EPILEPSY

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Epilepsy is condition where in abnormal paroxysmal hyper-synchronous electrical changes within brain causes unpredictable, sudden and repetitive spells of seizures.

CAUSES OF EPILEPSY

  • Neurodegenerative Diseases
  • Brain Injury
  • Infections of Central Nervous System
  • Stroke
  • Brain Tumour
  • Birth defects
  • Etc

It can be due to any structural or physiological abnormality within brain caused due to genetic mutations, injuries, infections, diseases, tumours and other unknown factors. Cause for epilepsy in many cases remains unknown.

SIGNS AND SYMPTOMS OF EPILEPSY

ICTAL STAGE OR SEIZURE

Epilepsy is caharacterised by different patterns of seizures.It is a state of sudden onset of varried degree of involuntary muscular stiffness or relaxation or combination of both with varied degree from mildly altered to complete loss in sensations and consciousness due to abnormal electrical changes within brain.

General Signs of Seizure

1)Outwardly seen signs

  • Complete stiffness of body due to contraction of muscles of body Or
  • Complete relaxation of body muscles Or
  • Contraction with relaxation causing twitching and jerking of body.
  • Suddenly losing and regaining of consciousness
  • Eyes turned ind fixed in one direction
  • Fixed, dilated or contracted pupils
  • Locked jaws, causing bitting of tongue between teeth, causing severe injury on tongue and bleeding.
  • Excessive salivation and froth from mouth
  • Excessive Perspiration
  • Involuntary passage of urine
  • Clenched thumbs
  • Etc

2) Signs Within felt only by the patient

  • Strong abnormal smells
  • Strong emotional swings
  • Phobic state
  • Tingling sensation in toes and fingers
  • Rising sensations in abdomen
  • Etc

Epilepsy patient may show varried pattern of symptoms, depending upon type of seizure, which is dependent on which region of brain is involved. Below is the classification of types of seizures

Types of Seizures

I)Focal or Partial Seizures

One Hemisphere or One lobe is involved it can be classified into two types:

  1. Simple Partial – Patient remains conscious, that is aware, realises and understands that something is happening is somewhat responsive, can recollect what had happened(during seizure), comparatively smaller region in brain is involved, patients feels strange sensations, jerking movements.
  2. Complex Partial – Patient loses consciousness completely or loss of awareness and responsiveness, may not be able to recollect episode of seizure or what had happened then.

2)Generalised Seizures

Both the hemisphere are involved, these type of seizures are classified into six sub-types

  1. Atonic – Also called drop seizure or akinetic seizure. Partial or complete loss of muscle tone and control especially of trunk muscles causing patient to fall forwards with head leaning forwards causing injury. Atonic seizures usually doesnt last more than fifteen seconds in some cases followed by paralysis in a muscle group not lasting for more than three minutes. Usually the onset in most cases is during childhood and may persist into aldulthood. All the cases of concurrent Atonic seizures with onset during childhood needs to be carefully evauated for Lenox-Gustaut Syndrome (LGS) characterised by concurrent episodes of either atonic or tonic seizures with cognitive disorders and spikes on electroencephalogram. LGS a rare, complex and fatal condition usually caused due to congenital infections, genetic disorders like Tuberous Sclerosis and West Syndrome, many other genetic mutations, brain lesions. Atonic seizures are also found in Dravets Syndrome.
  2. Tonic – Sudden stiffness due contractions of muscles of limbs and trunk causing patient to fall backwards which may result into injury due to fall, it often occurs in state of sleep as well. These type of seizures usually do not last for more than 20 minutes. Tonic seizures are one of the most commin type of seizures associatex with Lenox -Gustaut syndrome as mentioned above.
  3. Clonic – Sustained uncontrolled violent rythmic jerking of body parts due to rapid contraction and relaxation of muscles, cant be stopped even by exerting force. This type of seizures are also refered as convuslions.
  4. Tonic-Clonic – Tonic and Clonic pattern of seizures follows each other randomly in phases. In Tonic phase the muscles suddenly contracts and body stiffens followed by clonic phase when suddenly patient’s body starts jerking violently in rythm due to rapid contraction and relaxation of muscles.
  5. Myoclonic – Jerking and Twitching of group of muscles. Usually patient is conscious. This type of seizures are seen in many conditions amd syndromes like LGS(mentioned above), juvenile myoclonic epilepsy (usually appears during puberty, morning seizures usually after patient wakes up usually involves neck and upper limb), Progressive Myoclonic Epilepsy(rare syndrome of combination of Tonic-Clonic and Myoclonic)etc.
  6. Abscense – In this type patient suddenly lose conscious and soon regiains consciousness with no other evident external signs except patient suddenly stops and become stand still and visibly , for others, outwardly they seem as if lost out in thought for a while.

Secondary Generalised Seizures

Starts as partial seizure and progresses as generalised seizure. It is termed as secondary generalised seizure, as the primary event was initial partial seizure and then it progressed to generalised seizure.

Status Epilepticus

When seizures fail to stop and keep continuing for more than 5 minutes, usually the seizure pattern is of Tonic-Clonic type. Its a medical emergency and may prove fatal if not treated immediately

POST-ICTAL STATE

  • Confussion lasting for few munuted to couple of hours.
  • Paralysis of limbs one sided, lasting for upto 15 hours and may take upto 2 days for complete recovery, it is called Todd’s Paralysis.

DIAGNOSIS OF EPILEPSY

  • MRI
  • CT Scan
  • EEG
  • And may require many other tests to find out underlying cause of epilepsy.

HOMOEOPATHIC MEDICINES FOR EPILEPSY

  • TARRENTULA HISPANICA
  • STANNUM METALLICUM
  • BELLADONNA
  • GELSEMIUM SEMPERVIRENS
  • AETHUSA CYNAPIUM
  • PLUMBUM METALLICUM
  • ZINCUM METALLICUM
  • LACHESIS
  • NAJA
  • STROMONIUM

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