Epilepsy: A Spectrum Disorder

Epilepsy is a neurological condition characterized by recurrence seizures, which are brief and involuntary episodes of movements. Pharmacological intervention forms the basis of the epilepsy treatment process as it helps in reducing the seizure frequency and mitigating the severity of seizures. However, factors such as lack of sleep, stress, or anxiety greatly contribute to seizure frequency and severity as well, thus complementary therapies are gaining popularity to assist in addressing the multidimensional aspects of the patient suffering from epilepsy. Epilepsy is an incurable disease which can be managed with proper medication and treatment, among which ASM or anti-seizure medication has helped 70% of people with Epilepsy to gain good controls over their seizures. 

What are the treatments for Epilepsy?

Epilepsy can’t be cured but managed through medication. ASM is taken regularly to control and reduce excessive electrical activity to the brain and regulates seizures. Buccal training, also known as Buccal Midazolam training, refers to the proper administration of Midazolam delivered through the inner lining of cheek. It is commonly used in emergency situations to stop or control seizures that exceed more than 5minutes or recurrent seizure without recovery in between, known as status epilepticus. The training typically covers various aspects, including understanding the appropriate dose, the correct administration technique, and recognizing potential side effects. Buccal training is important for health care workers, as it can drastically reduce the potential danger caused by the prolonged seizures. Buccal training for Epilepsy covers necessary instructions on:

• Understanding epilepsy – causes, types, symptoms, impact of the neurological condition and understanding what an Epilepsy patient experiences.
• Administering buccal midazolam – locating buccal cavity to administrate medication ensuring proper absorption.
• Using equipment/supplies – getting familiar with medication formulation, dosage, delivery devices.
• Post-administration care – Trainees learn how to monitor and manage the side effects, ensuring the well-being and safety of the patient.
• The training emphasizes creating epilepsy awareness and a supportive environment for patients with the condition.

Warning Signs of Seizures

There are several warning signs for a seizure and early recognition can ensure the safety of the individual with Epilepsy. From subtle staring spells to dramatic convulsions, the spectrum of seizure signs reflects the complexity of this condition. Let’s discuss two major symptoms of seizures:

General Onset Seizure

Seizure affects all parts of the brain at the same time. There are six types of seizure that come under this category.

Absence Seizure:

These hallucinations are usually of short duration, lasting less than thirty seconds, and are characterized by staring spells, blank expressions, and temporary lack of responsiveness. For instance, they can have flashing eyes, tiny movements of the lips or hand, or they may just pause for a short time. Although they may appear not as severe as prolonged absent seizures, these types of seizures can interfere with overall thinking, learning, and daily activities particularly for children and teenagers.

Atonic and Tonic Seizure:

Drop attacks or atonic seizures result in a surprising decrease in muscle control or a loss of muscle strength, as a result the person might drop or fall quite unexpectedly. 

Tonic seizures, on the other hand, involve stiffening of the muscles in the body, arms, legs, or any part of that body. The rigidness can cause collapse of the whole body.

Myoclonic Seizure: 

Myoclonic seizures are marked by the short and shock-like muscle jerks and twitches with the arms, legs and sometimes the entire body involved. These seizures can come as an individual incident or as a cluster, and even though they may seem not serious, they can still cause injury if they happen during activities like walking or climbing a staircase.

Clonic Seizure: 

Clonic or clonus means fast repetition of muscle stiffening and relaxing. It happens when muscle suddenly becomes rigid after a few seconds of jerking or lose control after few second of stiffening.

Tonic-Clonic Seizure:

Those episodes usually begin with a sudden loss of consciousness and are followed by a tonic stage where the body stiffens, and a clonic phase, where there are movements of arms, legs and body, involving jerking. The person can then bite the tongue, lose bladder control and have irregular or temporary breathing.

Focal onset Seizure

Focal seizures, formerly referred to as partial seizures, start in certain parts of the brain, with different signs depending on the area of the brain that’s affected. These seizures may appear as repetitive movements or postures (e.g. lip-smacking, hand motions etc.), or they may lead to unusual feelings like tingling, dizziness, or a sense of déjà vu. In others, they may cause semi-consciousness, confusion, staring, or a loss of response. Often, the patient might experience uncontrollable jerking of a part of their body. This indicates seizures occurring in one region. There are two types of focal seizure.

Focal onset aware seizure:

During this seizure you are aware of your surroundings and can feel change in how things taste, smell, feel or sound. You can experience uncontrollable jerking movements, flashing lights, feel dizzy or have a tingling sensation.

Focal onset impaired awareness seizure:

Once known as complex partial seizure results in loss of consciousness. A person can experience

• Blank stare or a “staring into space.”
• Repetitive movements like eye blinking, lip-smacking or chewing motion, hand rubbing or finger motions.

What causes Epilepsy?

Some epilepsy cases are idiopathic, the cause is unknown, while others are symptomatic from a brain structural or metabolic disorder. Symptomatic epilepsies may result from factors such as genetic mutations, developmental disorders, brain damage, tumors, stroke, infections, and degenerative conditions. Abnormalities that are detected from birth are most cases of epilepsy, which can’t be controlled with anti- seizure medications. Some birth abnormalities known to cause epilepsy include focal cortical dysplasia, polymicrogyria and tuberous sclerosis. There’s a wide range of other brain malformations known to cause epilepsy.

Conclusion

Epilepsy is a wide spectrum of disease which ranges from different types of seizures to its cause and severity. Early recognition of the symptoms is crucial for accurate diagnosis, personalized treatment options and comprehensive care which can result in controlled and decrease occurrence of seizures. Through educating and organizing awareness campaigns, we can strive to improve the quality of life for those affected by epilepsy and promote a more inclusive and understanding society.