Navigating the Struggles of Life with Epilepsy

Epilepsy is a neurological condition characterised by recurrent seizures caused by abnormal electrical activity in the brain. It transcends age, gender, and cultural boundaries, affecting millions worldwide, yet, it remains one of the most misunderstood and stigmatised conditions.

These seizures can vary in type, duration, and intensity. They are the result of sudden, excessive electrical discharges in the brain, leading to a wide range of symptoms, from momentary loss of awareness to convulsions and loss of consciousness. There are many different types of seizures, but they generally fall into two main categories — Focal Seizures or Partial Seizures that originate in one specific area of the brain and can affect an individual's awareness and behaviour, or Generalised Seizures: These seizures affect the entire brain and are typically characterised by a loss of consciousness.

Some people lose consciousness during a seizure, whereas others do not. During a seizure, some people will look blankly for a few seconds. Others may repeatedly twitch their arms or legs, a condition known as convulsions or spasms. A single seizure does not indicate epilepsy. Epilepsy is diagnosed when you have at least two unprovoked seizures that are at least 24 hours apart. The aetiology of unprovoked seizures is unknown. In conjunction with Epilepsy Awareness Month, we dive into all you need to know about epilepsy and the struggles.

Seizure symptoms may include the following:

Temporary confusion.
A staring spell.
Stiff muscles.
Jerking movements of the arms and legs that are uncontrollable.
Loss of consciousness or awareness.
Fear, anxiety, or a sense of déjà vu are examples of psychological symptoms.

People suffering from epilepsy may experience behavioural changes from time to time. They may also exhibit psychotic symptoms. Most persons who suffer epilepsy have the same type of seizure every time. Symptoms are typically consistent from episode to episode.

Indications of seizures

Some persons who have focused seizures notice warning symptoms before the seizure occurs. These warning indicators are known as auras. They could include a stomach ache. They could also include an emotion, such as fear. Some people may experience déjà vu. Aura can also be a taste or odour, or could even be visual, such as a steady or flashing light, a hue, or a shape. Some persons may develop dizziness and loss of balance, while others may experience hallucinations, which are visions of things that aren't there. Seizures are defined as either focal or generalised based on how and where the brain activity that causes the seizure begins.

When seizures appear to be caused by activity in only one part of the brain, they are referred to as focal seizures. These seizures are classified into two types:

Focal seizures without loss of consciousness. These seizures, formerly known as simple partial seizures, do not result in loss of consciousness. They may modify emotions or change the appearance, smell, feel, taste, or sound of things. Some people have déjà vu. This type of seizure may also include involuntary jerking of one body part, such as an arm or a leg, as well as sudden sensory symptoms like tingling, dizziness, and flashing lights.
Focal seizures with impaired awareness. These seizures, formerly known as complex partial seizures, include a change or loss of consciousness or awareness. This type of seizure may appear to be a dream. People may look into space and not respond to their surroundings in conventional ways during a focal seizure with diminished consciousness. They may also engage in repeated activities like hand rubbing, eating, swallowing, or pacing in circles.

The symptoms of focal seizures can be mistaken for those of other neurological illnesses such as migraine, narcolepsy, or mental illness. To identify epilepsy from other illnesses, a thorough examination and testing is required.

Types of focal seizures include:

Frontal lobe seizures. Seizures in the frontal lobe begin in the front of the brain. This is the area of the brain that regulates movement. People with frontal lobe seizures move their heads and eyes to one side. When spoken to, they will not answer and may yell or laugh. They may extend one arm while flexing the other. They may also perform repetitive activities such as rocking or cycling.
Temporal lobe seizures. Seizures in the temporal lobes begin in the brain's temporal lobes. The temporal lobes are responsible for emotion processing and short-term memory. Auras are common in those who suffer these seizures. The aura can include unexpected emotions like dread or joy, a sudden flavour or scent, a sense of deja vu, or a rising sensation in the stomach. People may lose awareness of their surroundings, look into space, smack their lips, swallow or chew repeatedly, or have strange finger movements during a seizure.
Occipital lobe seizures. The occipital lobe of the brain is where these seizures originate. This lobe has an impact on vision and how people view. People experiencing this sort of seizure may have hallucinations. Alternatively, patients could lose some or all of their vision during the seizure. These convulsions may also produce eye blinking or movement.

Generalised seizures

Generalised seizures are seizures that appear to include all parts of the brain. Seizures that are widespread include:

Absence seizures. Children are more prone to absence seizures, also known as petit mal seizures. Staring into space, with or without slight body movements, is one of the symptoms. It may include movements that last 5 to 10 seconds like eye blinking or mouth smacking. These seizures can occur in clusters, up to 100 times each day, and cause a momentary loss of consciousness.
Tonic seizures. Tonic convulsions produce muscle stiffness and may impair consciousness. These convulsions typically affect the muscles of the back, arms, and legs, and can result in falls to the ground.
Atonic seizures. Muscle control is lost during atonic seizures, commonly known as drop seizures. Because this usually affects the legs, it frequently results in rapid collapse or falls to the ground.
Clonic seizures. Clonic seizures are characterised by recurrent or rhythmic jerking muscle movements. These seizures typically involve the neck, face, and arms.
Myoclonic seizures. Myoclonic seizures are characterised by quick, short jerks or twitches that affect the upper torso, arms, and legs.
Tonic-clonic seizures. Tonic-clonic seizures, often known as grand mal seizures, are the most severe type of epileptic seizure. They can cause a sudden loss of consciousness as well as muscle stiffness, twitching, and shaking. They can sometimes cause lack of bladder control or tongue biting.

When to seek medical help

Seek emergency medical attention if any of the following events occur:

The seizure continues for more than five minutes.
After the seizure has ended, neither breathing nor consciousness return.
A second seizure follows immediately.
You have a high fever.
You're pregnant.
You have diabetes.
You hurt yourself during the seizure.
You continue to suffer seizures despite using anti-seizure medication.

Consult a medical professional if you experience a seizure for the first time.

Causes

In nearly half of those who suffer from epilepsy, there is no known aetiology. In the other half, the disease could be attributed to a variety of circumstances, including:

Genetic influence. Some types of epilepsy are inherited. In these cases, there is most certainly a hereditary component. Some varieties of epilepsy have been linked to specific genes, according to researchers. However, some people have familial genetic epilepsy. Genetic alterations in a child can develop without being passed down from a parent. Genes are only a small component of the causation of epilepsy in most people. Certain genes may make a person more susceptible to environmental factors that cause seizures.
Head trauma. Head trauma from a car accident or other severe event might result in epilepsy.
Factors in the brain. Epilepsy can be caused by brain tumours. Epilepsy may also be caused by the formation of blood vessels in the brain. Seizures can occur in people with blood vessel disorders such as arteriovenous malformations and cavernous malformations. Stroke is also a prominent cause of epilepsy in persons over the age of
Infections. Meningitis, HIV, viral encephalitis and some parasitic infections can cause epilepsy.
Injury before birth. Babies are vulnerable to brain injury before birth, which can be caused by a variety of reasons. They could include a mother's illness, inadequate nourishment, or oxygen deficiency. Epilepsy or cerebral palsy can develop from brain injury.
Developmental disorders. Epilepsy can occur in conjunction with developmental problems. People with autism are more likely than people without autism to have seizures. People with epilepsy are also more likely to have other developmental abnormalities such as attention-deficit/hyperactivity disorder (ADHD), according to research. Both problems may be linked to genes that are implicated in both epilepsy and developmental abnormalities.

Risk factors

Certain things may raise your chances of developing epilepsy:

Age. Epilepsy is most frequent in children and older adults, but it can strike anyone at any age.
Family history. If you have a family history of epilepsy, you may be at a higher risk of getting a seizure disorder.
Head injuries. Some cases of epilepsy are caused by head injuries. Wearing a seat belt while driving and a helmet while bicycling, skiing, riding a motorbike, or participating in other sports with a high risk of head injury can lower your risk.
Stroke and other vascular diseases. Strokes and other blood vessel complications can damage the brain. Seizures and epilepsy can be triggered by brain injury. You can minimise your risk of these diseases by reducing your alcohol intake and avoiding cigarettes, eating a nutritious diet, and exercising regularly.
Dementia. In elderly persons, dementia can raise the risk of epilepsy.
Brain infections. Infections that produce inflammation in the brain or spinal cord, such as meningitis, can raise your risk.
Seizures in childhood. Seizures are sometimes related with high fevers in children. Children who have seizures as a result of high fevers are unlikely to acquire epilepsy. If a kid experiences a long fever-related seizure, another nervous system illness, or a family history of epilepsy, the chance of epilepsy increases.

Complications

Having a seizure at specific times can result in situations that are hazardous to yourself or others.

Falling. You could damage your skull or break a bone if you fall during a seizure.
Drowning. Because of the risk of having a seizure while swimming or bathing, people with epilepsy are 13 to 19 times more likely to drown than the general population.
Car accidents. A seizure that causes lack of awareness or control can be harmful if you're driving a car or running other machinery. Many countries impose driver's licence limits based on a driver's capacity to control seizures. In these states, a motorist must be seizure-free for a certain period of time, ranging from months to years, before being authorised to drive.
Problems with sleep. People with epilepsy are more likely to experience sleep issues, such as difficulty falling or staying asleep, which is known as insomnia.
Pregnancy complications. Seizures during pregnancy endanger both the mother and the foetus, and certain anti-epileptic medications increase the chance of birth abnormalities. If you have epilepsy and are considering becoming pregnant, seek medical advice while you plan your pregnancy. Most women with epilepsy can become pregnant and have healthy babies. Throughout your pregnancy, you'll need to be closely checked, and your medications may need to be modified. It is critical that you collaborate with your health care provider to plan your pregnancy.
Memory problems. Some types of epilepsy cause memory issues.

Emotional health problems

People suffering with epilepsy are more likely to suffer from psychological issues. Problems may arise as a result of dealing with the condition or as a result of medication side effects. However, even patients with well-controlled epilepsy are at danger. People with epilepsy may experience the following emotional health issues:

Depression.
Anxiety
Suicidal thoughts and behaviours.

Other life-threatening complications of epilepsy are rare, but they can occur. These are some examples:

Status epilepticus. This condition develops when you are in a state of continuous seizure activity for more than five minutes or if you have frequent recurrent seizures without regaining full consciousness in between them. People who suffer status epilepticus are at a higher risk of lifelong brain injury and death.
Sudden unexpected death in epilepsy (SUDEP). People who have epilepsy are also at risk of dying suddenly and unexpectedly. The origin is unknown, but some study suggests that it could be caused by cardiac or respiratory problems. People who have frequent tonic-clonic seizures or whose seizures are not controlled by medications may be at a higher risk of SUDEP. SUDEP kills around 1% of all epileptics. It is especially common in those with severe epilepsy who do not respond to treatment.