Epilepsy is a neurological condition, which affects the nervous system. Epilepsy is usually diagnosed after a person has had atleast two seizures that were not caused by some known medical condition like alcoholwithdrawal, extremely low blood sugar, heart problems or some other medical condition. Sometimes, epilepsy can be diagnosed after one seizure, if a person hasa pre existing condition that places them at high risk for having another. Greater awareness about Epilepsy is your insuranceto a more fit and healthy life.
Epilepsy is currently defined as a tendency to have recurrent seizures (sometimes called fits). A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal message passing between braincells. This disruption results in the brain’s messages becoming halted or mixed up.
Your doctor will take a detailed medical history (including a family history of seizures), gather information about your behaviour before, during, and after the episode, and do a physical examination. Anelectroencephalogram (EEG) or brain wave study - performed on a Sleep -deprived individual can reveal abnormal brain wavescharacteristic of Epilepsy and imaging tests such as an MRI or CT scan can identify brain abnormalities that may be causing seizures.
WHAT IS AN EEG
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain. Brain cells talk to each other by producing tiny electrical signals, called impulses. An EEG helps measure this activity. The test is done by a EEG specialist in your doctor's office or at a hospital or laboratory. You will be asked to lie on your back on a bed or in a reclining chair. Flat metal disks called electrodes are placed all over your scalp. The disks are held in place with a sticky paste. The electrodes are connected by wires to a speaker and recording machine. The recording machine changes the electrical signals into patterns that can be seen on a computer. It looks like a bunch of wavy lines.
You will need to lie still during the test with your eyes closed because movement can change the results. But, you may be asked to do certain things during the test, such as breathe fast and deeply for several minutes or look at a bright flashing light.
Brain electrical activity has a certain number of waves per second (frequencies) that are normal for different levels of alertness. For example, brain waves are faster when you are awake, and slower when you are sleeping. There are also normal patterns to these waves.
What Abnormal Results Mean
Abnormal results on an EEG test may be due to:
*. Abnormal bleeding (hemorrhage)
*. An abnormal structure in the brain (such as a brain tumor )
*. Attention problems
*. Tissue death due to a blockage in blood flow (cerebral infarction)
*. Drug or alcohol abuse
*. Head injury
*. Migraines (in some cases)
*. Seizure disorder (such as epilepsy or convulsions )
*. Sleep disorder (such as Narcolepsy)
*. Swelling of the brain (Encephalitis)
Note: A normal EEG does not mean that a seizure did not occur.
CT scans (computerised tomography)
A CT scan is a type of X-ray that shows the physical structure of the brain. It does not show if you have epilepsy. However it may show if there is anything in your brain, such as a scar, or damaged area, that could cause epilepsy. Not everyone will need to have a CT scan.
Magnetic resonance imaging (MRI) scan
An MRI scan can often detect possible causes of epilepsy, such as defects in the structure of your brain or the presence of a brain tumour. Read more about MRI Scans.
How can I prevent epilepsy?
In someone with epilepsy, certain triggers can lead to a seizure . Identify and watch for particular behaviours, environments, orphysical and emotional signs that precede attacks. It's not uncommon, for example, to feel annoyed or elated several hours prior to a grand mal seizure, and immediately before the attack. By far the most common approach to treating epilepsy is to prescribe Anti Epileptic drugs. The first effective antiepileptic drugs were bromides, introduced by an English physician named Sir Charles Locockin 1857. He noticed that bromides had a sedative effect and seemed to reduce seizures in some patients. More than 20 different antiepileptic drugs are now on the market, all with different benefits and side effects. The choice of which drug to prescribe, and at what dosage, depends on many different factors, including the type of seizures a person has, the person’s lifestyle and age, how frequently the seizures occur, and, for a woman, the likelihood that she will become pregnant. People with epilepsy should follow their doctor’s advice and share any concerns they may have regarding their medication.
In addition, the person may become aware of a warning "aura", perhaps a taste or smell: This warning may allow you to lie down in time to avoid falling. In cases where the aura is a smell, some people are able to fight off seizures by sniffing a strong odour, such as garlic or roses. Whenthe preliminary signs include depression, irritability, or headache, an extra dose of medication (with a doctor's approval) may help prevent an attack. In the case of a Jacksonian seizure, firmly squeezing the muscles around those that are twitching can sometimes stop the attack. Take as many precautions if your seizures are not fully controlled. Avoid or limit alcohol, comply with DVLA requirements for a seizure-free period prior to driving a vehicle (this is normally a year, but it is your responsibility to check with the relevant authority). It is important to teachfamily members about how to minimise injury if you have a seizure. Tell them to protect you against falling, and to roll you onto your side into the recovery position ifyou lose consciousness.
WHAT ARE TRIGGERS
Triggers are situations that can bring on anEpileptic Seizure in some people with epilepsy. Some people do not have any specific triggers for their seizures, but common triggers include tiredness and lack of sleep ,anxiety, panic, fear, stress, alcohol, and not taking medication. For some people, if they know what triggers their seizures, they may be able to avoid these triggers and so lessen the chances of having a seizure- or even avoid the situation. Triggers for seizures are not the same as as for the condition of Epilepsy it self. A trigger for someone to have their first seizure may be a stressful situation, but the underlying cause for that person to start having seizures may be quite different. Causes can include structural damage to the brain, from birth, from a stroke, or an infection such as meningitis, or through a head injury. Causes can also be genetic, for example a naturally low resistance to having seizures (a low seizurethreshold), or another condition that makes a person more likely to develop seizures, such as Tuberous Sclerosis.
How can stress cause seizures?
Stress can affect brain function in the following ways:
Stress can trigger an increase in the breathing rate, known as hyperventilation. Doctors use hyperventilation to provoke seizures in certain patients, especially those with absence seizures.
Stress may cause you to miss your medication, leading to an increase in seizures.
Stress can cause hormonal changes such as an increase in the steroid hormone cortisol, which also may influence seizure activity.
Negative emotions related to stress, such as worry or fright, may cause seizures. Thismay happen because the limbic system, theportion of the brain that regulates emotion, is one of the most common places for seizures to begin.
How can I deal with stress in my life?
Try to avoid situations that you know will be stressful.
Learn relaxation techniques or take yoga ortai chi classes.
During times when you can't avoid stress, make an extra effort to get enough sleep and to take your seizure medicine on time.
THE IMPORTANCE OF SLEEP AND EPILEPSY
There are a number of topics about sleep that are of particular concern to people with epilepsy. First, sleep disruption from any cause can be a reason for an increase inseizure frequency or severity. Second, sleepdisruption can also have a negative effect on short-term memory, concentration, and mood. Seizures during the night can disrupt sleep, possibly resulting in further problems with memory and concentration the following day. Finally, various anticonvulsant drugs can affect sleep in both positive and negative ways.
Studies have shown that, overall, about 20% of seizures occur during sleep. Most sleep seizures begin during stage 2, with few beginning during slow wave sleep. These are times during which the electrical activity of the brain is more synchronized (rhythmic), which is why scientists believe that seizures are more likely to begin during these states. By contrast, few or no seizures begin during REM sleep, though it is not known why the state of REM sleep (occupying roughly one quarter of sleep time) appears to be protective against seizures.
Sleep deprivation , whether due to sleep disorders, nocturnal seizures, or simply notsleeping enough, has long been thought to increase the risk of seizures. In specific syndromes such as juvenile myoclonic epilepsy, this relationship can be quite dramatic to the point where seizures rarelyor never happen when sufficient sleep is obtained. Sleep deprivation also increases the risk of partial seizures in many patientsparticularly when occurring frequently. This can be due to sleep disorders from outside influences like poor sleep hygiene, or because patients are busy and simply donot get enough sleep. Any of these influences can result in increased seizures, further disrupting the already limited sleeptime, and leading to a vicious cycle of sleepdisruption and intractable seizures. In this scenario, seizures are not likely to be controlled unless the sleep disruption is also resolved.
People with epilepsy are particularly vulnerable to the effects of sleep disruption, and unfortunately seizures and the medications used to control them can contribute to this problem. If you have problems with drowsiness or trouble with your memory or concentration, even when you seem to be spending enough hours asleep, you may need a change of seizure medicine or a sleep study. To achieve your best overall level of function, you must pay attention to the relationship between your seizures and your sleep.
Rapid eye movement sleep, or REM, is one of the five stages of sleep that most people experience nightly. It is characterized by quick, random movements of the eyes and paralysis of the muscles . The amount of time spent in REM sleep varies significantlywith age; it normally makes up around 20-25% of an adult humans total time spent asleep (on average about 90-120 minutes), and approximately 80% of a newborn's. People usually experience REM sleep 4 or 5 times a night (it comes in cycles), the first cycle - which occurs at the beginning of one's sleep - only lasts for a short time, with each following cycle beinga little longer.During REM, certain neurons in the brain stem, called REM sleep-on cells, become especially active - these cells are most likely what trigger this phase in the sleep cycle. Once triggered and in a state ofREM, the body stops releasing neurotransmitters - called monoamines - that are responsible for stimulating the motor neurons; this means that the muscles stop moving, essentially entering a state of temporary paralysis.
Try A Malt Drink at Bedtime
Malt are germinated cereal grains, usually barley, that have been dried out in a process known as "malting," which allows enzymes to break down the grain's complex sugars into simple sugars, such as maltose. The maltose is then consumed by yeast during the process of fermentation. Malt extract is a concentrated liquid or powdered form of malt used to make manybeverages, such as beer, whisky, malted shakes and flavored drinks such as Horlicksand Ovaltine. It is also considered a dietarysupplement and can provide some essential nutrients for your mind and body.Drinking malt extract beverages at night orcloser to bed time might help you get to sleep more easily because of the mineral content, which relaxes your muscles. The maltose in malt extract is easy for your body to digest and provides a quick source of energy. B vitamins are needed for metabolism and energy production. Minerals are needed for normal muscle toneand strong bones. Some people prefer hot beverages like Horlicks. Horlicks is a malt drink made from powdered granules and warm milk. It is marketed as an aid to promote sound sleep. The drink is manufactured by a UK company that is alsonamed Horlicks.
Or you may want to try a Hot Chocolate instead. Although, coco and hot chocolate, are thought to help you sleep. Itis recommended that you avoid pure chocolate drinks as these may be stimulants and keep you awake. Carefully read the label to see that there is no caffeine within the product.
Travel AND JET LAG
You should make sure you have sufficient medication with you for your travels. Long journeys and jet-lag may make you tired and more prone to a seizure. This should not stop you from travelling. However, it may be best that someone on the trip be aware of your situation. Some antimalarial tablets interfere with anti-epilepsy medication. Your Epilepsy nurse, pharmacist or travel clinic should be able to advise you about this.
LONG HAUL TRAVEL AND EPILEPSY
Long haul flights can add to stress and can provoke seizures by:
*. disturbing sleep/lack of sleep
*. days being longer (flights travelling eastwards)
*. days being shorter (flights travelling westwards)
*. (travelling north to south or vice versa doesn’t seem to pose the same problems)
*. crossing time zones can pose problems ofwhen to take medication (seek advice from your doctor before commencing the journey)
*. having unusual/erratic mealtimes
*. dry, stuffy atmosphere in the cabin—drink plenty of still water and avoid alcohol
*. jet lag on arrival.
Flights can reduce travel time but they can also be stressful. Stress may be further exacerbated by :
*. struggling with luggage
*. long queues for check-in, security, passport control
*. delayed flights
*. making connecting flights
*. long queues for check-in, security, passport control
Food and Drink
For your comfort and safety during your journey, make sure you have enough to eat and drink.
Air travel in particular can cause dehydration, which may be a seizure trigger for some people. When you are dehydrated, your attention and concentration can decrease by 13% and short term memory by 7%. No matter how you are travelling, drink 6-8 glasses of water a day to stay on top form during your journey. Don’t ever go hungry.
Hunger can cause blood sugar levels to fall which may in turn trigger seizures. Make sure you eat regularly; if travelling by car take plenty of breaks and plan ahead for rail and air journeys.
It is safest to avoid alcohol when travellingparticularly on long journeys and when flying. Alcohol can lead to dehydration and interferes with the absorption of antiepileptic medication, which in turn cancause seizures not whilst drinking but afterwards. Alcohol may pose the additional risk of status epilepticus occurring.
If you are going on a long trip find out wellin advance if your AEDs will be available in the country or countries you intend to visit. Older AEDs are normally available in Western Europe, USA, Canada, Australia, New Zealand and Japan. Newer AEDs may only be licensed for sale in a small number of other countries. Be aware that your AED may be known under a different name outside the UK. Your GP, pharmacist or Epilepsy Connections will be able to advise you about the availability of your particularmedication and how to get it while you aretravelling.
Epilepsy medicines available in the United Kingdom
The main way of treating epilepsy is with epilepsy medicines. You may hear these referred to as anti-epileptic drugs. The following information is taken mainly fromthe British National Formulary ( BNF ) Number 64 (September 2012). Published bythe British Medical Association and the Royal Pharmaceutical Society of Great Britain, it is updated twice a year. For the most up-to-date information, visit the British National Formulary w ebsite. The medicines listed are those usually prescribed for everyday seizure control. Other medicines, such as diazepam or midazolam, are available for emergency use. We have not included emergency medicines on this list. Most side effects of antiepileptic drugs involve such as fatigue, dizziness, or weight gain. However, severe and life-threatening side effects such as allergic reactions can sometimes occur. Epilepsy medication also may predispose people to developing depression or psychoses. People with epilepsy should consult a doctor immediately if they develop any kind of rash while on medication, or if they find themselves depressed or otherwise unable to think in a rational manner. Other danger signs that should be discussed with a doctor immediately are extreme fatigue, staggering or other movement problems, and slurring of words. People with epilepsyshould be aware that their epilepsy medication can interact with many other drugs in potentially harmful ways. For this reason, people with epilepsy should alwaystell doctors who treat them which medications they are taking. Women also should know that some antiepileptic drugscan interfere with the effectiveness of oral contraceptives, and they should discuss this possibility with their doctors.