Epilepsy is a disorder that occurs due to electrochemical dysfunction in the brain . It is commonly known as “Fits”. Fits are one of the common Neurological problems that affects 100/100000 and 5 % of people will experience seizure at least once in their life time.
Primarily every single neuron in the brain continuously discharges electrical signals. These signals travel through the nerve fibers to reach various parts of the body.
Through this electro chemical interaction brain is able to control every single activity including the thoughts and behavioural processes of the human body.
It is not surprising that an electrical upsurge can happen any time similar to the process of a “short circuit” that can shut down the normal process temporarily.
This usually manifest as sudden cry with loss of consciousness associated with jerky movements of the limbs followed by gradual recovery.
There are several varieties of fits, each one is different by nature and manifestations . In most situations it is difficult to pin point the exact cause of electrical disturbance they are grouped as “Idiopathic epilepsy”.
Where as in situations like brain scars following an injury , brain tumor , stroke, epilepsy can be a warning sign or an indicator of the underlying brain disease.
Therefore every single epilepsy need to be evaluated by a Neurologist to identify the type , pattern and to decide the treatment modalities.
Unfortunately the myths and the social taboo associated with epilepsy continues despite the increasing awareness and the knowledge about the current science.
Over the years a variety antiepileptic drugs which can control these attacks effectively have been developed. They act like spike arrestor and suppress all the abnormal electrical discharges in the brain and with time modulation the abnormality completely disappears.
Till such time it is mandatory to continue the drugs without fail. The compliance from the patient is so very important that irregular treatment can not only prolong the duration of the illness but can also make the epilepsy refractory to medical treatment.
The belief that drugs are like sleeping pills and they harm the brain function is not true. The benefit of controlling seizure is far superior than the side effects they produce.
Therefore these drugs have to titrated by Epileptologist to suit the individual requirements and to protect the brain functions. Uncontrolled epilepsy can lead to progressive brain damage.
In addition they make them susceptible for unprotected falls leading to injuries like (fractures or shoulder dislocations) and make them prone for accidents or a disc prolapse.
In spite of adequate medical treatment 1/3rd of epileptics do not respond and continued to have attacks ( Refractory epilepsy).
They require careful evaluation by a team to identify right modality of management including surgery.
The epilepsy surgery is primarily directed to remove the abnormal electrogenic area of the brain (FOCUS). If there is an underlying disease like a tumor, it may require surgery.
If the focus is not identified surgery can be directed to prevention of spread of the abnormal electrical activity within the brain which can minimize the severity of attacks.
Stereotaxy, deep brain stimulation and vagal nerve stimulation are some of the palliative procedures. Accurate diagnosis can be made with Electroencephalogram, Video EEG, depth electrode study, electro corticography, brain mapping and MRI.
Comprehensive Epilepsy Care Clinics are very few in our country despite the magnitude of the problem. BGS Global Hospital offers one such state of the art comprehensive Clinic for epileptics with a dedicated team which offers diagnostics, medical management, surgical treatment and supportive therapies.
Dr. N. K. Venkataramana
Chief Neurosurgeon
Vice Chairman-BGS Global Hospitals
BGS Health and Education City, # 67,
Uttarahalli Road, Kengeri, Bangalore – 560 060
UM– USEKE.RW
