Fits And Epilepsy: A Guide To Treatment And Diagnosis

By Shekhar Singh

Epilepsy is a condition well-known for centuries. Maybe you recognize it by its more common name 'fits'. No matter what name you use, epilepsy is a condition that affects the lives of millions of people all over the world. It is the most common neurological condition. It is estimated that 1-3% of the global population is affected by seizures, with men being more likely to have epilepsy than women.

Epilepsy is a neurological condition characterized by abnormal electrical activity in the brain. This abnormal electrical activity results in convulsions or fits. The most recognizable type of convulsion is one in which the person experiences rapid and violent jerking movements of the body. However, there are many other types of fits or convulsions that do not look like this and may sometimes be so small or so fast that even the patient does not notice them. Convulsions can be very varied and are different from person to person and sometimes varies in the same person at different times.

Epilepsy can affect anyone at any point in their lives. Contrary to popular belief, epilepsy does not mean that a person is incapable or mentally comprised. A seizure or fit generally lasts for less than a minute. If a person has a seizure for more than five minutes or if they remain unconscious for a prolonged period of time after the fit has stopped, call for emergency services.

How Is Epilepsy Diagnosed?

For a diagnosis of epilepsy to be made, a person must experience two or more unprovoked seizures. For a seizure to be called unprovoked, it means that there should be no environmental or detectable cause of the seizure such as overdose, hypoxia, infections, etc. A neurologist will diagnose epilepsy based on a thorough medical examination and medical history. It is important to be as honest as possible about symptoms so that you can receive an accurate diagnosis.

A neurological examination is a way to test for the motor, sensory, balance, mental functions, and other higher brain functions. A doctor may also ask for certain blood tests to paint a clearer picture of the situation and rule out other conditions. Neurophysiological tests such as an electroencephalogram (EEG) and imaging tests such as MRI help in the diagnosis of epilepsy and convulsions.

An electroencephalogram (EEG) measures the electrical activity of the brain. Metal electrodes covered with a conductive gel are placed over the scalp and these measure the electrical potentials generated by neurons in the brain. This is a painless procedure that can provide valuable insights into the functioning of the brain. This is the most commonly used test for epilepsy. If a person experience fits or convulsions, there is an electrical disturbance in the brain that can be detected with an EEG. By studying the patterns and types of abnormalities seen in the EEG, a specialist can determine the type of epilepsy. This will dictate further treatment and prognosis for the patient.

Imaging tests like CT and MRI help in visualizing the brain structure. This helps in detecting any structural damage or abnormalities that may be causing the fits.

Treatment Of Epilepsy And Convulsions

Once epilepsy has been diagnosed, a person may have to take medication every day. The type and frequency of medication depend on the person, their condition, and their doctor. Medications used to treat fits are called anticonvulsants. They are also called anti-seizure medications or anti-epileptic medications. Finding the right anti-epileptic can be a long and drawn out process. Some people may even need more than one anticonvulsant or may require additional medication apart from anticonvulsants. Remember to be patient, health can be an arduous journey.

Some people may not respond to medications. In such cases, specialists may suggest other treatment modalities such as surgery and novel therapies such as transcranial magnetic stimulation (rTMS). Surgery for epilepsy is not as scary as it sounds. It is grounded in sound medical and scientific work. Epilepsy surgery is usually recommended to people with focal seizures (a single, clear, defined area of abnormal electrical discharges) which are not controlled by adequate drug therapy. The aim of surgery is a complete cessation of convulsions.

In people who are not candidates for surgery, newer neurostimulation techniques like TMS can be tried. Other ways to control and reduce the severity of convulsions is getting enough sleep, eating regular meals, following a ketogenic diet, exercising, reducing stress, and other lifestyle modifications.

Epilepsy is nothing to be scared of. It can disrupt normal life but with correct diagnosis and treatment, a person with epilepsy can live a full, safe, and satisfying life. Epilepsy may not always be completely curable but it can be controlled. Don't be afraid of a diagnosis; it is the first step in a journey towards better health.