International Epilepsy Day: All you need to know about advance epilepsy treatments

International Epilepsy Day is observed on the second Monday of February, each year. This time, it clashed with the festival of love, Valentine’s Day. To show some love and awareness for epilepsy patients, let’s read on!

What is Epilepsy?

A disorder of the central nervous system, epilepsy is when brain activity becomes abnormal, causing seizures or periods of unusual behaviour, sensations, and sometimes loss of awareness.

Epilepsy is a chronic non-communicable disease of the brain that affects around 50 million people worldwide. Anyone can develop epilepsy, and it affects people of all genders, races, ethnic backgrounds, and ages.

Symptoms of epilepsy:

1. The symptoms of a seizure can vary widely. Some people with epilepsy stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs.
2. Having a single seizure doesn’t mean you have epilepsy. A person needs to have at least two seizures without a known trigger.
3. These triggers (unprovoked seizures) need to happen at least 24 hours apart – then only can an epilepsy diagnosis be given to a patient.

Epilepsy is not a contagious disease. Although many underlying disease mechanisms can lead to epilepsy, the cause of the disease is still unknown in most cases. The causes of epilepsy are divided into the following categories: structural, genetic, infectious, metabolic, immune, and unknown.

Causes of epilepsy

1. Brain damage from prenatal or perinatal causes (for example, a loss of oxygen or trauma during birth, low birth weight).
2. Congenital abnormalities or genetic conditions with associated brain malformations.
3. A severe head injury.
4. A stroke that restricts the amount of oxygen to the brain.
5. An infection of the brain such as Meningitis (swelling of the protective membranes covering the brain and spinal cord), Encephalitis (inflammation of the brain), or Neurocysticercosis (parasitic infection), specific genetic syndromes.
   Brain tumor.

Treatment for epilepsy

For patients who have epilepsy, treatment with medications (or sometimes surgery) can control seizures. Some people require lifelong treatment to control seizures, but the seizures eventually go away for others. Some children with epilepsy may outgrow the condition with age. In other words, the whole aim of the treatment of epilepsy is to alleviate seizures and cure epilepsy.

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With the reduction of seizures, these patients lead a better quality of life. If a patient is receiving medical treatment, they need to be vigilant and report any change in seizure frequency, any new seizure type that they may have noticed, and any medication-related side effects to their concerned doctor at the earliest. They should also note how the medicines or treatment plan has impacted their daily routine, including sleeping and eating patterns.

Who can consider a surgery for epilepsy?

Sometimes medication by itself may not be able to decrease the frequency of seizures, and in this scenario, another option available for patients is surgery. The most common surgery is a resection, which involves removing the part of the brain where the seizures start. The temporal lobe is often released in a procedure known as Temporal Lobectomy. In some cases, this can stop seizure activity. It is essential to keep in mind that if the patient has undergone epilepsy surgery. They will need to follow up closely with their respective Epileptologist and or Neurosurgeon for changes in medications. They should also report any new change they may perceive to their doctor at the earliest.

Additionally, recurrence of seizures is always a possibility even after surgery, and it should promptly be noted or reported to the hospital. If possible, a video of the seizure (be it at home or work) can benefit the healthcare team. Patients should also be encouraged to try and maintain a seizure diary.