Epilepsy is a condition of recurrent seizures which result from an abnormality of the brain’s electrical activity. It involves a disruption in the nerve cell connections in the brain, and there may be an imbalance in neurotransmitters or chemicals. The patient may display involuntary body movements or change in sensation, awareness, or behavior.
Several types of seizure disorders exist. For example, in cases of generalized tonic-clonic seizure or grand mal, the patient may cry, fall, and experience rigidity and muscle jerks over the whole body for a few minutes. Confusion and fatigue follow the attacks. In petit mal or absence seizures, there may be rapid blinking of the eyes, or the patient may stare into space for a few seconds.
Descriptions of seizures have existed since ancient Babylon more than 3,000 years ago. People believed that epilepsy was the result of demons, but in 400 B.C., Hippocrates wrote that these spells were from a disorder of the brain. Despite medical advances in the understanding and management of epilepsy, there is still considerable stigma, discrimination, and fear about it.
Worldwide there are approximately 50 million people with the condition, and 85 percent of them reside in developing countries where medication to treat epilepsy is often not available. In the United States, there are approximately two million cases of it. This medical condition is present in every country of the world. Ninety percent of epilepsy patients in Africa do not receive any treatment.
Epilepsy and human rights issues
Until the 1970s, patients in the United States with epilepsy did not have the privilege to visit restaurants, theaters, recreational centers, and other public facilities. In the United Kingdom, marriage was prohibited for them until 1970. In China and India, epilepsy has been grounds for marriage annulment or prohibition. These patients have encountered discrimination with regard to employment as well.
Epilepsy may be hereditary in some cases, and it affects people of all ages, race, and social class. Neither mental retardation nor mental illness causes it, but patients with mental retardation may have a seizure disorder as well. Some of the most highly accomplished and famous people have epilepsy.
In most cases, the cause of the seizures is not known. However, there are several medical conditions which may prompt a convulsion. These include stroke, low blood sugar, head injury, fever, alcohol or drug withdrawal, intoxication with certain illicit drugs such as cocaine, tumors of the brain, low oxygen level in the brain, and infectious disease such as meningitis.
It is important to understand that the occurrence of a seizure does not always mean that the patient has epilepsy. When medical conditions which cause a seizure are present, treatment of that problem may stop the convulsions.
Adequate prenatal care is essential in the prevention of epilepsy. Moreover, children must receive immunizations to prevent infections which can lead to the condition. Everyone must also take precautions to avoid head injury when they ride in automobiles, and cyclists should wear a helmet.
Clinical management of epilepsy
Medication is quite effective in the management of epilepsy, and the type of seizure disorder the patient has will determine which drugs are best. Surgical removal of an abnormal focus of the brain will help some patients. In refractory cases of epilepsy where aggressive medical therapy still does not control the spells, a ketogenic diet with high fat, low carbohydrate, and caloric restriction has achieved good results in certain cases.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
References:
Centers for Disease Control. (2011). "Epilepsy" (Retrieved January 13, 2011).
World Health Organization. (2011). "Epilepsy" (Retrieved January 13, 2011).
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
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