Epilepsy Essay, Research Paper

Epilepsy

In this report I plan to give a general overview of what epilepsy is. I will try to give examples and types of seizures, treatments, and in general some insight into the whole subject matter.

Many people regard epileptic seizures as a disease while, in fact, they are not. A disease rather is more an illness, which tends to imply sickness and being in poor health. Since epilepsy certainly is not that I don t think it has any reference or relativity to the term disease . Since there really is no proper term for epilepsy I find it best to look at it as more a disorder or symptom. A symptom is an event that is just one of the few ways the brain has to reacting to this sudden and unexpected internal process. This continuation of just such a reaction constitutes epilepsy. In more detailed terminology, a seizure is a paroxysmal (sudden unexpected attack or outbreak) discharge of cerebral nerve cells apparent to the person and/or any observer.

With as much we know about epilepsy most of it still remains a mystery. Why do some people develop it just out of the blue? What causes most seizures? Will there ever be a way to completely stop epilepsy? To answer these questions would be difficult, since nobody can. There are many theories, possibilities, and hopes but nobody knows yet if any will come true.

It seems like so few people have epilepsy although that really is not the case. About 2% of the U.S. population has epilepsy with 100,000 new cases emerging each year. Many things can cause a person to develop epilepsy itself. Epilepsy being defined not as single seizure but rather several which do not have any external causes. Some of the common things which cause epilepsy to begin are trauma to the head, brain tumors, genetics, old age, change in hormones (i.e. puberty), degenerative diseases, and any biochemical abnormality. Some of the external sources that will bring on a seizure, which is not necessarily related to epilepsy, are trauma to the head, high fever, alcohol, and drugs. Once someone is actually diagnosed with epilepsy there are some various factors which will lower the seizure threshold, or likeliness of having a seizure. Some of these are trauma to the head, menstruation, lack of sleep, alcohol, stress, drugs, strobe lights or any other flickering lights, lack of blood and/or oxygen to the brain, and missed medication.

Once someone has a seizure doctors need to decide if it was just external causes, if it could be a tumor or, what is most often the case, whether or not there is any explanation. Of course it is relatively easy to determine if it was external causes or not. A doctor would just have to find out if there were any blows to the head, alcohol, drugs, and/or fever involved within the past twenty-four hours preceding the seizure. If not doctors will usually go on to look for a tumor. The easiest way to do this is with a computerized tomography scan or CT scan. If there is no apparent tumor the doctors will usually move on to an EEG, electroencephalograph, in which they hook between sixteen and thirty electrodes to your head and then proceed to measure your brain waves and turn them into little lines on a piece of paper. While doing this they try to provoke a seizure to see if they can pinpoint where it is coming from. If they can get a rough idea they will usually look at your CT scan more thoroughly or do an MRI on you. An MRI, magnetic resonance imaging, is similar to a CT scan but much more detailed. The image shows all various tissues very clearly to look more closely for a tumor and more clearly. They use a giant magnet somehow to take hundreds of pictures that are remarkably thin slices of your brain from all different angles making it much easier to spot any abnormalities. If the doctors have any suspicions about anything on the MRI they will sometimes do a MANSCAN. A MANSCAN is the abbreviation for Mental Activity Network Scanner. It is just like an EEG but with many more electrodes. Instead of 16-20 it has 124, quite a difference. The MANSCAN makes it very easy for somebody to localize exactly where seizures are coming from to see if there is a very small abnormality or tumor in the brain. Most of the time the doctors won t proceed to a MANSCAN unless they feel it necessary. (Either that or the doctors like to upset insurance agencies.)

Once doctors have fully decided that there is not any external cause or tumor, and if the seizures persist, then they will try to determine what kind of seizure it is in order to put you on the correct medication. There are many different medications for epilepsy some of which include (given by commonly known brand or pharmaceutical names) Celontin, Depakene, Depakote, Dilantin, Phenobarbital, Klonipin, Felbatol, Milontin, Mysoline, Lamictal, Neurontin, Pariadione, Peganone, Tegretol, Tranxene, Tridione, Valium, Valrelease, Zarontin, Diamox, Frisium, Rivotril, Clonopil, Diazemuls, Emeside, Mogadon, Gardenal, Luminal, Epanutin, Epilim, Depomide, and Sabril. Since there are so many I m certainly not going to go into any detail about them. With as many medications there are there must be a lot of different types of seizures. Some of the most common are Grand Mal (tonic-clonic), petit mal, atypical absences, clonic, tonic, infantile spasms, and partial. Thankfully 91% of seizures can be classified into one or more of these groups and therefore be successfully treated. Once again, with as many seizures as there are, I m not going to go into any detail about all of them, just one which will be Grand Mal seizures.

Grand Mal seizures, also known as tonic-clonic, are the most common of all seizures. Grand Mal seizures make up 35% of all seizure occurrences. Grand Mal seizures have two stages, the tonic and the clonic. The tonic stage is characterized by tightening of all muscles and the person becoming rigid, stiff, and they will fall to the ground. The clonic phase is characterized by the person having tremors or going into convulsions depending on the individual. Grand Mal seizures involve most or all of the brain.

In general most epilepsy is not dangerous to an epileptic or anyone nearby. Epilepsy cannot be spread unlike a virus or disease. The worst that could happen to an epileptic is if they fell and injured themselves or got into a bad situation. Naturally falling into water or into the street is not safe. Falling in the bathroom you can crack your head open or get a serious concussion. Of course, most the time you can live through any of those scenarios but there is one thing that can happen which is quite detrimental; status epilepticus.

Status epilepticus is the term used to indicate seizures occurring so close together that one seizure runs into another, without recovery of normal cerebral function between seizures. This can be very damaging to the brain and if it continues for more than five minutes without a person regaining consciousness then medical help is needed, and fast. Without ever regaining consciousness that is indicative that the brain just isn t right yet. Status epilepticus is considered a medical emergency and can go on for 30 minutes to hours if left untreated. Regardless of how long it goes on status epilepticus can always be potentially damaging. Status epilepticus can cause brain damage, severe retardation, and sometimes even death. Status epilepticus can be brought about just like the average seizure regardless of type or by an infection of the brain, such as meningitis or encephalitis. The most common cause is an extremely low or sudden drop in the amount of medication in blood level. Thankfully most of the time this can be stopped successfully with a person experiencing no permanent damage.

As with many medical emergencies there is some general first aid that should be followed by somebody witnessing a seizure. Despite the common myth a person will not swallow his or her tongue. Therefore it is not necessary to put any objects in a persons mouth before, during, or after a seizure. By doing so you could cause the person having a seizure to break/crack teeth, bite themselves or you, or dislocate their own jaw. The worst that could probably happen is if when a person began to regain consciousness they choked or suffocated on an object put in their mouth. You also never want to restrain somebody while they are having a seizure, this could sometimes also lead to bone dislocation. You would want to roll a person to his/her side so that any saliva will drain out of the mouth rather than into the back of the throat. If possible put something soft under the persons head such as a coat, pillow, sweater to avoid excessive banging of the head. Clear any sharp, heavy, or potentially dangerous objects within reach of the person away so that no harm can come to somebody by flailing and hitting something. Try to loosen any tight clothing around the persons neck so that breathing will not be impaired. After the seizure stay with the person until they are fully conscious and able to perform normal activities. Try to be comforting and reassuring to the person. Remember, as bad as it may look, there is no reason to call an ambulance unless the seizure persists for five minutes. But most importantly .do not panic!

Many people do not fully understand the effect epilepsy can have on a persons life until it happens to somebody you know or meet. Hopefully one day neurologists will find a cure for epilepsy, it would sure be nice.

Devinsky MD, Orrin. A Guide to Understanding and Living with Epilepsy. Philadelphia, PA. F.A. Davis publishers. 1994

Freeman MD, John M. Vining MD, Eileen P.G. Pillas, Diana J. Seizures and Epilepsy in Childhood: A Guide for Parents. Baltimore, Maryland. The Johns Hopkins University Press. 1990

Hopkins, Anthony. Appleton, Richard. Epilepsy, the Facts. Oxford University Press. 1996