches. Typically, the symptoms of epilepsy are controlled using anti-seizure medications, along with lifestyle changes such as: B. after aketogenic diet.
What is epilepsy?
The Epilepsy Foundation notes that epilepsy is misunderstood by much of the public, particularly due to the fact that "seizures and epilepsy are not the same thing". (2) A seizure is “a disturbance in the electrical communication signals between neurons in the brain”. While a seizure is a unique neurological event that affects the nervous system, epilepsy ischronic diseasethat causes recurrent unprovoked (including reflex) seizures. Seizure disorder is a broader term that includes individual seizure episodes and different types of epilepsy. According to the National Institute of Neurological Disorders and Stroke, "Having a single seizure as a result of a high fever (called a febrile seizure) or a head injury does not necessarily mean that a person has epilepsy." (3)
The definition of epilepsy is "a disease characterized by a persistent predisposition to the generation of epileptic seizures and the neurobiological, cognitive, psychological and social consequences of this condition." The definition of epilepsy has changed over the last few decades. This change is due to some controversy over how patients are properly diagnosed. A person is now considered to have epilepsy if they have at least two unprovoked (or reflex) seizures more than 24 hours apart.
One unprovoked (or reflex) seizure increases the risk of another, particularly in the next 10 years. There is still some debate among experts about the appropriate time to diagnose someone with epilepsy. After a first seizure, some doctors wait for a second seizure before diagnosing epilepsy.
Many people who have only had one unprovoked seizure have other risk factors that make it very likely that they will have another seizure in the near future. As a result, some clinicians treat these patients as if they actually have epilepsy, even though they technically don't fit the current definition.
The International League Against Epilepsy (ILAE) created the above definition of epilepsy in 2005. However, some experts feel that it does not cover important aspects of epilepsy - such as the genetic component of the disease or the fact that some people outgrow the disease.
Although epilepsy is a chronic illness, it can be "cured" in certain individuals. Doctors assume that a patient no longer has epilepsy if they have been diagnosed with age-related epileptic syndrome but are appropriately over-aged. Epilepsy is also no longer considered active if a patient remains seizure-free for 10 years while not taking any medication to control symptoms for the past 5 years.
Common signs and symptoms of epilepsy and seizures
Not only does epilepsy cause different types of seizures that vary greatly in frequency and severity, but in some cases epilepsy can also increase the risk of other health problems. Seizures often cause symptoms such as loss of consciousness/consciousness, changes in mood and emotion regulation, loss of motor and muscle control, and seizures or tremors. This can sometimes lead to falls, injuries, accidents, mood swings, complications during pregnancy, or other secondary issues.
Seizures have a beginning, middle, and end, with each stage of the seizure causing different signs and symptoms. Each patient experiences seizures differently. Not every person will have a clear division between the different stages or each type of symptoms described below.
Signs that a seizure may start:
- Unusual changes in thoughts and feelings, including “deja vu” or feeling that something is very familiar
- Changes in sensation, including experiencing unusual sounds, tastes, or sights
- Visual loss or blurring
- anxious feelings
- dizziness or daze
- nausea or other stomach pain
- numbness or tingling
Symptoms of the "middle stage" of a seizure (referred to as the ictal phase):
- Loss of consciousness, loss of consciousness, confusion, forgetfulness, or memory lapses
- Hearing unusual sounds or noticing strange smells and tastes
- vision loss,blurry visionand flashing lights
- Numbness, tingling, or electric shock sensation
- Mood swings, particularly anxiety/panic, which may accompany a racing heart
- difficulty speaking etc.To swallowand sometimes drooling
- Lack of exercise or muscle tone, tremors, spasms or spasms
- Repetitive movements of the hands, lips, eyes and other muscles
- Loss of control of urine or stool
- increased sweating
- change in skin color (looks pale or flushed)
- Difficulty breathing normally
Symptoms at the end of or after an attack (the so-called post-ictal phase):
- Drowsiness and confusion, which may disappear quickly or last for several hours or longer, depending on the patient
- Confusion, memory loss, dizziness, lightheadedness or vertigo
- Difficulty completing tasks, speaking or writing
- Mood changes, including feeling depressed, sad, excited, anxious, or scared
- headache andnausea
- Injuries are possible if the seizure ends in a fall, such as bruises, lacerations, broken bones, or head injuries
- You feel very thirsty and have a strong urge to go to the bathroom
Causes of epilepsy and risk factors
In most cases (about 60% of cases), the exact cause of epilepsy remains unknown. Being a child or being over 60 puts you at greater risk for seizures and epilepsy. Experts know that seizures caused by epilepsy are due to abnormal disturbances in the electrical activity of the central nervous system (brain, neurons and spinal cord). It is believed that some of the reasons someone may develop epilepsy include: (4)
- Due to a brain injury
- Brain disorders that contribute to damage, including tumors, dementia, or aAVC
- Genetics and family history of seizures/epilepsy
- Abnormal brain development during childhood or in utero. The reasons for this could be infections in the mother, poor diet during pregnancy, lack of oxygen orparalisia cerebral.
- An imbalance of nerve signaling chemicals called neurotransmitters, or changes in the brain channels that allow for normal cell communication
- Infectious diseases that damage parts of the brain, such asMeningitis, AIDS and viral encephalitis
- Taking medication or having a high fever can also cause seizures (not always related to epilepsy). There is some evidence that factors such as high levels ofto emphasize, anxiety, nutritional deficiencies orthe electrolyte disorder, alcohol use and withdrawal symptoms can contribute to seizures in some cases. (6)
Conventional treatments for epilepsy
Conventional treatment for epilepsy depends on the patient's condition and is always individualized by the patient's medical team. Not every seizure or sign of epilepsy necessarily requires treatment. What distinguishes single seizures from epilepsy is that people with epilepsy may need chronic treatment (such as antiseizure medications or surgery). A single isolated seizure is treated by identifying and treating the trigger (eg, head trauma or fever). (7)
Drugs for epilepsy:
Epilepsy can be diagnosed through tests, including measuring electrical activity in the brain and brain scans such as magnetic resonance imaging (MRI) or computed tomography. Some patients only suffer from mild epileptic seizures, which is why they often stop taking the medication to avoid unwanted side effects. Although treatment has come a long way, around one in three people with epilepsy still live with uncontrollable seizures because no available treatment works effectively for them.
For those who respond well to drug treatments, several options are available, including antiseizure medications. Most medications are taken orally in pill form to control seizures due to neurological changes, sometimes in various combinations of 2-3 pills taken together. It can be difficult for people with epilepsy to figure out which types of medications (or combinations of medications) are best for managing their symptoms, as it varies from person to person.
Anticonvulsant medications carry a risk of certain side effects, which can sometimes be very troublesome. This can include:
- Dizziness, unsteadiness, loss of coordination and confusion
- weight gain
- mood swings
- skin rashes
- language problems
Surgery to prevent seizures:
When the side effects of antiseizure medications become severe or the medications don't work well enough to help people improve their quality of life, other methods of controlling seizures are used, including surgery or the treatments described below. such as the ketogenic diet and vagus nerve stimulation.
Surgery is most appropriate and effective when a patient's seizures occur in parts of the brain that can be removed or "cut out" without affecting normal functions such as motor skills, speech or language, vision, and hearing. Surgery can stop seizures from spreading and getting worse by isolating the affected area of the brain. It involves removing a small part of the patient's brain or making several cuts to specific neurons (this is called multiple subpial transection surgery). Surgery is usually a last resort and very serious because of the risk of complications such as: B. Changes in mood regulation, learning, thinking, or other cognitive abilities.
3 natural ways to treat epilepsy
1. Reduce seizure triggers
It is not always possible to prevent a seizure. However, there are some steps you can take to lessen the odds by managing your individual triggers.
Some common seizure triggers to be aware of are:
- Increased physical or emotional stress, anxiety, fatigue and lack of sleep: try to find itways to reduce stressand make sure you get enough sleep (seven to nine hours a night for most adults).
- Alcohol or drug use, or side effects from stopping any of these medications.
- Changing or skipping medications, especially anticonvulsants, that are needed: Always take medications as directed or you risk having a seizure.
- Being overstimulated by lights, loud noises, television, or screens like televisions, electronics, and computers: Take breaks from screen time. Work to find a balance between work and "play" to reduce mental stress and fatigue.
- Experiencehormonal imbalancesor changes like B. during pregnancy, puberty or menopause:Eat healthy, rest, and manage stress to ease these transitions.
2. A ketogenic diet
a ketogenic dietit has been used by physicians since the 1920s to control their patients' seizures, particularly in children with epilepsy. Ketogenic diet treatment consists of eating a very low carb diet, consuming large amounts of fat to fuel the body, and reducing protein intake to small to moderate amounts. About 65 to 80% of calories come from fat sources and up to 20% from protein. Carbohydrates rest (only about five to ten percent of daily calories).
While it's not entirely clear how the keto diet works for epilepsy, it does raise blood ketones. Elevated ketones in blood areas associated with reduced seizure symptoms. During ketosis, the body uses fat for energy because glucose from carbohydrate-rich foods is severely limited. This changes the way neurons in the brain seem to work and communicate and helps control symptoms. (8)
The ketogenic diet is an option, especially for children with intractable epilepsy who are taking multiple antiseizure medications; However, some adults also find improvements following this dietary approach. It has proven to be an effective treatment for seizures associated with glucose transporter protein deficiency syndrome and pyruvate dehydrogenase complex deficiency. There are some potential concerns about the diet, including initial side effects due tolow carb dietsuch as fatigue and weakness, rigor and limitations in meal preparation, and certain "unpalatability".ketogenic foods. The side effects of the ketogenic diet usually go away within a few weeks. But for some, it can be an uncomfortable transition.
People with epilepsy who want to use this as a primary or adjunctive treatment approach can test whether they are "in ketosis" (a state of burning fat for fuel) using strips and doing a urine test at home. Patients may also want to work with a registered dietitian for help. This is especially true in the early stages of transitioning to this diet.
3. Vagus nerve stimulation
The vagus nerve is the longest cranial nerve that runs through the neck and chest to the trunk/abdomen. It contains fibers that send signals throughout the body that regulate motor and sensory information. (9)
In vagus nerve stimulation therapy, a nerve stimulator the size of a silver dollar coin is implanted in the patient's chest. The stimulator connects to the nerve and controls the flow of electrical energy to and from the brain. The device is sometimes called a "pacemaker for the brain". If a person with epilepsy has signs and symptoms that a seizure may be starting ("auras"), they can activate the stimulator with a magnet, which can help prevent a seizure. (10) Researchers have found that this type of therapy does not work for all patients and medication often requires medication. But it can still help reduce seizures by about 20-40% on average.
4. Emergency care and prevention of complications
Being with someone who is having a seizure can be very frightening, especially the first time around. Experts advise that you take some steps to avoid falls or other accidents. This is how you help make sure the person having the seizure is as safe as possible:
What to do if someone has a seizure:
- Call an ambulance or seek medical help.
- Roll the person onto their side and try to place something under their head for cushioning. If you are wearing something tight around your neck, loosen the garment.
- Get the person to move or shake if they are doing so (don't try to grab or hold them).
- Make sure they wear a bracelet that indicates the condition they have. Or check your wallet for relevant information (some people with severe epilepsy wear a bracelet to identify themselves and warn of allergies or complications).
Precautions regarding epilepsy
When a seizure occurs for the first time, it is very important to see a doctor to evaluate it and make a possible diagnosis. If your doctor diagnoses you with epilepsy, you probably won't need medical help every time you have a minor seizure. Even if you've had epilepsy for a long time, always seek help from your doctor when you first notice any of the following signs and symptoms:
- Seizures lasting more than five minutes
- Slow recovery from an attack
- A second attack immediately after a previous one
- A seizure during pregnancy, illness, or after a recent injury
- Changes in duration and intensity of seizures after changing medication
- Seizures and epilepsy are often confused with the same thing. A seizure is actually a single disruption of normal electrical communication signals between neurons in the brain. Epilepsy is the chronic disease that causes seizures.
- Symptoms of epilepsy include changes in cognition, sensation, mood, emotion regulation, motor control, and sometimes other complications due to falls, injuries, or accidents.
- Prevention and treatment of epilepsy include limiting "triggers" such as intense stress or anxiety, overstimulation, and lack of sleep; after a ketogenic diet; vagus nerve stimulation; Use of antiseizure medications and, in some cases, brain surgery to control the spread of seizures.