The word “epilepsy is derived from Greek word “epilepsia” which means “to be taken, seized or attacked”. Epilepsy is more common in developing countries than in developed countries. It is disease condition which is related to nervous system. It results in repeated seizures. This condition is sudden nature. So it is known as ictal events. Ictus is Latin word meaning “to strike”.
Causes of Epilepsy
Exact cause of disease is not known but some conditions are related to epilepsy-
- Head injury
- Infections which generally affect the brain
- Brain tumour
- Alzheimer’s disease
- Genetic factors
Sometimes epilepsy may occur without any identifiable cause. Then it is called idiopathic epilepsy.
Meaning of seizure:
It occur as a result of disturbed brain function. It is seen as a sudden abnormal function of the body. Other names of seizure are- convulsion, fit, or attack.
Symptoms which are generally seen during seizure are:
- Loss of consciousness
- Excess muscular activity
- Loss of muscular activity
- Abnormal sensation felt by patient
- Low glucose level
- Low calcium level
- Imbalance in electrolyte
- Low magnesium level
- High bilirubin.
- Cerebral malaria
- Trauma during birth- can result in seizures in the first year of life
- Low body temperature
- Use of alcohol
- Withdrawal of alcohol
- Drug abuse
- Brain tumour-It can occur in any age group, but it is seen more common in older age group. If epilepsy seizures starts after the age of 20 years then it may be due to tumour.
- Lead poisoning.
- Brain haemorrhage– It is associated with repeated seizures if blood is not removed successfully.
- Neurocysticercosis-which is a parasitic infection occurring as a result of poor hygiene.
- Malformations of the brain.
Genetic factors– If one parent has epilepsy the risk of child developing epilepsy is 4-6 %. But if both parents have epilepsy. The risk increases to 12-20%.
Other factors which increases the tendency of seizures:
- Flashing lights
- Lower alertness
- Lack of enough sleep
- Emotional factor
- Physical stress
- Special smells, sounds or sensations of touch
- Hormonal changes like in females during menses
- High fever
Stages of seizures:
Prodromal phase– It is starting phase of seizure. It begins a few hours or even days before the actual seizure.
- Bad temper
- Increased activity of mind
- Lack of sleep
Aura– Aura comes before seizure by seconds or a few minutes. It means beginning of the seizure.
- Extreme fear
- Dream like experiences
- Unpleasant smells
- Seizures- It is also known as ictus. Loss of consciousness is seen. Patient has no memory of the seizure.
Post ictal phase– This phase may be absent, brief or may last several hours, or may be some days.
- Deep sleep
- Waking up with headache
- Muscular aches
Paralysis of a part of body is also seen which is known as Todd’s paresis. This may occur for a few hours or days.
- Altered speech or lack of speech may be seen.
- Emotional behaviour or altered behaviour is seen.
- Violent behaviour may be seen.
Types of seizures:
Simple partial seizures– Where patient does not lose consciousness. He is able to tell what happened.
- Feeling of pins and needles.
- Feeling of cold or heat.
- Loss of sensation of limb.
- Altered hearing or smelling sensations.
- Changes in mood, memory or thought. Problems with language is also seen.
Complex partial seizures:
Where patient may be unconscious or he may be slight conscious.
- Strange feeling in the stomach rising up to the throat and head.
- Sensation of light, smell, sound or taste.
- He feels as it time passes too slowly or too fast.
- Surroundings may suddenly seem completely strange. He has difficulty in differentiating things whether they are large or smaller.
- He has feeling that things have happened before.
Symptoms may be violent like:
- Pulling at the clothes, chewing, lip smacking, repeated aimless movements. Patient is able to perform difficult tasks. He can travel somewhere.
- Patient can become aggressive and violent when restricted to a place.
- Patient has slow recovery from this phase. Patient may complain of complete loss of memory.
- Absence seizures
- There may be short periods of loss of consciousness lasting only a few seconds. It may sudden in origin.
Symptoms- Patient will stare blank. There can be brief upward rotation of the eyes. There may interruption of ongoing activity.
If patient is child then he may be unresponsive when spoken to. When seizure is over, the child continues what he was doing before the seizure came.
Child will not hear what the teacher is saying during seizures.
Myoclonic seizures- This type of seizures are usually sudden, brief, shock like muscle contractions. This can occur in one limb or may be widespread.
Patient may have single jerks or jerks may be repeated over longer periods.
Clonic seizures– Symptoms like repetitive flexing and stretching of limbs.
Tonic seizures– Symptoms like loss of consciousness, deviation of the eyes and head towards one side. Rotation of the whole body is also seen. It is seen more during sleep and in childhood.
Tonic clonic seizures:
Symptoms: Loss of consciousness. He falls down, sometimes with a scream. He has generalized stiffness. Breathing stops, patient becomes blue, head falls back, arms flexed and legs extended. After sometime muscles relax. During this patient might bite his tongue. He may pass urine or stool. This phase may be for short duration. When jerking stops, patient regains consciousness.
Post seizures symptoms: Patient feel tired with headache and confusion. There will be loss of memory. He later falls into a deep sleep.
This type of seizure occur from one a day to one a month or once a year. It may occur even once every few years.
Atonic seizures– Loss of muscle tone is seen. Patient falls suddenly to the floor. This type of seizure is of short duration lasting only seconds. This type of attack may occur several times a day.
Patient may have scars or fresh wounds on chin, cheek or forehead or the back of the head.
Infantile spasms- Symptoms like spasms in head, bending of the knees and bending of arms is seen. It may occur in first year of life.
Status epilepticus- It is a case of emergency where seizure persists for at least 30 minutes or is repeated very fast that recovery between attacks does not occur. In this case patient should immediately transfer to clinic. It can lead to brain damage or even death.
Prevalence of Epilepsy
This condition can occur in children, adults, men and women, people of all religions and in all social classes. This condition can occur in any age, though most of the cases are diagnosed either in childhood. It is generally lifelong condition. Some suffer from it their whole live and others only for a few years.
It is seen through research that the cases are seen highest in the youngest age groups, decreases
during childhood, diminishes among adults and cases rises again in old age.
Various types of conditions present in different type of age groups are:
Children– Epilepsy is seen mostly before the age of 20 years. Some of common epileptic syndromes seen in children and young people:
Benign childhood epilepsy: It usually seen between 7-9 years of age but can be seen before puberty.
Juvenile myoclonic epilepsy: Usually seen between 10 -16 years of age. This condition usually continues into adulthood. They have typical symptom like increased sensitivity to light as in this type seizures provoked by flashing lights like by watching television.
Childhood absence epilepsy: Seen as brief and frequent absence seizures. It is seen with loss of consciousness. It is often associated with learning disabilities. This condition can often seen in puberty.
West syndrome: It is seen in patients aged 4-6 months. It results lifelong learning disabilities.
Warning signs for patients of epilepsy
- If seizure lasts more than 5 minutes.
- Breathing or consciousness doesn’t return after the seizure stops.
- If a second seizure follows immediately.
- If patient has a high fever.
- If patient has heat exhaustion.
- Epilepsy is seen during pregnancy.
Complications of epilepsy
- Injury can occur to head or bones during seizures.
- If a person has epilepsy, he is more likely to drown while swimming or bathing as he can have seizure while in the water.
- Car accidents are more common as patient may lost control on car. He may be unconscious during drive.
- Anti-epileptic drugs can cause severe birth defects in children.
- Patients of epilepsy have social issues like depression, anxiety.
- They can do suicide.
- Sudden unexplained death in epilepsy (SUDEP)- Its cause is not known.
- What to do when patient has seizures–
- Don’t panic.
- Attendant should note time when the seizure starts.
- Keep hazardous things away from the reach of patient, as it may pose problem.
- If patient has convulsive seizure, turn him on his side and cushion his head.
- Remove glasses and loosen tight clothing.
- Do not put anything in the mouth.
- Do not give liquids or medication.
- Do not restrain.
- Liver function test
- Skull X ray
- CT scan
Homeopathic medicines for managing the cases of epilepsy
This remedy is often in recent cases of epilepsy. It is given when convulsions return at the same hour in day-time or come at night. These convulsions are of especial type. Patient is silent and in stupid state. He has jerking of whole body with partial contraction of one limb. It is given when epilepsy occur as a result of emotional reasons. Patient feel very weak after the fit.
Dosage: 200 4 pellets to be given 2 times a day, for 10 days.
In case of fits give 1M potency, one dose and wait till improvement.
It is given when patient has epilepsy attacks in night. In this fits return at regular intervals. It is given when seizures begins with a sudden scream. Patient is unconsciousness with loss of sensibility and throwing the body upward and forward. seizures starts at the fingers or toes or in the arms. Patient feel coldness of the hands and feet with paleness of face. He often has clenching the thumbs with feeling that he is unable to breathe. It is given in violent cases of seizures where patient has frequent emission of urine and violent screaming. It is very good remedy when seizures are seen in children during eruptions of teeth. Patient himself tells about the attack before attack begins.
Dosage: 200C single dose during seizures to be applied on forehead followed by an additional dose during each seizure.
It is given when patient is irritable and depressed during the day before a fit at night. The cause of fit is emotions. Fit are seen as a result of fear. It is given when several convulsions come close together and after that patient has a long interval of rest. This fit is followed by sleep. As a result of fits patient loses his power of thinking. He feel insensible after the fit. His left pupil is more dilated than the right. It is given when mouth drawn to left with injury marks on tongue. It is good remedy when patient has violent cramps in abdomen. It is also a good remedy where patient is unconscious only for a few seconds or minutes and then continues his occupation unconscious of anything unusual having happened.
Dosage: 30 2 times a day for 10 days.
It is given in cases where patient has sudden complete loss of consciousness and sensation. He is in coma for several hours. He has occasional sudden convulsive movements. It is given when patient has confusion of the head and vertigo. This remedy has violent type of fits where patient has jaws clenches teeth are firmly set, froth comes from mouth forming large bubbles. He is unable to swallow. Patient has involuntary discharge of urine and faeces. His upper extremities contracted and his hands clenched. Patient has unusual stiffness of the legs when spasms starts in the toes followed by distortion of the eyes towards the right and upward. Patient has violent distortion of face. It is given when patient has great weakness and he does not want to do any work. Fit always preceded by a cry.
Dosage: 30 2 times a day for 10 days.
It is given when patient has aura with a feeling as if a mouse were running up the arm. It is given when epilepsy begins at the age of puberty. Epilepsy often occurs as a result of irregular menses. It is given to children who plays with penis. It is given when patient has sudden attacks of vertigo with loss of consciousness. These attacks often comes as a result of emotional disturbances. Patient has week memory.
Dosage- 200 4 pellets, 2 times a day for 6 days.