An A to Z of Epilepsy

1. What
According from readers digest epilepsy is serious brain disorder which can
cause on anyone with no axcuse. Prof Mark Richardson say that epilepsy is a
neurological condition and most commonly diagnosed in childhood and
people over 60 years (Readers Digest)
Epilepsy is a central nervous system (neurological) disorder in which brain
activity becomes abnormal, causing seizures or periods of unusual behavior,
sensations, and sometimes loss of awareness. Seizure symptoms can vary
widely. Some people with epilepsy simply stare blankly for a few seconds
during a seizure, while others repeatedly twitch their arms or legs. Having a
single seizure doesn't mean you have epilepsy. At least two unprovoked
seizures are generally required for an epilepsy diagnosis (Epilepsy research)
Epilepsy is a condition that causes seizures — temporary glitches in the
brain’s electrical activity. These electrical disruptions can cause a range of
symptoms. Some people stare off into space, some make jerky movements,
while others lose consciousness (Healthline).
2. Why
Same as epilepsy research, readers digest also conclude that cause of
epilepsy are a blow to the head, stroke, tumour, infection and heavy dringking
habbit. Some women with epilepsy find that their seizures occur at a specific
time in their hormonal cycle.
Epilepsy has no identifiable cause in about half the people with the
condition. In the other half, the condition may be traced to various factors,
including:
a. Genetic influence.
Some types of epilepsy, which are categorized by the type of seizure you
experience or the part of the brain that is affected, run in families. In these
cases, it's likely that there's a genetic influence. Researchers have linked
some types of epilepsy to specific genes, but for most people, genes are
 only part of the cause of epilepsy. Certain genes may make a person more
sensitive to environmental conditions that trigger seizures.
b. Head trauma.
Head trauma as a result of a car accident or other traumatic injury can
cause epilepsy.
c. Brain conditions.
Brain conditions that cause damage to the brain, such as brain tumors or
strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults
older than age 35.
d. Infectious diseases.
Infectious diseases, such as meningitis, AIDS and viral encephalitis, can
cause epilepsy.
e. Prenatal injury.
Before birth, babies are sensitive to brain damage that could be caused by
several factors, such as an infection in the mother, poor nutrition or oxygen
deficiencies. This brain damage can result in epilepsy or cerebral palsy.
f. Developmental disorders. Epilepsy can sometimes be associated with
developmental disorders, such as autism and neurofibromatosis.
Certain factors may increase your risk of epilepsy:
a. Age. The onset of epilepsy is most common in children and older adults,
but the condition can occur at any age.
b. Family history. If you have a family history of epilepsy, you may be at an
increased risk of developing a seizure disorder.
c. Head injuries. Head injuries are responsible for some cases of epilepsy.
You can reduce your risk by wearing a seat belt while riding in a car and
by wearing a helmet while bicycling, skiing, riding a motorcycle or
engaging in other activities with a high risk of head injury.
d. Stroke and other vascular diseases. Stroke and other blood vessel
(vascular) diseases can lead to brain damage that may trigger epilepsy. You
can take a number of steps to reduce your risk of these diseases, including
 limiting your intake of alcohol and avoiding cigarettes, eating a healthy
diet, and exercising regularly.
e. Dementia. Dementia can increase the risk of epilepsy in older adults.
f. Brain infections. Infections such as meningitis, which causes inflammation
in your brain or spinal cord, can increase your risk.
g. Seizures in childhood. High fevers in childhood can sometimes be
associated with seizures. Children who have seizures due to high fevers
generally won't develop epilepsy. The risk of epilepsy increases if a child
has a long seizure, another nervous system condition or a family history of
epilepsy.
Complication
Having a seizure at certain times can lead to circumstances that are dangerous
to yourself or others.
a. Falling. If you fall during a seizure, you can injure your head or break a
bone.
b. Drowning. If you have epilepsy, you're 15 to 19 times more likely to
drown while swimming or bathing than the rest of the population because
of the possibility of having a seizure while in the water.
c. Car accidents. A seizure that causes either loss of awareness or control can
be dangerous if you're driving a car or operating other equipment. Many
states have driver's license restrictions related to a driver's ability to
control seizures and impose a minimum amount of time that a driver be
seizure-free, ranging from months to years, before being allowed to drive.
d. Pregnancy complications. Seizures during pregnancy pose dangers to both
mother and baby, and certain anti-epileptic medications increase the risk of
birth defects. If you have epilepsy and you're considering becoming
pregnant, talk to your doctor as you plan your pregnancy. Most women
with epilepsy can become pregnant and have healthy babies. You'll need to
be carefully monitored throughout pregnancy, and medications may need
to be adjusted. It's very important that you work with your doctor to plan
your pregnancy.
 e. Emotional health issues. People with epilepsy are more likely to have
psychological problems, especially depression, anxiety and suicidal
thoughts and behaviors. Problems may be a result of difficulties dealing
with the condition itself as well as medication side effects.
3. Who
Everyone can diagnosed epilepsy because seizures occur without obvious
trigger. From epilepsy research, epilepsy can affect anyone in any age, sex and
may :
a. Develop shortly after birth due to complications
b. Begin in childhood because febrile convulsions or illness
c. Develop at the time of hormonal changes example puberty and pregnancy
d. Identical twins or different generations from same family
Frequent or severe seizures can impact severely upon a person’s life, and they
may even require constant supervision. However, the majority of people with
epilepsy respond well to treatment and they are able to continue with their
lives; albeit with a bit more caution. Because epilepsy is caused by abnormal
activity in the brain, seizures can affect any process your brain coordinates.
Seizure signs and symptoms may include:
a. Temporary confusion
b. Uncontrollable jerking movements of the arms and legs
c. Loss of consciousness or awareness
d. Psychic symptoms such as fear, anxiety or deja vu
Symptoms vary depending on the type of seizure. In most cases, 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
4. When
Epilepsy can start at any age but must diagnosed in people unden 20 and over
65 because some causes are common in young people (example difficulties at
their birth and accidents) in older people (example strokes that lead to epilepsy
(example epilepsy society)

5. Where
The causes of differences is unknown maybe related to social and economic
factors or the ability of people to get health care. Example :
 a. People with lower sosio economic status have higher rate of developing
seizures and epilepsy
b. Differences in where people get health for their epilepsy has been found
for people in different racial backgrounds
(Epilepsy Foundation)
6. How
When epilepsy occurs, the brain produces sudden intense burst of electrical
energy which disrupt the brain normal working. When someone having
seizure the epilepsy society recommend three instructions, they are : calm,
cushion and call. The most important is dont put something in a person’s
mouth when they are having a seizure that can injure the jaw or block their
breathing.
There are 2 broad categories of seizure.
a. Focal seizure
1) Focal seizures without loss of consciousness.
Once called simple partial seizures, these seizures don't cause a loss of
consciousness. They may alter emotions or change the way things
look, smell, feel, taste or sound. They may also result in involuntary
jerking of a body part, such as an arm or leg, and spontaneous sensory
symptoms such as tingling, dizziness and flashing lights.
2) Focal seizures with impaired awareness.
Once called complex partial seizures, these seizures involve a change
or loss of consciousness or awareness. During a complex partial
seizure, you may stare into space and not respond normally to your
environment or perform repetitive movements, such as hand rubbing,
chewing, swallowing or walking in circles.
Symptoms of focal seizures may be confused with other neurological
disorders, such as migraine, narcolepsy or mental illness. A thorough
examination and testing are needed to distinguish epilepsy from other
disorders.
b. Generalised seizure
Seizures that appear to involve all areas of the brain are called generalized
seizures. Six types of generalized seizures exist.
1) Absence seizures.
 Absence seizures, previously known as petit mal seizures, often occur in
children and are characterized by staring into space or subtle body
movements such as eye blinking or lip smacking. These seizures may
occur in clusters and cause a brief loss of awareness.
2) Tonic seizures.
Tonic seizures cause stiffening of your muscles. These seizures usually
affect muscles in your back, arms and legs and may cause you to fall to
the ground.
3) Atonic seizures.
Atonic seizures, also known as drop seizures, cause a loss of muscle
control, which may cause you to suddenly collapse or fall down.
4) Clonic seizures.
Clonic seizures are associated with repeated or rhythmic, jerking muscle
movements. These seizures usually affect the neck, face and arms.
5) Myoclonic seizures.
Myoclonic seizures usually appear as sudden brief jerks or twitches of
your arms and legs.
6) Tonic-clonic seizures.
Tonic-clonic seizures, previously known as grand mal seizures, are the
most dramatic type of epileptic seizure and can cause an abrupt loss of
consciousness, body stiffening and shaking, and sometimes loss of
bladder control or biting your tongue.
(Mayo Clinic)

Medication
Most people with epilepsy can become seizure-free by taking one anti-
seizure medication, which is also called anti-epileptic medication. Others
may be able to decrease the frequency and intensity of their seizures by
taking a combination of medications.
Many children with epilepsy who aren't experiencing epilepsy symptoms
can eventually discontinue medications and live a seizure-free life. Many
adults can discontinue medications after two or more years without seizures.
Your doctor will advise you about the appropriate time to stop taking
medications. Finding the right medication and dosage can be complex. Your
doctor will consider your condition, frequency of seizures, your age and
 other factors when choosing which medication to prescribe. Your doctor will
also review any other medications you may be taking, to ensure the anti-
epileptic medications won't interact with them. Your doctor likely will first
prescribe a single medication at a relatively low dosage and may increase the
dosage gradually until your seizures are well-controlled. Anti-seizure
medications may have some side effects. Mild side effects include:
a. Fatigue
b. Dizziness
c. Weight gain
d. Loss of bone density
e. Skin rashes
f. Loss of coordination
g. Speech problems
h. Memory and thinking problems
More-severe but rare side effects include:
a. Depression
b. Suicidal thoughts and behaviors
c. Severe rash
d. Inflammation of certain organs, such as your liver

Therapies
a. Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a
device called a vagus nerve stimulator underneath the skin of your chest,
similar to a heart pacemaker. Wires from the stimulator are connected to
the vagus nerve in your neck. The battery-powered device sends bursts of
electrical energy through the vagus nerve and to your brain. It's not clear
how this inhibits seizures, but the device can usually reduce seizures by 20
to 40 percent. Most people still need to take anti-epileptic medication,
although some people may be able to lower their medication dose. You
may experience side effects from vagus nerve stimulation, such as throat
pain, hoarse voice, shortness of breath or coughing.
b. Ketogenic diet. Some children with epilepsy have been able to reduce their
seizures by following a strict diet that's high in fats and low in
carbohydrates. In this diet, called a ketogenic diet, the body breaks down
fats instead of carbohydrates for energy. After a few years, some children
may be able to stop the ketogenic diet — under close supervision of their
doctors — and remain seizure-free. Consult a doctor if you or your child is
 considering a ketogenic diet. It's important to make sure that your child
doesn't become malnourished when following the diet. Side effects of a
ketogenic diet may include dehydration, constipation, slowed growth
because of nutritional deficiencies and a buildup of uric acid in the blood,
which can cause kidney stones. These side effects are uncommon if the
diet is properly and medically supervised. Following a ketogenic diet can
be a challenge. Low-glycemic index and modified Atkins diets offer less
restrictive alternatives that may still provide some benefit for seizure
control.
c. Deep brain stimulation. In deep brain stimulation, surgeons implant
electrodes into a specific part of your brain, typically your thalamus. The
electrodes are connected to a generator implanted in your chest or your
skull that sends electrical pulses to your brain and may reduce your
seizures.
Lifestyle
a. Take your medication correctly. Don't adjust your dosage before talking to
your doctor. If you feel your medication should be changed, discuss it with
your doctor.
b. Get enough sleep. Lack of sleep can trigger seizures. Be sure to get
adequate rest every night.
c. Wear a medical alert bracelet. This will help emergency personnel know
how to treat you correctly.
d. Exercise. Exercising may help keep you physically healthy and reduce
depression. Make sure to drink enough water, and rest if you get tired
during exercise. In addition, make healthy life choices, such as managing
stress, limiting alcoholic beverages and avoiding cigarettes.
What You Can Do
a. Keep a detailed seizure calendar. Each time a seizure occurs, write down
the time, the type of seizure you experienced and how long it lasted. Also
make note of any circumstances, such as missed medications, sleep
deprivation, increased stress, menstruation or other events that might
trigger seizure activity. Seek input from people who may observe your
seizures, including family, friends and co-workers, so that you can record
information you may not know.
b. Be aware of any pre-appointment restrictions. At the time you make the
appointment, ask if there's anything you need to do in advance, such as
restrict your diet.
c. Write down key personal information, including any major stresses or
recent life changes.
d. Make a list of all medications, vitamins or supplements that you're taking.
e. Take a family member or friend along. Sometimes it can be difficult to
remember all the information provided to you during an appointment.
Someone who accompanies you may remember something that you
missed or forgot. Also, because you may not be aware of everything that
happens when you're having a seizure, your doctor may want to ask
questions of someone who has witnessed them.
f. Write down questions to ask your doctor. Preparing a list of questions will
help you make the most of your time with your doctor.