16, Nov 2024
From Diagnosis to Empowerment: Navigating the Epilepsy Journey
By – Dr. Ravi Kumar CP, Consultant – Pediatric Neurology, Aster CMI Hospital, Bangalore
Epilepsy is one of the most common neurological disorders affecting approximately 1 in 100 people in India. Characterized by recurrent seizures, which result from abnormal electrical activity in the brain. Seizures can vary in type and severity, and their unpredictability can significantly impact the daily life and well-being of those affected. Despite its prevalence, epilepsy remains underdiagnosed and misunderstood in many parts of the world. Through increased awareness, appropriate treatment, and lifestyle changes, individuals with epilepsy can lead fulfilling lives.
Symptoms
The hallmark symptom of epilepsy is seizures, but their nature can vary greatly.
• Focal Seizures: These originate in one area of the brain. They can be further divided into simple partial seizures (where consciousness is preserved) and complex partial seizures (where consciousness is impaired). Symptoms may include unusual sensations, changes in perception, or involuntary movements.
• Generalized Seizures: These involve both sides of the brain. The most common type of generalized seizure is the tonic-clonic seizure (formerly known as grand mal), which involves loss of consciousness, muscle rigidity, and rhythmic jerking movements. Other generalized seizures include absence seizures (brief lapses in consciousness), atonic seizures (sudden loss of muscle strength), and myoclonic seizures (sudden, brief jerks of the body).
Diagnosis
The diagnosis of epilepsy typically involves a combination of medical history, physical examination, and specialized tests. The most common diagnostic tool is an electroencephalogram (EEG), which measures the brain’s electrical activity. The EEG can detect abnormal patterns that indicate epilepsy, especially during or after a seizure. Additional tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be conducted to rule out structural abnormalities in the brain or other underlying conditions that could contribute to seizure activity.
In some cases, blood tests may be performed to check for metabolic or genetic factors, infections, or other medical conditions that could trigger seizures. A detailed assessment by a neurologist is critical to differentiate epilepsy from other conditions that may mimic seizure-like symptoms.
Management & Prevention
In recent years, dietary strategies have emerged as a conventional treatment, particularly for individuals whose seizures are difficult to control with medication. The two most commonly studied dietary approaches are the ketogenic diet and the low glycemic index treatment.
Ketogenic Diet: The ketogenic diet is a high-fat, low-carbohydrate diet that has been shown to reduce seizures in some people with epilepsy. On a ketogenic diet, the majority of your calories come from fats (about 70-80%), with a moderate amount of protein (around 20-25%), and very few carbohydrates (only about 5-10%).
• Fats: This includes foods like meat, fish, butter, oils, avocados, and nuts.
• Proteins: Foods like eggs, cheese, and meats like chicken, beef, and fish are common.
• Carbohydrates: You avoid or eat very small amounts of high-carb foods like bread, pasta, rice, potatoes, sugary snacks, and most fruits.
Low Glycemic Index Diet: The Low Glycemic Index (GI) Diet is an eating plan that focuses on choosing foods that cause a slower rise in blood sugar levels. The idea is to eat foods that are digested more slowly, helping to keep blood sugar levels steady rather than causing sharp spikes and crashes.
• High-GI foods (like white bread, sugary snacks, and sodas) cause a quick spike in blood sugar because they break down quickly into sugar.
• Low-GI foods (like whole grains, legumes, and most vegetables) break down more slowly and lead to a gradual rise in blood sugar.
Treatment
Epilepsy treatment focuses on controlling seizures and improving the quality of life for the patient. The approach typically involves a combination of medication, lifestyle adjustments, and in some cases, surgical intervention.
• Medications: Antiepileptic drugs (AEDs) are the most common treatment for epilepsy. These medications help to regulate the brain’s electrical activity and prevent seizures. It may take time to find the right medication and dosage for each individual, and some patients may experience side effects that require adjustments to their treatment plan.
• Surgery: For patients who do not respond to medications, surgical options may be considered. Surgery involves removing the part of the brain responsible for seizure activity. In some cases, a procedure called vagus nerve stimulation or deep brain stimulation may be used to help control seizures.
Despite the significant advances in understanding and treating epilepsy, there remains a widespread lack of awareness about the condition. Raising awareness is crucial to improving the lives of people and by enhancing access to effective treatments.
A multi-faceted plan of action should also include better integration of dietary therapies, holistic approaches, and individualized care to address the diverse needs of individuals living with epilepsy. By fostering a deeper understanding of epilepsy and promoting timely intervention, we can ensure that those affected by this disorder lead healthier, more empowered lives.
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- By Rabindra
21, Feb 2024
Breaking the Stigma: Understanding Epilepsy, its causes, effects and treatment
Dr. Sowmya M, Senior consultant Neurologist, Aster RV Hospitals
Come February, Epilepsy awareness is planned and observed as International Epilepsy day. The aim is to improve awareness about epilepsy in the general public , reduce stigma related to epilepsy due to the misunderstanding and misconceptions that surround it and provide support to individuals and families living with epilepsy . “Milestones on My Epilepsy Journey”. The theme of International epilepsy day this year , emphasises to highlight personal achievements despite the challenges brought about by the condition.
For the benefit of people who are not clear about Epilepsy, Epilepsy is a neurological disorder that affects the brain, where there is sudden abnormal electrical activity in the brain causing a person to loose control over his body and have a seizure. There are many different types of seizures. There is the major type where a person looses consciousness, falls down and has involuntary jerky movements of the whole body and minor types where they do not lose consciousness completely, may be confused and have partial symptoms depending on the area of brain affected, like simple twitching movements of the face, jerking of one part of the body, visual or hearing symptoms or abnormal feelings. Epilepsy is a condition where a patient has 2 or more recurring seizure without a provoking cause.
In India over 1 crore people are affected with epilepsy , that is 6-10 persons per 1000 but unfortunately a large number of these people do not get access to proper treatment causing major suffering to the patient and the family members.
What are the types of Seizure?
Seizures can vary in type and intensity, Auras or warning signs or sensations which lead to visual disturbances or strange smells, experience temporary confusions, memory loss, or difficulty speaking or understanding language, or uncontrollable movements of the arms, legs, or other parts of the body are all symptoms of an Epileptic attack.
What are the causes of Epilepsy?
Epilepsy has no identifiable cause in about half of the people while in the other half the condition can be due to various causes like genetic influence, developmental conditions. Other causes can be structural problems in the brain like head trauma from accidents or injuries, brain tumour or structural abnormalities in the brain, infections, vascular conditions like stroke , hypoxic injury to brain during birth. Other causes for seizure can be due to effect of illicit drug abuse, excessive alcohol consumption or sudden alcohol withdrawal, low or very high blood sugar levels, low blood sodium levels, high blood creatinine levels which occurs in renal failure and various other causes. It is important to try and identify the underlying cause and receive appropriate treatment.
Effects of Epilepsy
Seizures can result in physical injury due to falls or involuntary movements. This risk of injury may lead to limitations in daily activities and independence. Epilepsy can have psychological effects, including anxiety, depression, and social stigma, which may impact mental well-being and quality of life. Some individuals with epilepsy may experience cognitive impairments, such as memory problems or difficulty concentrating, which can affect academic or occupational performance. In many countries, individuals with epilepsy are subject to driving restrictions due to the risk of seizures while operating a vehicle, which can impact mobility and independence.
Treatments for Epilepsy:
Anti seizure medications have to be appropriately chosen. Antiepileptic drugs (AEDs) are often the first-line treatment for epilepsy. These medications help control seizures by stabilizing electrical activity in the brain. In about 30 % of epilepsies which do not respond to medications, there are alternative modalities of treatment like neuromodulation and epilepsy surgeries. Surgical options include removing the area of the brain responsible for seizures or implanting devices to regulate brain activity. There is also Vagus Nerve Stimulation (VNS) therapy which involves implanting a device that delivers electrical impulses to the vagus nerve, helping to reduce the frequency and severity of seizures. Some individuals with epilepsy may benefit from following a ketogenic diet, which is high in fat and low in carbohydrates. This diet has been shown to help control seizures in some cases, particularly in children. Lifestyle modifications, such as getting adequate sleep, managing stress, and avoiding triggers known to precipitate seizures, can help reduce the frequency and severity of epilepsy episodes.
15, Feb 2024
Wockhardt Hospitals, Mumbai Central organised Painting Competition on International Epilepsy Day to spread awareness on Epilepsy
Mumbai, February 15, 2024 – Wockhardt Hospital, Mumbai Central, in a commendable effort to raise awareness about epilepsy, organized a vibrant painting competition on the occasion of International Epilepsy Day. The event, held on February 13, 2024, witnessed enthusiastic participation from hospital nurses, doctors, and paramedical staff, who showcased their artistic talents while advocating for epilepsy awareness.
The theme of the competition, “Epilepsy: Breaking Barriers, Inspiring Hope,” aimed to foster understanding and compassion for individuals living with epilepsy, as well as to dispel myths and misconceptions surrounding the condition. Participants were encouraged to express their creativity and insights through their artwork, conveying messages of support, empowerment, and education.
As a neurologist deeply committed to enhancing epilepsy awareness, I am heartened by the remarkable creativity and dedication displayed by our hospital staff in today’s painting competition. Through their artwork, they not only express empathy and solidarity with individuals affected by epilepsy but also contribute significantly to breaking down barriers and fostering understanding. Events like these are essential in our collective effort to create a more inclusive and supportive community for those living with epilepsy.” Said Dr. Prashant Makhija, Consultant Neurologist at Wockhardt Hospitals, Mumbai Central
The competition saw a diverse array of artistic expressions, ranging from poignant portrayals of personal experiences with epilepsy to colorful representations of hope and resilience. Each artwork served as a powerful testament to the creativity and compassion of the hospital staff, as well as their dedication to raising awareness about epilepsy.
The event concluded with an exhibition of the artwork, providing an opportunity for hospital staff and visitors to admire the creativity and passion displayed by the participants. Wockhardt Hospital, Mumbai Central, reaffirmed its commitment to supporting initiatives that promote health education and community engagement, with plans for future events aimed at raising awareness about various health issues.
13, Feb 2024
Childhood Epilepsy: A Comprehensive Guide For Parents On Diagnosing And Treating Different Types
Mumbai – Childhood epilepsy can be a daunting and overwhelming diagnosis for parents, as it comes with a range of complexities and uncertainties. Understanding the different types of childhood epilepsy is crucial in providing the best possible care for your child. From absence seizures to focal onset seizures, each type presents unique challenges and requires tailored treatment approaches. Parents need to work closely with the experts to accurately diagnose the specific type of epilepsy their child is experiencing, as this will guide the most effective treatment plan.
Childhood epilepsy is a neurological disorder characterized by recurrent seizures. It can have a significant impact on a child’s development, cognitive function, and overall quality of life.
“While many children with epilepsy outgrow the condition as they age, some continue to experience seizures into adulthood. One of the most challenging aspects of childhood epilepsy is the unpredictability of seizures, which can disrupt daily activities and lead to social stigmatization. The management of childhood epilepsy often involves a complex regimen of medications and lifestyle modifications which can be burdensome for both the child and their family,” Said Dr Priyanka Tater, Neurologist, Zynova Shalby Hospital.
“When child has a seizure, parents can become overwhelmed. Two major reasons for this are difficulty in understanding seizures and concern about the child’s future. Normally, one part of our brain communicates with another using tiny electrical currents. Sometimes, there is a sudden storm during which these electrical currents become disorganized. This event is a Seizure. A seizure may produce varied symptoms. This depends on the part of the brain affected. Based on the symptoms, seizures have many different names. During an Absence seizure, the child stares off into blank space and becomes unresponsive. Sometimes the eyes may flicker during this episode. In Myoclonus, there are sudden jerks, usually of the upper part of the body. If the child is holding a toothbrush or a toy, it may fall from the child’s hand. Focal seizure means the electrical storm happens in a small part of the brain. In this case, the child has sensations or movements only in one body part. For example, only the right hand may twist or shake. Generalized convulsion is when an electrical storm takes over the entire brain. The whole body starts to shake violently. This kind of seizure is also known as a generalized tonic-clonic (GTC) seizure. Atonic Seizures are seen when there is a sudden loss of body power. This can cause a sudden fall called a “Drop Attack”. To categorize the seizures, doctoars may need MRI, EEG, and sometimes video-EEG monitoring. An MRI is a picture of the brain. An EEG measures electrical activity in the brain. If the EEG is done for 1 day or more with video-recording, it is called “Video-EEG monitoring,” Said Dr Siddharth Kharkar, Neurologist, at Lilavati Hospital.
“Upon receiving a diagnosis, the treatment plan for each child is customized to address their specific requirements. The management of seizures often involves the prescription of antiepileptic drugs. Determining the appropriate medication and dosage may require careful oversight by experts. In instances where medications are not effective, some children may undergo surgical interventions,” highlighted Dr Priyanka.
“There are more than 30 medications to treat seizures. Without knowing the seizure type, one cannot choose the right medication.80% of children become completely seizure-free with properly chosen medications. But, about 20% of children don’t stop having seizures, even with many medications. There are many life-changing options for such children as well. Just like medications, not all these treatments are effective for all children. The doctor has to choose the right treatment very carefully. Steroids may reduce EEG abnormalities, improve thinking, and stop seizures. Removal Epilepsy surgery means if the electrical storm comes from a small brain part, we remove that small part. Vagus Nerve Stimulation (VNS) is a small device, about the size of a matchbox. It is kept below the skin of the chest. It calms down abnormal brain activity. Precise diagnosis is essential in children to stop seizures,” said Dr Kharkar.
