Epilepsy: Symptoms, treatment, when to consider surgery for this brain disease

Updated on Feb 13, 2022 07:12 PM IST

Epilepsy is a brain disease where the brain circuits have abnormal firing. Know all about its causes, common symptoms, treatment and when should you consider surgery for it, as revealed by the doctors

Epilepsy: Symptoms, treatment, when to consider surgery for this brain disease  (Pixabay)
Epilepsy: Symptoms, treatment, when to consider surgery for this brain disease  (Pixabay)
ByZarafshan Shiraz, Delhi

One of the most common neurological diseases globally, epilepsy is a chronic noncommunicable disease of the brain that affects around 50 million people worldwide. According to the World Health Organization, epilepsy is not contagious and even though many underlying disease mechanisms can lead to epilepsy, the cause of the disease is still unknown in about 50% of cases globally.

The stigma associated with epilepsy results in patients don't disclosing it as driving licenses and jobs are not given, marriage is not easy which amounts to the challenges that patients face. Know all about its causes, common symptoms, treatment and when should you consider surgery for this brain disease, as revealed by the doctors.

Causes:

In an interview with HT Lifestyle, Dr Atma Ram Bansal, Associate Director - Epilepsy Programme at Institute of Neurosciences in Medanta Hospital explained, “Epilepsy is a brain disease where the brain circuits have abnormal firing. This results in multiple symptoms of seizures, convulsions. It is caused by multiple reasons depending on the age of the person - in a new born, it can be due to a birth defect or an oxygen problem during delivery. In the slightly elder age group, it can be because of head injury or infection and at times it might be also due to a brain tumour.”

Symptoms:

Dr Atma Ram Bansal listed the common symptom of epilepsy as fits, which means jerking in the body, a person becoming episodically unresponsive like a statue, may show some chewing kind of movements, rubbing hands for 2 mins, confusion and sudden jerks in the body to the extent that they drop objects or fall especially during the morning.

Epilepsy can develop at 5 to 15 years of age and then post 70 to 80 years. By birth, it is in just five to ten percent but there are different types of epilepsy, some which doesn’t need any treatment at all and some where patients get fits only while sleeping with mild jerks.

Treatment:

Normally, 60-70% of epilepsy are treatable with the help of medicines. The patient must take medicine for 2-3 years depending upon the type of epilepsy. In some patients, we need to give medicines for lifelong as well and in some cases, when the patient doesn’t respond to medications, we may have to perform surgery,” informed Dr Atma Ram Bansal.

He added, that though there are no good references for food for epilepsy patients, a healthy diet is okay while too many carbs can be avoided. He revealed, “It can be treated or cured easily. 75 percent have a very good response to the medications and the rest can be treated with surgery.”

When should you consider surgery for epilepsy?

Dr. Atma Ram Bansal said, “If a patient doesn’t respond to medicines for 1-2 years and gets fits daily, every week, every month, every alternate month as well, the doctor may advise you to go for surgery depending upon your condition. Surgery is done in a very special type of epilepsy - where we need to find the root cause and which involves investigations like special video EG, special MRI and various other tests and then we find the reasons for epilepsy and that point is removed.”

Dr Khusbu Goel, Consultant Neurologist at HCMCT Manipal Hospital Dwarka, revealed, “We prefer first to treat with epilepsy medicine and when the patient has been given at least two or three medicines and they are not responding even after giving them appropriately chosen drugs and adequate trial have been done, we label them as drug-resistant epilepsy. We evaluate why the patient is drug-resistant and sometimes there are lesions inside the brain."

She added, "In such cases, removal of these lesions can help the patients. There are few patients whose drug resistance and the brain is normal. Even in that case, we do the pre-surgical evaluation where we try to look for the legion with Video EEG and migraine electrode mapping. We localize the area and focal cortical extension helps in this. We first try the medicines because surgeries have their own pros and cons but in those cases where the medical trial has been given appropriately but the patient is not responding, we send the patient for surgery.”

 

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