EDP column by Professor Ketan Dhatariya
“I have just been diagnosed with epilepsy. What is this?”
The brain is made up of hundreds of billions of nerve cells that usually communicate with each other through a series of coordinated electrical signals. When these signals occur in an uncoordinated way, then the brain does not work properly and seizures occur. Being diagnosed with epilepsy means that you have had more than one such episode.
Epilepsy is one of the most common conditions affecting the brain. The condition can start at any age, although it tends to first occur in children and the elderly. One person in 50 will have epilepsy at some point in their life. It is not a single condition, but a group of conditions with differing causes, treatments and outlooks.
Seizures can be classified as being generalised or partial, depending on whether the whole of the body is involved or part of it (indicating if part or all of the brain is involved), and can be simple or complex, depending on whether consciousness is lost or not.
Depending on where in the brain is affected, determines the way that the seizure manifests itself. If the part of the brain that controls movement is affected, then the seizure shows itself by the ‘twitching’ and uncontrolled movements that many people associate with the condition. However, if the part of the brain involved in memory is involved, then the person may experience ‘déjà vu’. Other parts of the brain affected my result in a series of ‘automatic movements’. It is important to recognise these to get the correct treatment.
Occasionally people will sense an episode about to start and may get warning. This is referred to as an aura. The seizures are usually brief, lasting from seconds to a few minutes and once the attack is over, the normal electrical activity of the brain resumes. However, the person may be sleepy for a time afterwards.
There are several causes for epilepsy, although the cause for most cases remains unknown. Other causes include congenital brain problems, infections, brain tumours, or strokes. The use of recreational drugs such as ecstasy and cocaine make epilepsy more likely.
When the condition is suspected, the a brain wave test called an electroencephalogram (EEG) is carried out and a scan of the brain (CT or MRI) may be done. The treatment is usually with drugs.
A few simple measures should be taken to ensure your safety and of those around you. However, most people with epilepsy are fit free and live completely normal lives. There are some restrictions on driving, but as always, talk to your doctor about these.