Epilepsy
What Is Epilepsy?
Epilepsy is defined as two or more unprovoked seizures occurring at least 24 hours apart. Seizures result from sudden, excessive electrical discharges in brain cells, leading to changes in awareness, movement, sensation, or behavior. Worldwide, about 50 million people live with epilepsy, making it one of the most common neurological disorders.
Signs and Symptoms
Seizure manifestations depend on the brain region involved:
| Seizure Type | Features |
|---|---|
| Focal Onset | Movements or sensations in one body part, emotional changes, déjà vu experiences |
| Focal to Bilateral | Starts localized, then spreads to both hemispheres causing convulsions |
| Generalized Onset | Involves the whole brain from onset: tonic-clonic (stiffening and jerking) or absence (brief staring spells) |
| Other Generalized | Myoclonic (sudden jerks), atonic (loss of muscle tone), tonic (stiffening) |
Between seizures, some patients experience auras—sensory or emotional warnings that a seizure is imminent.
What Causes Epilepsy?
Epilepsy has diverse etiologies; in about half of cases, no cause is identified:
Genetic Factors: Mutations in ion‐channel or neurotransmitter genes.
Structural Brain Abnormalities: Stroke, tumors, traumatic brain injury, malformations.
Infections: Meningitis, encephalitis, neurocysticercosis.
Metabolic & Developmental: Prenatal injury, hypoxia at birth.
Degenerative Conditions: Alzheimer’s disease or other neurodegenerative disorders in older adults.
How Is Epilepsy Diagnosed?
Dr. Budhwar’s evaluation includes:
Clinical History: Detailed account of seizure events, triggers, and frequency.
Electroencephalogram (EEG): Records brain electrical activity to detect epileptiform discharges.
Neuroimaging: MRI or CT scans to identify structural causes.
Laboratory Tests: Blood work to rule out metabolic or infectious contributors.
Treatment Options
Treatment aims to eliminate or reduce seizure frequency and manage side effects. Most patients achieve control with medication alone, while others may require additional interventions:
1. Antiseizure Medications
First-Line Agents:
Levetiracetam, lamotrigine, carbamazepine for focal seizures.
Valproate, ethosuximide for generalized seizures.
Monitoring: Regular blood levels and side effect assessments (fatigue, dizziness, rash) guide dosing.
2. Dietary Therapies
Ketogenic Diet: High-fat, low-carbohydrate regimen effective in medication-resistant pediatric epilepsy.
3. Neurostimulation
Vagus Nerve Stimulation (VNS): Implanted device delivering electrical pulses to reduce seizure frequency.
Responsive Neurostimulation (RNS): Detects and interrupts abnormal activity in focal onset epilepsy.
4. Epilepsy Surgery
For drug-resistant focal epilepsy (~30% of cases), resection of the epileptogenic zone or disconnection procedures can be curative. Candidates undergo invasive monitoring to precisely localize seizure focus.
Self-Management Strategies
Seizure Diary: Track episodes, triggers (sleep deprivation, stress, flashing lights), and medication adherence.
Lifestyle: Ensure adequate sleep, stress reduction, and avoidance of barriers (alcohol, certain medications).
Safety Planning: Wear medical identification, avoid unsupervised swimming or heights, adapt home environment (padding sharp edges).
When and How to Seek Help
If you experience new-onset seizures, increased frequency, or medication side effects, consult Dr. Budhwar for:
Contacting us for questions
Visiting our home page for more resources
Epilepsy is manageable. With personalized treatment and ongoing support, patients can significantly reduce seizure burden and enhance overall quality of life.