The word “epilepsy is derived from the Greek word “Epilepsia” which means “to be taken, seized or attacked”. Epilepsy is more common in developing countries than in developed countries. It is a disease condition that is related to the nervous system. It results in repeated seizures. This condition is sudden in nature. So it is known as ictal events. Ictus is a Latin word meaning “to strike”.
Causes of Epilepsy
The exact cause of the disease is not known but some conditions are related to epilepsy-
- Head injury
- Infections which generally affect the brain
- Stroke
- Brain tumor
- Alzheimer’s disease
- Genetic factors
- Meningitis
Sometimes epilepsy may occur without any identifiable cause. Then it is called idiopathic epilepsy.
Meaning of seizure:
It occurs as a result of disturbed brain function. It is seen as a sudden abnormal function of the body. Other names of seizure are- convulsion, fit, or attack.
Symptoms which are generally seen during a seizure are:
- Loss of consciousness
- Excess muscular activity
- Loss of muscular activity
- The abnormal sensation felt by the patient
- Low glucose level
- Low calcium level
- Imbalance in electrolyte
- Low magnesium level
- High bilirubin.
- Encephalitis.
- AIDS.
- Cerebral malaria
- Rabies
- Fever
- Tetanus
- Trauma during birth- can result in seizures in the first year of life
- Low body temperature
- Use of alcohol
- Withdrawal of alcohol
- Drug abuse
- Brain tumour-It can occur in any age group, but it is seen as more common in the older age groups. If epilepsy seizures start after the age of 20 years then it may be due to a tumor.
- Lead poisoning.
- Brain hemorrhage– It is associated with repeated seizures if blood is not removed successfully.
- Neurocysticercosis-which is a parasitic infection occurring as a result of poor hygiene.
- Malformations of the brain.
Genetic factors– If one parent has epilepsy the risk of a child developing epilepsy is 4-6 %. But if both parents have epilepsy. The risk increases to 12-20%.
Other factors that increase the tendency of seizures:
- Flashing lights
- Lower alertness
- Lack of enough sleep
- Emotional factor
- Physical stress
- Special smells, sounds, or sensations of touch
- Alcohol
- Hormonal changes like in females during menses
- High fever
Stages of seizures:
Prodromal phase– It is the starting phase of the seizure. It begins a few hours or even days before the actual seizure.
Symptoms
- Bad temper
- Depression
- Headache
- Increased activity of the mind
- Irritability
- Lack of sleep
Aura– Aura comes before seizure by seconds or a few minutes. It means the beginning of the seizure.
Symptoms:
- Extreme fear
- Dreamlike experiences
- Unpleasant smells
- Seizures- It is also known as as ictus. Loss of consciousness is seen. A patient has no memory of the seizure.
Post ictal phase– This phase may be absent, brief, or may last several hours, or maybe some days.
Symptoms:
- Deep sleep
- Waking up with a headache
- Tiredness
- Irritability
- Vomiting
- Confusion
- Muscular aches
Paralysis of a part of the body is also seen which is known as Todd’s paresis. This may occur for a few hours or days.
- Altered speech or lack of speech may be seen.
- Emotional behavior or altered behavior is seen.
- Violent behavior may be seen.
Types of seizures:
Simple partial seizures– Where a patient does not lose consciousness. He is able to tell what happened.
Symptoms:
- Twitching
- Feeling of pins and needles.
- Feeling of cold or heat.
- Loss of sensation of the limb.
- Altered hearing or smelling sensations.
- Changes in mood, memory, or thought. Problems with language are also seen.
Complex partial seizures:
Where the patient may be unconscious or he may be slightly conscious.
Symptoms:
- Strange feeling in the stomach rising up to the throat and head.
- A sensation of light, smell, sound, or taste.
- He feels as if time passes too slowly or too fast.
- Surroundings may suddenly seem completely strange. He has difficulty in differentiating things whether they are large or smaller.
- He has feelings that things have happened before.
Symptoms may be violent like:
- Pulling at the clothes, chewing, lip-smacking, repeated aimless movements. The patient is able to perform difficult tasks. He can travel somewhere.
- Patients can become aggressive and violent when restricted to a place.
- A patient has a slow recovery from this phase. A patient may complain of a complete loss of memory.
- Absence seizures
- There may be short periods of loss of consciousness lasting only a few seconds. It may sudden in origin.
Symptoms- Patient will stare blank. There can be a brief upward rotation of the eyes. There may interruption of ongoing activity.
If the patient is a child then he may be unresponsive when spoken to. When the seizure is over, the child continues what he was doing before the seizure came.
The child will not hear what the teacher is saying during seizures.
Myoclonic seizures- This type of seizures are usually sudden, brief, shock-like muscle contractions. This can occur in one limb or may be widespread.
Patients may have single jerks or jerks may be repeated over longer periods.
Clonic seizures– Symptoms like repetitive flexing and stretching of limbs.
Tonic seizures– Symptoms like loss of consciousness, deviation of the eyes, and head towards one side. Rotation of the whole body is also seen. It is seen more during sleep and in childhood.
Tonic-clonic seizures:
Symptoms: Loss of consciousness. He falls down, sometimes with a scream. He has generalized stiffness. Breathing stops, the patient becomes blue, head falls back, arms flexed and legs extended. After sometime muscles relax. During this patient might bite his tongue. He may pass urine or stool. This phase maybe for a short duration. When jerking stops, the patient regains consciousness.
Post seizures symptoms: The patient feels tired with headache and confusion. There will be a loss of memory. He later falls into a deep sleep.
This type of seizure occurs from one a day to once a month or once a year. It may occur even once every few years.
Atonic seizures– Loss of muscle tone is seen. The patient falls suddenly to the floor. This type of seizure is of short duration lasting only seconds. This type of attack may occur several times a day.
A patient may have scars or fresh wounds on the chin, cheek, or forehead, or the back of the head.
Infantile spasms- Symptoms like spasms in the head, bending of the knees, and bending of arms is seen. It may occur in the first year of life.
Status epilepticus- It is a case of an emergency where seizure persists for at least 30 minutes or is repeated very fast that recovery between attacks does not occur. In this case, the patient should immediately transfer to the clinic. It can lead to brain damage or even death.
Prevalence of Epilepsy
This condition can occur in children, adults, men and women, people of all religions, and in all social classes. This condition can occur at any age, though most of the cases are diagnosed either in childhood. It is generally a lifelong condition. Some suffer from it their whole life and others only for a few years.
It is seen through research that the cases are seen highest in the youngest age groups, decreases
during childhood, diminishes among adults, and cases rise again in old age.
Various types of conditions present in a different type of age groups are:
Children– Epilepsy is seen mostly before the age of 20 years. Some of the common epileptic syndromes seen in children and young people:
Benign childhood epilepsy: It is usually seen between 7-9 years of age but can be seen before puberty.
Juvenile myoclonic epilepsy: Usually seen between 10 -16 years of age. This condition usually continues into adulthood. They have typical symptoms like increased sensitivity to light as in this type of seizures provoked by flashing lights like by watching television.
Childhood absence epilepsy: Seen as brief and frequent absence seizures. It is seen with loss of consciousness. It is often associated with learning disabilities. This condition can often be seen in puberty.
West syndrome: It is seen in patients aged 4-6 months. It results in lifelong learning disabilities.
Warning signs for patients of epilepsy
- If the seizure lasts more than 5 minutes.
- Breathing or consciousness doesn’t return after the seizure stops.
- If a second seizure follows immediately.
- If a patient has a high fever.
- If a patient has heat exhaustion.
- Epilepsy is seen during pregnancy.
Complications of epilepsy
- Injury can occur to the head or bones during seizures.
- If a person has epilepsy, he is more likely to drown while swimming or bathing as he can have seizures while in the water.
- Car accidents are more common as patients may lose control of cars. He may be unconscious during the drive.
- Anti-epileptic drugs can cause severe birth defects in children.
- Patients of epilepsy have social issues like depression, anxiety.
- They can do suicide.
- Sudden unexplained death in epilepsy (SUDEP)- Its cause is not known.
What to do when a patient has seizures–
- Don’t panic.
- The attendant should note the time when the seizure starts.
- Keep hazardous things away from the reach of the patient, as it may pose a problem.
- If a patient has a convulsive seizure, turn him on his side and cushion his head.
- Remove glasses and loosen tight clothing.
- Do not put anything in the mouth.
- Do not give liquids or medication.
- Do not restrain.
Laboratory investigations:
- Hemoglobin
- Liver function test
- Skull X-ray
- CT scan
- MRI
Homeopathic medicines for managing the cases of epilepsy
Ignatia
This remedy is often in recent cases of epilepsy. It is given when convulsions return at the same hour in the day-time or come at night. These convulsions are of a special type. The patient is silent and in a stupid state. He has jerking of the whole body with partial contraction of one limb. It is given when epilepsy occurs as a result of emotional reasons. The patient feels very weak after the fit.
Dosage: 200 4 pellets to be given 2 times a day, for 10 days.
In case of fits give 1M potency, one dose, and wait till improvement.
Cuprum met
It is given when a patient has epilepsy attacks at night. In this fits return at regular intervals. It is given when seizures begin with a sudden scream. The patient is unconscious with a loss of sensibility and throwing the body upward and forward. seizures start at the fingers or toes or in the arms. The patient feels the coldness of the hands and feet with the paleness of the face. He often has to clench the thumbs with the feeling that he is unable to breathe. It is given in violent cases of seizures where the patient has frequent emission of urine and violent screaming. It is a very good remedy when seizures are seen in children during eruptions of teeth. The patient himself tells about the attack before the attack begins.
Dosage: 200C single dose during seizures to be applied on the forehead followed by an additional dose during each seizure.
Artemisia vulgaris
It is given when the patient is irritable and depressed during the day before a fit at night. The cause of fit is emotions. Fit is seen as a result of fear. It is given when several convulsions come close together and after that patient has a long interval of rest. This fit is followed by sleep. As a result of fits, the patient loses his power of thinking. He feels insensible after the fit. His left pupil is more dilated than the right. It is given when the mouth was drawn to the left with injury marks on the tongue. It is a good remedy when a patient has violent cramps in the abdomen. It is also a good remedy where the patient is unconscious only for a few seconds or minutes and then continues his occupation unconscious of anything unusual had happened.
Dosage: 30 2 times a day for 10 days.
Hydrocyanic acid
It is given in cases where the patient has a sudden complete loss of consciousness and sensation. He is in a coma for several hours. He has occasional sudden convulsive movements. It is given when a patient has confusion of the head and vertigo. This remedy has a violent type of fits where a patient has jaws clenches teeth are firmly set, froth comes from the mouth forming large bubbles. He is unable to swallow. The patient has an involuntary discharge of urine and feces. His upper extremities contracted and his hands clenched. A patient has unusual stiffness of the legs when spasms start in the toes followed by distortion of the eyes towards the right and upward. A patient has violent distortion of the face. It is given when a patient has a great weakness and he does not want to do any work. Fit always preceded by a cry.
Dosage: 30 2 times a day for 10 days.
Calcarea carb
It is given when a patient has an aura with a feeling as if a mouse were running up the arm. It is given when epilepsy begins at the age of puberty. Epilepsy often occurs as a result of irregular menses. It is given to children who play with a penis. It is given when a patient has sudden attacks of vertigo with loss of consciousness. These attacks often come as a result of emotional disturbances. A patient has week memory.
Dosage- 200 4 pellets, 2 times a day for 6 days.