Epilepsy: is there a cure? Types, Causes, Symptoms and Treatment

What is epilepsy?

Epilepsy is a non-communicable brain disorder in which the activities of nerve cells are disrupted. This causes excessive and abnormal activity in the brain cells, causing epileptic seizures.

When this disorder occurs, the brain temporarily disrupts its usual function and produces involuntary manifestations in the individual’s behavior, muscle control, consciousness and sensitivity.

Epilepsy is manifested by repeated seizures and there is more than one type of epileptic seizure. Therefore, anyone can experience an isolated epileptic seizure, which does not necessarily mean that the person suffers from the disease.

Isolated epileptic seizures can be triggered for several reasons, some of which are:

  • Sudden changes in luminous intensity;
  • Excessive alcohol consumption;
  • High fever;
  • Anxiety;
  • Tiredness;
  • Use of some drugs and medication;
  • Metabolic disorders;
  • Head trauma;
  • Some diseases like meningitis, stroke and neurocysticercosis.

Epilepsy is more common and frequent than we think, since among every hundred people, one or two have the disease. It is estimated that 50 million people have active epilepsy, individuals who are undergoing treatment or have had seizures in the past year, worldwide. And in Brazil, 1.3% of the population suffers from the disease, with 50% of this percentage being children.

Most cases of epilepsy begin in childhood or adolescence. This fact favors early diagnoses, because the sooner a treatment is established, the easier the symptoms are eased.

Types of epilepsy

Seizures are divided into two types, partial and generalized.

Generalized crises

They are those that involve the whole brain and the most common of this type are:

  • Absence crises : it is known as “disconnection”, because the person keeps his eyes fixed and loses contact with the environment for a few seconds, as if he were disconnected.
  • Tonic-clonic seizures : known as seizures, the individual loses consciousness and may fall, with a rigid body, in addition to having muscle contractions throughout the body, biting the tongue, salivating intensely, breathing hard and, at times, it can even release urine or feces.

Partial Crises

They are those in which the disorder is limited to one area of ​​the brain. It can be classified as simple and complex.

  • Simple partial seizures: it does not alter the individual’s consciousness, but consists of the convulsion of a limb or tingling in it, in addition to uncontrolled movements of a part of the body.
  • Complex partial crisis : the individual loses consciousness, becoming confused or making automatic gestures, such as chewing or continuing what he was doing.

Partial Crisis with Secondary Generalization

There are cases in which the disorder starts in one part of the brain and subsequently affects the entire brain. This crisis is classified as partial with secondary generalization .

Other types of crises

  • Myoclonic seizures , which consist of rapid tremors in the body;
  • Clonic seizures , which consist of repetitive flexing and stretching movements;
  • Tonic seizures , which consist of sudden and long-lasting muscle contractions;
  • Atonic crises , which consist of a continuous crisis and with falls, which can last up to 5 seconds;
  • Status epilepticus , which consists of prolonged or repetitive crises, without recovery of the patient’s memory.

Causes

Often, the root causes of epilepsy are not identified, and when this occurs, it is called idiopathic epilepsy .

However, epilepsy can also be genetic or acquired, also called secondary or symptomatic epilepsy , and some possible causes for these types are:

  • Trauma during or after childbirth;
  • Excessive alcohol and drugs;
  • Brain injuries due to trauma to the head;
  • Infections;
  • Neurological diseases.

A rarer case is pyridoxine-dependent epilepsy , which involves seizures from the first months of life or, in some cases, even before birth. Its most likely cause is a mutation in the ALDH4A1 gene, antiquitin.

Epilepsy can also be triggered by loud sounds, bright flashes and sleep deprivation. Pregnancy can also cause seizures.

Symptoms of epilepsy

The symptoms of epilepsy are those that make up partial and generalized seizures. They can leave the individual with a sudden fear, stomach discomfort, loss of consciousness, muscle contraction, bite on the tongue, urinary incontinence, mental confusion and can cause hallucinations causing the patient to see or hear in different ways.

After a crisis, the individual may feel confused and not remember the episode.

Symptoms of partial seizures

During this type of crisis, the following may occur:

  • Tremors of the face or other limbs;
  • Sensory disorders, such as hallucinations;
  • Mood swings and memory loss;
  • Malaise, palpitations, salivation, sweat or redness;
  • Tingling in the mouth and hands.

Symptoms of generalized seizures

Symptoms of this type of crisis can be:

  • Grunts;
  • Rigid body;
  • Roll your eyes and head;
  • Movement of arms and legs;
  • Foamy salivation.

Symptoms of pyridoxine-dependent epilepsy

This classification of epilepsy is mainly characterized by its long periods of epileptic seizures, and by low body temperature ( hypothermia ) and low muscle tone after birth. Other symptoms are:

  • Muscle stiffness;
  • Convulsions;
  • Loss of consciousness;
  • Irritability before the seizure period.

Read more: What is Hypothermia and what are the symptoms?

What to do during a crisis?

Do not try to stop an epileptic seizure or hold the victim. To help you, follow the tips below:

  1. Place the person on his side with his head down so that he can breathe better and not choke;
  2. Place a comfortable support under the head, to prevent the individual from hitting it, which may cause trauma;
  3. Loosen the individual’s clothes;
  4. Remove objects that are close to the individual who may injure you;
  5. Count the duration of the crisis.

Never put your hand or any object inside the individual’s mouth, as he may bite his fingers or choke. You should not eat or drink, as it can cause suffocation.

If the attack lasts less than five minutes and the patient has a history of epilepsy, there is no need to call a doctor. Otherwise, take the patient to a hospital or call an ambulance.

Pregnant and diabetic women must be taken to a hospital.

Diagnosis

The diagnosis of epilepsy must be made by a neurologist and is made from the detailed report of the patient or someone who witnessed the crisis on the case. Detailed information is needed about what happened, how part of the body was affected, how long the crisis lasted, what time of day it happened; all the information helps in the diagnosis and, consequently, in the search for the appropriate treatment.

Based on the detailed report, complementary exams are carried out to search for the classification of epilepsy. The tests that help most in this case are:

  • Electroencephalogram : it evaluates brain activity using electrodes placed on the patient’s scalp;
  • Computed Tomography : an imaging method that uses X-rays to check the craniocerebral structure;
  • Magnetic Resonance Imaging : a non-invasive method that allows you to clearly visualize various nerve tissues, the brain stem and the posterior brain. This method is especially useful for finding out whether or not epilepsy was caused by brain disorders;
  • Functional Resonance : a neuroimaging method that makes it possible to detect localized changes in the cerebral blood flow related to a certain function and, thus, determine what this function would be in the brain;
  • Electrocardiogram : checks whether the epilepsy was caused or not by heart problems;
  • Lumbar Puncture : a process that collects fluid from the spinal cord to check whether the epilepsy was caused by a brain infection or not;
  • Blood Test : evaluates sugar, calcium and sodium levels. If the levels are too low, they can lead to epileptic seizures.

These tests recognize the classification of epilepsy more easily when they are performed during or shortly after an attack. When performed outside the crisis, it is difficult to show any brain alteration. In 65% of cases, no cause is identified.

Regarding pyridoxine-dependent epilepsy , as it is a rare condition, its diagnosis is not always accurate.

Does epilepsy have a cure?

As already mentioned, most cases start in childhood or adolescence and, in half of these cases, epilepsy disappears with time and brain maturation. However, there are no cures for the disease, but there are treatments that are able to decrease symptoms on a large scale.

Patients who have been without medication for years and have not experienced a seizure in that time, can consider themselves cured.

Treatment

The most suitable treatment is medication, which helps to regulate abnormal brain activity. The neurologist, after identifying the classification, prescribes an anticonvulsant suitable for your specific type of epilepsy. Anticonvulsants are remedies that alter the functioning of the brain, helping to reduce epileptic seizures.

Drug treatment is usually long, in some cases it lasts a lifetime, and must be done with medical supervision. The medication should be taken at the times and in the prescribed amounts and the dose should not be doubled if you forget to take it at the previous time. Consult the doctor periodically, so that he will be able to adjust the doses of the medication to your need, in addition to facilitating the discovery of factors that may contribute to the increase of the crises and to verify the side effects of the use of the medicine.

Treatment with anticonvulsants is ineffective for pyridoxine-dependent epilepsy , so the treatment most indicated in this case is that of large daily doses of Vitamin B6, pyridoxine. However, if not treated in time, the child can develop neurological problems, such as developmental delays, learning disorders and severe brain dysfunction.

Getting enough sleep, eating your meals at regular times and not abusing alcohol are essential habits, as they help to control crises. Acupuncture and meditation, together with medication, also help to control epileptic seizures, as they make the individual relax and eliminate tension.

Another treatment method is brain surgery, used in the most severe cases where the drug does not help control seizures. This procedure consists of removing the epileptic focus, that is, the part of the brain affected by epilepsy and can only be performed if the location affected by the problem is located. In addition, it should not be performed when the two hemispheres of the brain are affected by the disease. Another factor that prohibits surgery is the need for the epileptic focus to be small, as thus removing it does not affect the overall functioning of the brain.

There are also other treatments such as:

  • Vagus nerve stimulation : a treatment that, from an implant located under the skin of the patient’s chest, releases electrical impulses that stimulate the vagus nerve, the main nerve that connects the brain to the body. This treatment reduces seizures by 40%.
  • Colosotomy : a surgery that interrupts the path of the nerve that originates the crises, consists of cutting the nerve bridge that connects the two hemispheres of the brain. Despite the interruption of the connection between the two hemispheres, this treatment does not damage the intellectual function.
  • Temporal Lobectomy : total or partial removal of the anterior and neocortical portion of the temporal lobe and the total or partial extraction of the mesial temporal structures (amygdala, hippocampus and parahipocampal gyrus).
  • Hemisferectomy : a rare treatment, it is a surgical procedure that removes, disconnects or disconnects the hemisphere of the brain responsible for epileptic discharges.

Treatment in Children

Drug treatment can cause unpleasant side effects for children, such as drowsiness, weight gain and speech problems, but they can be done with medical advice.

Another treatment, most used in this group, is the ketogenic diet , based on higher amounts of fat and reduced amounts of sugars and proteins , calculated according to the patient’s age and weight. 1% of patients are able to control seizures from this diet.

The ketogenic diet must be indicated and controlled by a nutritionist, so that the child receives the necessary amounts of fat, vitamins and minerals. A poorly managed diet can cause damage to the child’s nutrition, in addition to diseases such as hypoglycemia .

Treatment in Pregnant Women

Drug treatment is not recommended for pregnant women, as the drugs can cause malformations and changes in the development of the fetus.

One should try to control epileptic seizures using relaxation techniques , to avoid stress , and to avoid the factors that cause epilepsy.

Women who need the medication to control seizures should be advised by a neurologist and change their anticonvulsant medication to medications with lesser side effects on the fetus.

Pregnant women should also take 5mg of folic acid , before and during pregnancy, and vitamin K should be administered in the last month of pregnancy.

Remedies for epilepsy

  • Amato ;
  • Carbamazepine ;
  • Clonazepam ;
  • Clopam ;
  • Diamox ;
  • Depakene ;
  • Phenytoin ;
  • Gabaneurin ;
  • Gabapentin ;
  • Hidantal ;
  • Lyrica ;
  • Oxcarbazepine ;
  • Rivotril ;
  • Topiramate ;
  • Phenobarbital ;
  • Sodium Valproate ;
  • Lamotrigine ;
  • Etosuximide ;
  • Clonazepam .

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Complications

The epileptic can encounter several complications and challenges.

Complications of drug treatment

Some complications are derived from drug treatment and can involve side effects such as:

Physical injuries

Caused by epilepsy during a crisis. The individual may be injured by falling to the ground or hitting objects while convulsing, and sometimes the seizure is strong enough to cause damage, such as muscle damage.

Status epilepticus

These are prolonged crises and are considered a serious medical emergency that can involve life risks.

Sudden and unexplained death

These are greater risks for people with epilepsy. This phenomenon has not yet been fully understood, but it may be related to a cardiac disorder that can occur during the seizure. The Foundation for Epilepsy lists other possible causes for this type of unexplained death, such as breathing problems, changes in brain circulation and hormonal and metabolic changes caused during consultation.

Complications of surgical procedures

There are several types of surgery to eliminate or neutralize the part of the brain affected by epilepsy and, like drug treatment, there are also risks during it.

  • In Temporal Lobectomy there may be some loss of vision or impaired memory and it can rarely cause loss of speech or psychosis ;
  • In Hemispherectomy involves disabling one hemisphere of the brain, removing operating portions;
  • In callosotomy, the collapsing body is partially or completely separated, tissue that makes the communication between the two hemispheres of the brain. When they separate, communication between the two hemispheres is impeded;
  • In Vagal Stimulation , it can cause pain, shortness of breath, hoarseness and sore throat.

Pregnancy complications

For pregnant women, the biggest risks involve:

  • Spontaneous abortion;
  • Premature birth;
  • Death of the baby after birth;
  • Delay in the child’s development;
  • Malformations in the fetus;
  • Low weight at birth;
  • Pre-eclampsia, when the woman has hypertension;
  • Vaginal bleeding.

It is not known whether these complications are due to the disease or drug treatment.

During breastfeeding, some medications can cause drowsiness and irritation in the child. The orientation is to breastfeed only after 1 hour after taking the medication. It is also advised to breastfeed while sitting or lying down, as epileptic seizures can occur during breastfeeding.

Social complications

In addition to the complications already mentioned, there are also social complications, and some are due to the mistaken concept of the disease.

Some challenges for epileptics involve common activities such as:

  • Cooking : accidents can occur in the event of a crisis;
  • Driving : Some people with epilepsy cannot drive. However, there is specific legislation for this, in which it is possible to drive, as long as the epilepsy is controlled and the individual has been out of crisis for at least two years;
  • Practice of some sports and recreational activities, such as swimming in rivers, dams and the sea : in the event of a crisis, relief is very difficult. Swimming in pools is allowed only under supervision.

Epilepsy can also cause anxiety and depression .

Living together

It is not uncommon for epileptics to develop emotional problems. This, in most cases, is related to the difficulty of accepting the diagnosis, because, for these individuals, the risk of epileptic attacks restricts their independence.

Normally, epileptics develop denial as a development of defense, after this phase the period of conflict occurs, that is, when the person tries to accept his condition. When the individual begins to assimilate the situation of his diagnosis, he may go through a period of pressure, which is considered normal if it is not too long. After this period, the acceptance phase begins.

The prejudice against the disease is still great, but it only occurs due to lack of information, and the best way to get through it is to talk to a doctor, who can help you better understand your condition. This improves the quality of life and the psychosocial adjustment of the epileptic.

Despite facing some difficulties, people with epilepsy can lead a normal life, being able to work, play some sports, have children and drive.

Prevention

There are not many ways to prevent epilepsy, but there are still some things that can be done, such as:

  • Avoid head injuries;
  • Do not use medications without medical advice;
  • Always get vaccinated against infectious diseases.

Epilepsy is a disease that can be treated and the epileptic can enjoy a normal life, but these patients still suffer many prejudices due to ignorance about the subject.

Share this text with your friends and help spread useful information about the disease, as it can help someone to get involved in the social environment and avoid psychological problems.

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