Epilepsy is a neurological disorder characterized by a tendency to have recurrent seizures or convulsions. Seizures are characterized by sudden transient changes in motor or behavioral activity or sensory perception due to transient changes in the electrical activity of the brain. Excessive and uncontrolled electrical activity generally reflects changes in the normal functioning of that area of the brain from where the seizure activity started.
Broadly epilepsy is classified into two types, viz, partial and generalized epilepsy. In partial epilepsy, abnormal electrical activity arises and is restricted to a limited area of the brain. It does not involve loss of consciousness. It manifests with changes in activity restricted to part of the body, for example, it may present with repetitive shaking of a hand or leg, repeated twitching on one side of the face, uncontrolled movements of eyes on one side, turning of head on one side of the body with uncontrolled salivation, involuntary lip-smacking, transient memory impairment about an event and so on.
In generalized epilepsy, there is loss of consciousness and involuntary jerking of all four limbs for a short time. Sometimes in generalized epilepsy, there is no limb jerks, but only loss of consciousness. There are various causes for somebody having a tendency for seizures or epilepsy. Some epilepsies are genetically mediated, and so have a tendency to run in families while others may arise due to various reasons like brain prematurity due to premature birth, trauma to the brain, as an effect of high-grade fever, bleeding in the brain, brain inflammation or infections, tumors so on.
Partial and generalized epilepsy events reflect specific changes in certain brain areas on different investigations like electroencephalogram and MRI of the brain.
Epilepsy management can be broadly divided into 3 parts viz, Medicinal management, Diet therapy, and surgical treatment. There are at least 30 antiepileptic medications available today and they vary in the type of epilepsy they are effective for, the side effect profile, and cost. They may be used as a single agent or in combination with other antiepileptic medications. Duration of treatment varies according to epilepsy type. The ketogenic diet and modified Atkins diet are dietary therapies suggested mostly in combination with medications in difficult-to-treat epilepsies. Approximately 25-30% of epilepsies are refractory to drugs and might benefit from surgical treatment options.
Pregnancy poses a particular challenge in epilepsy management since most of the available anti-epileptic medications can pose a threat to the developing fetus. Ideal epilepsy management in pregnancy should involve preconceptionally counseling the potential mother regarding the effect of epilepsy on motherhood and fetus, selecting the proper anti-epileptic drug causing the least threat to the fetus and being effective in seizure control as well. Therapeutic drug level monitoring with respect to maternal weight changes in pregnancy and physiological changes in the volume of drug distribution in the body and Monitoring the fetal development, Levetiracetam, and Lamotrigine are the safest drug options in pregnancy as noted by various pregnancy registries worldwide.
If you are suffering from migraine or headache problems, don't hesitate to consult the specialist neurologist at Dr Rami Hamed Center. The hospital is situated nearby Dubai Healthcare City. For Appointments, Call +97142798200
