Express News Service
KOCHI: seizures or seizures & # 39; in speech usage, refers to the short-term signs or symptoms that occur as a result of abnormal and excessive failure of brain cells. It can be characterized by short episodes of involuntary movements that may include part or all of the body, and may be accompanied by loss of consciousness and control of bowel movements or bladder function.
The term epilepsy has a different connotation, pointing to a constant predisposition to repeated attacks and also to the resulting physical, psychological and social consequences of this condition. The most recent WHO figures show that around 50 million people worldwide live with epilepsy, with nearly 2.5 million new cases diagnosed each year.
There are a number of different causes that cause abnormal electrical fires or storms in the brain network. In the acute setting, medical conditions such as a low sodium or sugar level, stroke, trauma, alcoholism-related, certain infections and inflammations affecting the brain can all cause epileptic seizures. A large proportion of the attacks of children, adolescents and even adults is a result of injuries in very vulnerable fetal brains during and after delivery. There is a group of epilepsies that occur in a certain age with no apparent causes, some of which may have a high attack burden, adversely affect the development of the child and can have devastating consequences.
Recent research has shown that many such epileptic disorders have a genetic component that does not always have to be applied in families. Depending on the nature of the events that occur during seizures, epileptic seizures can be broadly divided into focal and generalized seizures. In the case of focal attacks, one part of the body can usually be involved in the disorder, but it can go on to involve all four limbs in which they are called generalized seizures.
The correct identification of the type of seizure and epilepsy syndrome is of the utmost importance and helps the doctor to supervise the treatment of a patient.
Dos & Don'ts during attack
First of all, do not panic and lose your mental power. The sensible actions of the bystanders can sometimes protect the patient from a significant injury and can help with the recovery. The falls during attacks can result in serious injuries that are much more dangerous than the effect of epileptic seizures. In case of generalized seizures, protect the patient from injury by helping him on the floor or taking the necessary measures in bed to prevent a fall.
Gently turn the patient one way so that foam and saliva that may collect can flow out. One must try to loosen tight or oppressive clothing that can block his or her breathing. Do not press the patient to suppress the shocks. Unless specifically stated by the physician, do not attempt to give medication or attempt to give drinks until the patient is fully aware and awake. The evidence is lacking or the introduction of any material in the mouth to prevent tongue biting can be useful, it can even be counterproductive and can injure the patient or the helper.
During your first consultation the doctor may be more interested in your description of the incident and physical examination. Accordingly, the physician would decide on relevant studies. These include routine blood tests, Electroencephalogram (EEG) with or without sleep and Magnetic Resonance Imaging (MRI) of the brain with particular focus from the epilepsy point of view. These are not exclusive or mandatory and are geared to the nature of the confiscation of each patient. Sometimes for better characterization of the seizures, the doctor may request a video EEG, which includes recording and continuous video and EEG recording of the patient, including his or her usual seizures if necessary. Vision assessment, speech and language evaluation, psychological research are all necessary tools for research in selected cases.
There are many myths and misconceptions about the pharmacological treatment of epilepsy. It is often the unjustified and unwarranted phobia with regard to anti-epileptic medication, their possible side effects and the duration of treatment. Side effects of medication can occur with any medication and with any treatment system and are not limited to anti-epileptic medication. Like any other drug class, this group of medicines has its own spectrum of side effects, no more and no less. The type of seizure and the epilepsy syndrome would determine the choice for an anti-epileptic and vary from patient to patient and do not follow one-for-all-for-everything policy. The diagnosis of seizure does not always justify the treatment, but when it is taken, the decision is in accordance with the wishes of the patient after discussing all the pros and cons. Patients are encouraged to clarify all their doubts.
Epilepsy continues to evoke emotions of fear and there are still misunderstandings about treatment in the community. Account must be taken of the fact that the majority of patients have the right freedom of attack with setting the right medication with the right dose. In those unfortunate patients in whom medical treatment fails to adequately control epileptic seizures, surgical management is a treatment option.
Dr. Deepak Menon
KIMS Hospital, Thiruvananthapuram
(The views of the author are his own)