Epilepsy

• Generalised epilepsy (jerking of all the four limbs accompanied with unconsciousness)
• Focal seizures (affecting a single part of the brain)
• Temporal lobe epilepsy (originates from the temporal lobe, often linked to déjà vu, unusual smells, or emotional changes before a seizure)
• Absence epilepsy (usually seen in children, causing brief lapses in awareness without convulsions)

Symptoms depend on the seizure type, but common signs include:

• Aura, which is an abnormal sensation or feeling before the convulsions start
• Bloating, nausea, visual phenomenon, olfactory hallucinations, or déjà vu, which means feeling that you have already experienced something which is happening for the first time
• Convulsions, which are motor reflexes following aura with tonic posturing or jerky movements of the limbs
• Confusion or a feeling of disorientation
• Repetitive seizures which may lead to cognitive impairment

Several factors can lead to epilepsy:

• Genetic mutations
• Head injuries
• Infections (meningitis, encephalitis)
• Stroke or haemorrhage
• Mass lesions in the brain

Doctors use a combination of tests to confirm epilepsy and locate the source of seizures:

• History and clinical examination: details of seizure episodes
• EEG (Electroencephalogram): demonstrates specific epileptiform discharges, localised to a particular area in focal epilepsy
• Ictal PET scan: shows hypermetabolism of the area from where the seizure starts
• Interictal SPECT: shows hypometabolism of the affected area

While epilepsy cannot always be cured, seizures can often be well controlled with:

• Antiseizure medication: the first line of treatment for most patients
• Epilepsy surgery: considered when the seizures tend to arise from a single focus in the brain repetitively and when they are poorly controlled even after using adequate doses of appropriately chosen medication for an adequate duration
• Vagal nerve stimulation: a device that stimulates the vagus nerve to stop seizures before they spread
• Ketogenic diet: a special high-fat, low-carbohydrate diet helpful in some patients
• Lifestyle modifications: regular and adequate sleep, avoiding the use of stimulating medications, and using antiseizure medications help decrease the frequency of attacks

Seek immediate care if you or your loved one experiences:

• A first-time seizure
• Repeated seizures despite taking medicines
• Seizures lasting more than 5 minutes (medical emergency)

Not all cases of epilepsy can be prevented, but risks can be reduced by:

• Protecting the head (using helmets, preventing falls)
• Managing risk factors like high blood pressure, stroke, and infections
• Avoiding seizure triggers (e.g., sleep deprivation, missed medications, alcohol, flashing lights in some cases)

For diagnosis and management of epilepsy, consult a Neurologist (specialist in brain and nerve disorders).