Things That You Need To Know About Epilepsy

Prepared by,

Dr Chris Chong

Consultant Neurologist

Gleneagles Kota Kinabalu

1. What is epilepsy?

Epilepsy is a chronic, non-infectious, neurologic condition defined by seizures (which involve abnormal electrical discharges in the brain). After a person has had two or more unprovoked seizures—not caused by immediate recognisable stimulus such as a stroke, brain tumor or traumatic brain injury—he or she is considered to have epilepsy. Epilepsy is a physical disorder, NOT a mental disease.

2. What are the signs and symptoms and how long does it last?

The symptoms of epilepsy are recurring seizures, which can include temporary loss of awareness or consciousness and disturbances of movement, sensation (including vision, hearing and taste), mental function or mood (such as anxiety and depression). Several different types of seizures can occur with epilepsy.

Seizure types can be divided into two major groups. First, there are seizures that begin in a particular part of the brain: focal or partial seizures. Second, there are other seizure types that essentially start in the whole brain (or at least both halves of the brain) at once: generalised seizures. Most seizures last less than five minutes.

3. Why do some patients with epilepsy act abnormally?

Following a seizure, there is often a period of confusion. The period of time after a seizure when the person (and his or her brain) is recovering from a seizure is called the postictal period. Following a seizure the person is said to be in the postictal state. This period of confusion and disorientation often lasts for seconds to a few minutes. During this period of confusion, people may act in ways that are out of character for them. They may be more aggressive or combative, especially if someone tries to hold or restrain them. It can be very challenging for friends or family members to know what to do. They have to be concerned about safety, as someone could wander off and get into trouble in the postictal state. Maintaining safety in the postictal state is of paramount importance.

4. How is epilepsy been diagnosed?

It is important to determine the cause of epilepsy, especially because doing so will help your doctors to focus on the best treatment programme. EEG (electroencephalography) is the gold standard for diagnosing epilepsy. MRI scans (Magnetic Resonance Imaging) and other imaging techniques can provide detailed views of brain abnormalities.

5. What are the factors that might trigger seizures?

There are a few common triggering factors for seizures, namely sleep deprivation, physical/emotional stresses, alcohol withdrawal, fever, etc.

6. How is it been treated?

For about 60% of those diagnosed with epilepsy, seizures can be controlled with medications and surgical procedures. Some drugs are more effective for specific types of seizures. In some patients, special diets may help to control seizures when medications are either not effective or cause serious side effects. Some anti epileptic drugs are linked to pregnancy risks. Women of reproductive age should discuss their opinions with their neurologists before conceiving.