Breaking the Stigma: Understanding Epilepsy, its causes, effects and treatment

Dr. Sowmya M, Senior consultant Neurologist, Aster RV Hospitals

Pune, 20th February 2024: Come February, Epilepsy awareness is planned and observed as International Epilepsy day. The aim is to improve awareness about epilepsy in the general public , reduce stigma related to epilepsy due to the misunderstanding and misconceptions that surround it and provide support to individuals and families living with epilepsy . “Milestones on My Epilepsy Journey”. The theme of International epilepsy day this year , emphasises to highlight personal achievements despite the challenges brought about by the condition.

For the benefit of people who are not clear about Epilepsy, Epilepsy is a neurological disorder that affects the brain, where there is sudden abnormal electrical activity in the brain causing a person to loose control over his body and have a seizure. There are many different types of seizures. There is the major type where a person looses consciousness, falls down and has involuntary jerky movements of the whole body and minor types where they do not lose consciousness completely, may be confused and have partial symptoms depending on the area of brain affected, like simple twitching movements of the face, jerking of one part of the body, visual or hearing symptoms or abnormal feelings. Epilepsy is a condition where a patient has 2 or more recurring seizure without a provoking cause.

In India over 1 crore people are affected with epilepsy , that is 6-10 persons per 1000 but unfortunately a large number of these people do not get access to proper treatment causing major suffering to the patient and the family members.

What are the types of Seizure?

Seizures can vary in type and intensity, Auras or warning signs or sensations which lead to visual disturbances or strange smells, experience temporary confusions, memory loss, or difficulty speaking or understanding language, or uncontrollable movements of the arms, legs, or other parts of the body are all symptoms of an Epileptic attack.

What are the causes of Epilepsy?

Epilepsy has no identifiable cause in about half of the people while in the other half the condition can be due to various causes like genetic influence, developmental conditions. Other causes can be structural problems in the brain like head trauma from accidents or injuries, brain tumour or structural abnormalities in the brain, infections, vascular conditions like stroke , hypoxic injury to brain during birth. Other causes for seizure can be due to effect of illicit drug abuse, excessive alcohol consumption or sudden alcohol withdrawal, low or very high blood sugar levels, low blood sodium levels, high blood creatinine levels which occurs in renal failure and various other causes. It is important to try and identify the underlying cause and receive appropriate treatment.

Effects of Epilepsy

Seizures can result in physical injury due to falls or involuntary movements. This risk of injury may lead to limitations in daily activities and independence. Epilepsy can have psychological effects, including anxiety, depression, and social stigma, which may impact mental well-being and quality of life. Some individuals with epilepsy may experience cognitive impairments, such as memory problems or difficulty concentrating, which can affect academic or occupational performance. In many countries, individuals with epilepsy are subject to driving restrictions due to the risk of seizures while operating a vehicle, which can impact mobility and independence.

Treatments for Epilepsy:

Anti seizure medications have to be appropriately chosen. Antiepileptic drugs (AEDs) are often the first-line treatment for epilepsy. These medications help control seizures by stabilizing electrical activity in the brain. In about 30 % of epilepsies which do not respond to medications, there are alternative modalities of treatment like neuromodulation and epilepsy surgeries. Surgical options include removing the area of the brain responsible for seizures or implanting devices to regulate brain activity. There is also Vagus Nerve Stimulation (VNS) therapy which involves implanting a device that delivers electrical impulses to the vagus nerve, helping to reduce the frequency and severity of seizures. Some individuals with epilepsy may benefit from following a ketogenic diet, which is high in fat and low in carbohydrates. This diet has been shown to help control seizures in some cases, particularly in children. Lifestyle modifications, such as getting adequate sleep, managing stress, and avoiding triggers known to precipitate seizures, can help reduce the frequency and severity of epilepsy episodes.