Epilepsy – Signs, Symptoms, Epidemiology

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Epilepsy

Epilepsy is characterized by a long-term danger of recurring seizures.

Epilepsy

Epilepsy is an ancient Greek term related to seize, possess, or afflict. Epilepsy is an array of neurological disorders with repeated epileptic seizures. This brain disorder characterized predominantly by recurrent and unpredictable interruptions of normal brain function, called epileptic seizures. Epilepsy isn’t the single unit of disease; it is a range of illnesses that can be caused by various causes that reflect underlying brain dysfunction. Epileptic seizures are episodes that may range from short and almost undetectable periods to lengthy shaking periods.

Epilepsy Signs and Symptoms

Epilepsy is characterized by a long-term danger of recurring seizures. This seizure may occur in several ways, depending on the brain portion concerned and the age of the person. Convulsion is the most prevalent form (60%) of seizures. One-third begins from the beginning as generalized convulsions affecting both hemispheres of the brain. Two-thirds start with focal seizures that can lead to general seizures (which influence one hemisphere in the brain).

The other 40% are non-convulsive seizures. An example of this is the absence seizure, which usually takes about 10 seconds and is a reduced level of awareness. Focal seizures are often preceded by the so-called auras. Sensory (visual, hearing or smell), autonomic and psychological phenomena are part of them. Jerking activity can begin in a particular muscle group and spread to surrounding muscle groups, so it is called the Jacksonian march.

Automatisms that are non-consciously-created activity and mostly easy repetitive moves like lip-smacking or complicated operations, like efforts to pick things up, may happen. Six kinds of seizures are common: tonic-clonic, tonic, clonic, myoclonic, absence and atonic seizures. There is a large number of seizures. They are all conscious losses and usually occur without warning. Tonic-clonic seizures happen with limb contraction and expansion, along with back arching lasting 10–30 seconds (the tonic stage). followed by a shaking of the limbs in unison (clonic phase).

Tonic attacks cause steady muscle contractions, individual often becomes blue when he stops breathing. The limbs are shaken in unison in clonic seizures. After shaking stops the individual can return to normal for 10-30 minutes, which is referred to as the ‘ postictal state ‘ or ‘ postictal stage. ‘ During an attack, loss of control over the bowel or bladder may happen. During a seizure, the tongue may be bitten at the tip or on the side. Bites on the sides are more prevalent in tonic-clonic seizures. In psychogenic non-epileptic seizures, tongue bites were also comparatively prevalent. Myoclonic seizures caused muscle spasms in some or all areas.

Absence seizures may be subtle with only a slight turn of the head or eye. Right after it ends, the person will not fall and return to normal (McPhee and Ganong, 2010). Atonic attacks involve muscle loss of more than a second of activity, This usually happens on either side of the body. 6% of epilepsy patients suffer from seizures often caused by special events and known as reflex seizures. Those with reflex epilepsy have an attack caused only by certain stimuli.

Flashing lights and sudden noises are common triggers. Seizures occur more often during sleep in certain kinds of epilepsy, and almost only when they are sleeping in other types. There is a typical recovery period after an active seizure (the ictal state) during which confusion exists. A postictal period prior to returning to a normal level of consciousness. It usually lasts between 3 and 15 minutes but may last for hours. Fatigue, headache, difficulty talking and abnormal conduct are other common symptoms. 6-10% of people experience psychosis after the seizure.

Often people don’t remember during that time what happened. After a focal seizure, localized weaknesses, known as Todd’s paralysis, can also occur. It normally takes seconds to minutes when it happens, but can seldom last for one or two days. Epilepsy can have an adverse impact on psychological and social well-being. These consequences can include social isolation, stigma or disability. They could lead to less education and a worse job outcome. Learning disabilities, and especially in children with epilepsy, are common in those who have the condition. Epilepsy stigma can also influence the families of people affected.

In people with epilepsy, certain disturbances occur more often, partly dependent on epilepsy syndrome, include depression, anxiety, obsession with compulsion and migraine. A hyperactivity disorder with attention deficit affects three to five times more children with epilepsy than children without epilepsy. Epilepsy is more common in children living with autism and has significant implications for their behavior, learning, and social development.

Epidemiology of Epilepsy

It impacts 1% of the population by age 20 and 3% by 75 years of age. It is more frequent in men than in women with a small overall difference. The majority (80 percent) of people with this disease are in the developing world. In developed countries, epilepsy starts every year in 40–70 of 100,000, and in developing countries, 80–140 of 100,000. Poverty is a risk and includes both being from a poor country and being poor relative to others within one’s country.

Epilepsy most frequently begins in young and old people in the developed world. In the developing world, the onset of is more frequent among old children as well as young adults due to trauma and infectious disease. In developed countries, the number of cases per year in children has fallen and has risen between the 1970s and 2003 among the elderly. This was partially due to improved survival in elderly patients after strokes.

Etiology of Epilepsy

Genetic as well as acquired factors can cause epilepsy. Epilepsy which is thought to be mainly genetic is referred to as “idiopathic epilepsy” and includes 30% of all instances. Epilepsy is identified as ‘symptomatic’ owing to acquired factors and accounts for approximately a quarter of patients. The causes that have been acquired or environmental include head trauma, serious perinatal injuries, stroke, developing tumors, post-infective lesions, and tumor.

The incidence and triggers of epilepsy in the world are usually thought to be comparatively comparable. However, in the developing world incidence and prevalence may be greater because of infectious causes like cysticercosis, an endemic cestode infestation. In the previous 20 years, the percentage of cases with recognizable causes has risen, mainly because of improvements in MRI.

They have demonstrated that subtle lesions are more common than before, particularly developmental abnormalities. There are no particular causes for the remaining instances (about 40-50 %) due either to lack of adequate investigations or absence of conclusions despite thorough analysis. Although the division into “idiopathic” and “symptomatic” cases remain convenient, this distinction is artificial and potentially confusing for basic clinical and educational purposes.

A significant proportion of cases (and families) of epilepsy considered ‘symptomatic’ (e.g. severe child myoclonic epilepsy and some forms of temporal and frontal lobe epilepsy) have recently been shown to be genetic disorders. While the role of genetic factors may have been overestimated in certain idiopathic epilepsy. The interaction of genes and environmental factors is evidence in many cases.

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