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Epilepsy

 

Epilepsy is a brain disorder involving recurrent seizures. Epilepsy is a disorder which involves repeated seizures.Seizures which are called as fits are nothing but episodes of disturbed brain function that can cause changes in attention and behaviour.

Causes

At times, seizures may be related to a temporary condition such as exposure to drugs, withdrawl from certain drugs,abnormal levels of sodium or glucose in the blood.Repeated seizures may not recur once the underlying problem is corrected.In some other cases, injury to the brain like stroke or head injury causes brain tissue to be abnormally excitable. In some cases, an inherited abnormality affects nerve cells in the brain which causes seizures. And in some cases, no cause at all can be identified.

Some of the more common causes are:
Idiopathic (no identifiable cause)
- usually begin between ages 5 to 20
- can occur at any age
- no other neurologic abnormalities present
- often a family history of epilepsy or seizures

Developmental or genetic conditions present at birth, or injuries near birth.In this case, the seizures usually begin in infancy or early childhood

Metabolic abnormalities
- may affect people of any age
- diabetes mellitus complications
- electrolyte imbalances
- kidney failure, uremia (toxic accumulation of wastes)
- nutritional deficiencies
- phenylketonuria (PKU).This can rarely cause seizures in infants
- other metabolic diseases, such as inborn error of metabolism
- use of cocaine, amphetamines, alcohol or certain other recreational drugs
- withdrawal from alcohol
- withdrawal from drugs, particularly barbiturates and benzodiazepines

Brain injury
- may affect any age, highest incidence in young adults
- most likely to occur if the brain membranes are damaged
- seizures usually begin within 2 years after the injury
- early seizures (within 2 weeks of injury).They do not necessarily indicate that chronic seizures (epilepsy) will develop

Tumors and brain lesions that occupy space (such as hematomas)
- may affect any age, more common after age 30
- partial (focal) seizures most common initially
- may progress to generalized tonic-clonic seizures
Disorders affecting the blood vessels (such as stroke and TIA)
- most common cause of seizures after age 60

Degenerative disorders (senile dementia Alzheimer type, or similar organic brain syndromes)
- mostly affect older people

Infections
- may affect people of all ages
- may be a reversible cause of seizures
- brain infections like meningitis and encephalitis can produce seizures
- brain abscess
- acute severe infections of any part of the body
- chronic infections (such as neurosyphilis)
- complications of AIDS or other immune disorders
Seizure disorders affect about 0.5% of the population. Approximately 1.5 to 5.0% of the population may have a seizure in their lifetime. Epilepsy can affect people of any age.

Risk Factors

Risk factors include a family history of epilepsy, head injury, or other condition that causes damage to the brain.
The following factors may present a risk for worsening of seizures in a person with a previously well-controlled seizure disorder:

Pregnancy
Lack of sleep
Skipping doses of epilepsy medications
Use of alcohol or other recreational drugs
Certain prescribed medications
Illness

Treatment

If you witness a seizure, your account of the seizure will help a doctor diagnose and treat the person. Try to stay calm. Pay close attention to what happens during and after the seizure.

During a seizure :
- Protect the person from injury. If possible, keep the person from falling. Try to move furniture or other objects that might cause injury during the seizure.
- Do not force anything, including your fingers, into the person's mouth. This may cause injuries such as chipped teeth or a fractured jaw. You also could get bitten.
- Do not try to hold down or move the person.
- Time the length of the seizure, if possible. Although the seizure may seem to last a long time, most seizures last only 60 to 90 seconds.
After a seizure:
- Check the person for injuries.
- Turn the person onto his or her side when the seizure ends and he or she is more relaxed.
- If the person is having trouble breathing, use your finger to gently clear the mouth of any vomit or saliva.
- Loosen tight clothing around the person's neck and waist.
- Provide a safe area where the person can rest.
- Do not give the person anything to eat or drink until he or she is fully awake and alert.
- Stay with the person until he or she is awake and familiar with the surroundings. Most people will be sleepy or confused after a seizure.

Prevention

If you are informed that you have a seizure disorder or are being evaluated for one, do not drive, operate heavy machinery, swim, climb ladders, or participate in other potentially dangerous activities until you have been specifically cleared to do these things by your doctor.

Many causes of seizures such as some forms of epilepsy cannot be prevented. But head injury is a common cause of seizures and epilepsy that you may be able to prevent. To prevent a head injury:

Avoid driving motor vehicles.
Wear your seat belt when you are in a motor vehicle. Use child car seats.
Do not use alcohol or other drugs before or during sports (such as soccer, football, horseback riding, or bicycling) or when operating an automobile or other equipment.
Wear a helmet and other protective clothing whenever you are bicycling, motorcycling, skating, kayaking, horseback riding, skiing, snowboarding, or rock climbing.
Wear a hard hat if you work in an industrial or construction area.
Do not dive into shallow or unfamiliar water.
Prevent falls at home by removing hazards that might cause a fall.
Do not keep firearms in your home. If you must keep firearms, lock them up and store them unloaded and uncocked. Lock ammunition in a separate area.

If you are being treated for a seizure disorder:

Be sure to follow your treatment plan. Taking too little or too much of your medicine, abruptly stopping your medicine, or changing your medicine schedule can cause seizures.
Do not drive, operate heavy machinery, swim, climb ladders, or participate in other potentially dangerous activities until you have been specifically cleared to do these things by your doctor.
Avoid activities that might trigger a seizure, such as playing video games that have flashing or flickering lights. In rare cases, the flashing lights and geometric patterns of video games can trigger seizures in children.

 

Related articles
Seizures and Epilepsy

 
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