Epilepsy

Wednesday, September 17, 2008

Epilepsy is a chronic neurological disorder that is characterized by recurrent unprovoked seizures. These seizures are transient signs of abnormal neuronal activity in the brain manifested by clouding of consciousness. Clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, convulsions, muscle spasms, and loss of consciousness.

About 50 million people worldwide have epilepsy at any one time. Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as a group of syndromes with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain.

Epilepsy is a disorder with many possible causes. Anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development - can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, or some combination of these factors. Having a seizure does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. EEGs and brain scans are common diagnostic test for epilepsy.

Treatment: Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 80 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some antiepiletic drugs can interfere with the effectiveness of oral contraceptives. In 1997, the FDA approved the vagus nerve stimulator for use in people with seizures that are not well-controlled by medication.

Prognosis: Most people with epilepsy lead outwardly normal lives. While epilepsy cannot currently be cured, for some people it does eventually go away. Most seizures do not cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems, sometimes the consequence of embarrassment and frustration or bullying, teasing, or avoidance in school and other social setting. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. People with epilepsy are at special risk for two life-threatening conditions: status epilepticus and sudden unexplained death.

Epilepsies are classified in five ways:

A) By their first cause (etiology).

B) By the observable manifestations of the seizures, known as semiology.

C) By the location in the brain where the seizures originate.

D) As a part of discrete, identifiable medical syndromes.

E) By the event that triggers the seizures, as in primary reading epilepsy.


Scientists are studying potential antiepileptic drugs with goal of enhancing treatment for epilepsy. Scientists continue to study how neurotransmitters interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures. One of the most-studied neurotransmitters is GABA, or gamma-aminobutyric acid. Researchers are working to identify genes that may influence epilepsy. This information may allow doctors to prevent epilepsy or to predict which treatments will be most beneficial. Doctors are now experimenting with several new types of therapies for epilepsy, including transplanting fetal pig neurons into the brains of patients to learn whether cell transplants can help control seizures, transplanting stem cells, and using a device that could predict seizures up to 3 minutes before they begin.


Frontal Lobe Epilepsy: Frontal lobe epilepsy is a type of seizure that often goes unnoticed by sufferers. Since the frontal lobe of the brain does not have a known function, seizures that occur within this area generally have mild symptoms. On the other hand, if the seizure spreads to other parts of the brain, the sufferer may experience involuntary body movements or twitches. Epilepsy is a disorder of the nervous system. Individuals who suffer from the condition may have experienced epileptic seizures since childhood, or developed the condition later in life. Because frontal lobe epilepsy can consist of seizures lasting only a few seconds, some sufferers disregard the incidents. During those few seconds, a person may feel slightly dizzy or lightheaded. However, unless a brain scan is preformed, these persons may never be aware of their condition.