Epilepsy is a neurological condition that leads to recurrent seizures. Seizures arise when electrical activity in the brain suddenly surges causing a temporary disturbance within the messaging systems located between the brain cells.

Epilepsy is more common in children below the age of two years and adults above the age of 65 years.

Seizure Types

Seizures are classified into two main categories depending on their area of impact. 

A focal seizure is one that affects only one part or area of the brain whereas a generalised seizure affects the whole brain. Further, both focal and generalised seizures have various sub-categories which are as follows-

Previous nomenclature- 

Partial Seizure

  Simple Partial Seizure
  Complex Partial Seizure
  Partial Seizure with Secondary Generalization

Generalized Seizure

  Absence Seizures
  Myoclonic Seizure
  Atonic Seizure
  Tonic Seizure
  Tonic-clonic Seizure
  Mixed Seizure
  Status Epilepticus

Latest nomenclature of seizure types:

Focal seizures-

  Focal aware seizures
  Focal impaired awareness seizures (previously called complex partial seizures)
. Bilateral tonic clonic seizures

Generalised onset seizures-

  Tonic clonic seizures.
  Atonic seizures (sometimes called drop attacks) and tonic seizure.
  Myoclonic seizures.
  Absence seizures.

Symptoms

The well know symptom of epilepsy is a convulsion/ fit, a few other symptoms include-

  Intermittent spells of fainting. When this happens the patient is likely to lose control of his/her bladder or bowel movements. Following this, the person is likely to suffer from extreme tiredness.
  Spells of a blackout with difficulty in remembering
  Becoming unresponsive to any instructions or questions asked during brief periods of time
  Bouts of continuous blinking without any known reason
  Inappropriate movements that keep on occurring
  Changes in sensory perceptions
  Sudden stiffness in the body

Reasons for Epilepsy

Messaging systems within the brain are responsible for every function that goes about in your body. A disruption to this system caused by defective electrical activity leads to epilepsy in a person. Many people inherit epilepsy while others may develop this condition as a result of-

  Head trauma sustained during an accident
  A stroke or a tumour that has affected the brain impairing its normal capabilities
  An injury to the brain before or during birth
  Associated with developmental issues
  Infections of the brain

Treatment for Epilepsy

Epilepsy in childhood can be treated by using medications and by adopting dietary changes in some cases. Medications for epilepsy mainly include-

  Anticonvulsants - Helps control seizures and manages the symptoms of epilepsy
  Medications for nerve pain - Reduce pain that is caused by the damaged nerves

These medications should be consumed as and when prescribed by the doctor. You must consult a paediatrician for this, as he/she will take your child s physical and mental in consideration before starting the treatment.

Seizures that occur in childhood may be benign. This means that it will not continue into one s adult life. Further, those children who have suffered from epilepsy in their childhood have been seen to have normal mental and intellectual development in their adulthood. However, some epilepsy syndromes in children can have a devastating effect on the child.

Seizure threshold is a term that is used to refer to the conditions that are important for the production of seizures. The threshold is lower for people who are more prone to having seizures whereas the threshold is higher for those who do not have a tendency to suffer from seizures.

A Complete Guide To Childhood Epilepsy!

Epilepsy is one of the most common neurological disorders. This condition can affect men and women of all ages. However, it is associated with a number of myths. As a result of these myths, epileptic patients are often discriminated against. Let s bust a few of these myths.

Myth 1: Epilepsy is contagious
Coming in contact with an epileptic patient will not increase your risk of suffering from this condition. Epilepsy can be caused by a number of factors but is not transferable from one person to another. Factors triggering epilepsy include genetic defects, oxygen deprivation at birth, trauma to the head and strokes.

Myth 2: Epilepsy cannot be treated
There is no known cure for epilepsy but this condition can be managed with treatment. Treatment for epilepsy can take many forms. The most common amongst these is medication to reduce and stop seizures. In some cases, brain surgery may also be advised. A special diet can also help control epileptic attacks. Lastly, nerve stimulation may also be used to treat epilepsy.

Myth 3: Epileptic patients cannot lead a normal life
There is nothing stopping an epileptic patient from living a normal life like everyone else. Epilepsy does not affect a person s intelligence or any other ability. It is also a misconception that epileptic women cannot have children or that their children will also have epilepsy. With treatment and a healthy prenatal plan, they can have a healthy pregnancy and give birth to a healthy child. However, certain activities like driving should be avoided by epileptic patients.

Myth 4: A person having an epileptic fit should be restrained
An epileptic seizure will run its course and restraining the person may do more harm than good. Instead, the person should be made to lie down on their side. This will keep saliva from collecting in their mouth. Clear the area around the person and loosen their clothing. If the person wears spectacles, these should be removed. Do not try and put anything into the person s mouth. An epileptic fit usually lasts for up to 5 minutes. If the person does not recover within that time, call a doctor immediately.

Myth 5: Anyone who has a seizure is epileptic
Seizures are not synonymous with epilepsy. They can be triggered by a number of factors including excessive drinking, heat, injury to the head etc. To be diagnosed with epilepsy, a person should have had two or more seizures with unrelated triggers. 

Myths About Seizures - Debunked!

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

Women are not really sure about frozen embryos  ability to result in pregnancy. Ironically, the success of Frozen Embryo Transfer has dramatically improved over the last few years. In the days gone by, the chance of women getting pregnant through the use of frozen embryos seemed to be on the lower side compared to that from the transfer of fresh embryos. Recent data related to this suggests that this is no longer the case.

Reasons behind the low success rate of frozen embryo transfer in the past
Previously during the frozen embryo transfer process, the embryos which had to get frozen were the ones that did not get chosen for the fresh embryo transfer initially. The reason being that the embryologist had gone ahead to choose the best possible embryos for getting them transferred initially. As far as the fresh embryo transfer is concerned, quality of embryo has got a major effect on the chance of a woman getting pregnant. On the other hand, if quality of embryos frozen is not good, the rate of survival after it gets thawed along with the rate of pregnancy would be on the lower side.

The second important reason is the amount of embryos that got transferred. Let us consider a couple who produce four very good quality embryos. Two of them are transferred during fresh In Vitro Fertilization Process and the remaining two are frozen. This leads to pregnancy and the woman gives birth to a baby. Later on, the couple once again decides to go for pregnancy by using the frozen embryos. Though only one embryo survives after getting thawed. The frozen embryo transfer is that of a single embryo. The success rate of a frozen embryo transfer through a single embryo is always going to be on the lower side than what it will be when multiple embryo transfer is involved.

Finally the method of freezing embryos has seen a sea change quite a number of years ago. Nowadays the freezing of embryos takes place by a fast method, known as vitrification. This process has got a much better survival rate when embryos get thawed along with good rates of pregnancy when those particular embryos are transferred in a much better manner.

Studies about high success rate of frozen embryo transfer
There have been studies performed in women, who have had quite a vigorous stimulation of their ovaries and were considered to be at high risk for Ovarian Hyperstimulation Syndrome. The physicians took the decision of skipping the process of embryo transfer and instead go ahead to freeze all the embryos for use at a later stage.

This tends to significantly decrease the risk of having serious Ovarian Hyperstimulation Syndrome along with decrease in complications. Other cases involved, physicians deciding to move on with a fresh embryo transfer depite the risk of Ovarian Hyperstimulation Syndrome. In both the scenarios the couples have quite a large number of embryos and the embryos selected for transfer were the best embryos.

The studies have shown no difference in the rates of pregnancy between fresh or frozen embryos or for that matter higher rate of pregnancy with frozen embryos.

How Successful Is Frozen Embryo Transfer?

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Autism is a developmental disorder that is usually diagnosed within the first three years of a child s life. Speech disorders and an inability to communicate with others are characteristic symptoms of autism. Speech therapy can be very beneficial for such children. Thus, it is often a major part of a treatment plan for autism. Some of the benefits of speech therapy for autistic children include:

Better articulation: Autistic children often find it hard to make certain sounds. Hence, they tend to babble or make harsh sounds or grunt instead of talking. A speech therapist can help the child learn to articulate sounds in a better way. For this, the therapist will help the child exercise the facial muscles and lips. This can make it easier for them to be understood by others.
Treating echolalia: Echolalia refers to a child s behaviour where he or she answers a question by repeating part of it. This may be because they find it difficult to express their own thoughts and feelings. Echolalia is very common amongst autistic children. Speech therapy is the only way to treat this condition. If left untreated, it could make the child withdraw into himself.
Better vocabulary: Autistic children often memorize words without understanding them. A speech therapist can help the child put words into context and thus help reduce their dependence on gestures. This can also make autistic children more confident. In addition to expanding their vocabulary, a therapist can also teach children the proper time and place for communication. For example, when to say good morning and good evening.
Initiate communication: When children are not confident of expressing themselves, they wait to be called on before saying anything. By helping them articulate sounds better and expanding their vocabulary, a speech therapist can help children gain the confidence needed to initiate conversations. With therapy, autistic children can also follow simple instructions and begin to answer questions independently. This will make them more independent.
Speech therapy does not follow the same techniques for all children. For therapy to be effective, the therapist must work in close collaboration with the child s parents and caregivers to set the right goals and monitor the child s progress. Some of the techniques that may be used include the use of electronic talkers, typing or signing, picture boards, facial exercise and massages, using rhyme to help construct sentences and using sounds to help the child expand speech sounds. If the child is non-verbal, the therapist may also introduce alternatives to verbal communication.

Can Speech Therapy Help Autistic Children?

Don't wait any longer, manage your Vascular Neurologist online with a Lybrate doctor today

Consult for Vascular Neurologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES