Epilepsy

• Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures due to abnormal electrical activity in the brain.
• Seizures can vary in type and severity, ranging from brief lapses in attention or muscle jerks to severe and prolonged convulsions.

Causes of Epilepsy

1. Genetic Factors: Certain types of epilepsy are linked to genetic mutations.
2. Structural Brain Abnormalities: Brain injuries, tumors, or congenital anomalies.
3. Infections: Meningitis, encephalitis, or neurocysticercosis.
4. Metabolic Disorders: Conditions like hypoglycemia or electrolyte imbalances.
5. Developmental Disorders: Such as autism or neurofibromatosis.

Types of Seizures

1. Focal Seizures:

   • Originating in a specific area of the brain.
     • Simple Focal Seizures: Affect a small part of the brain and do not cause loss of consciousness.
     • Complex Focal Seizures: Affect a larger part of the brain and can alter consciousness.

2. Generalized Seizures:

   • Affecting both hemispheres of the brain.
     • Absence Seizures (Petit Mal): Brief, sudden lapses in attention.
     • Tonic-Clonic Seizures (Grand Mal): Involve both tonic (stiffening) and clonic (jerking) phases.
     • Myoclonic Seizures: Sudden, brief jerks or twitches.
     • Atonic Seizures: Sudden loss of muscle tone.
     • Tonic Seizures: Stiffening of muscles.
     • Clonic Seizures: Repeated jerking movements.

Symptoms of Epilepsy

• Temporary confusion
• Staring spells
• Uncontrollable jerking movements of arms and legs
• Loss of consciousness or awareness
• Psychic symptoms such as fear or anxiety

Diagnosis

1. Electroencephalogram (EEG): Records electrical activity in the brain.
2. Magnetic Resonance Imaging (MRI): To identify structural abnormalities.
3. Computed Tomography (CT) Scan: To detect lesions or abnormalities in the brain.
4. Blood Tests: To check for underlying conditions or infections.

Pathophysiology of Epilepsy

1. Abnormal Electrical Activity: Epilepsy involves excessive and abnormal electrical discharges in the brain’s neurons.
2. Neuronal Hyperexcitability: Imbalance between excitatory and inhibitory neurotransmitters, often involving glutamate and GABA.
3. Structural Abnormalities: Can result from brain injuries, tumors, congenital malformations, or scarring.
4. Genetic Factors: Certain mutations can predispose individuals to epilepsy

Treatment

1. Medications: Antiepileptic drugs (AEDs) like carbamazepine, valproate, and levetiracetam.
2. Surgery: For patients with drug-resistant epilepsy; includes resective surgery or implantation of a vagus nerve stimulator.
3. Dietary Therapy: Ketogenic diet, especially in children with refractory epilepsy.
4. Lifestyle Adjustments: Avoiding seizure triggers, ensuring adequate sleep, and stress management.
5. Neuromodulation: Devices like responsive neurostimulation (RNS).

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