Have you ever seen someone suddenly have a "fit"? Everyone gets scared when they see things like body twitching and losing consciousness, right? We often call this condition epilepsy. So, what exactly is epilepsy? Why does this happen? Is it dangerous? Today we will talk about all this very simply, in a way that you can understand.
What really happens inside the brain?
To understand this, let's take a small example. Imagine that our brain is like an electrical system in a house. The cells (neurons) in the brain send messages to each other through small electrical signals. Everything happens in a very orderly, rhythmic way.
However, in the brain of someone with epilepsy, this electrical signaling system suddenly 'short-circuits'. Cells in one or more areas of the brain suddenly start firing uncontrollably, causing excessive electrical signals. Like a lightning storm. That's when we have a condition called a seizure . This electrical disturbance causes a person to lose consciousness, twitch, and change behavior.
Simply put, epilepsy is not just a disease. It is a chronic condition that occurs in the electrical activity of the brain. One seizure does not mean that someone has epilepsy. If there are repeated episodes of epilepsy, it may be epilepsy.
What types of seizures are there?
When most of us think of a 'fit', we think of a severe condition where we fall to the ground, convulse, and drool. But did you know that there are many types of seizures? These can be divided into two main categories: one is based on where in the brain the seizure starts.
| Seizure category | Description and symptoms |
|---|---|
| 1. Focal Onset Seizures | These start in a specific place on one side of the brain. There are also two types of this. Focal Aware Seizure: • At this time, the patient is conscious and can feel things happening around him. • Tingling, like in one arm or leg. • Suddenly feeling a strange smell or taste. • Feeling like you are seeing lights before your eyes, dizziness. Focal Impaired Awareness Seizure: • At this time, you may lose consciousness a little, or become unaware of your surroundings. • Staring blankly. • Repeating the same things over and over again, such as pursing the lips, rubbing the hands, or blinking the eyes. |
| 2. Seizures that spread throughout the brain at once (Generalized Onset Seizures) | These affect both sides of the brain at once. The types we see most often belong to this category. Absence Seizures: • This often happens to young children. They suddenly stop what they are doing for a few seconds and stare blankly. It's like they've gone into a dream world. Many people mistake this for daydreaming. Tonic-Clonic Seizures: • This is the 'fit' we all know (old name Grand Mal). • Suddenly, you lose consciousness and fall to the ground. First, your body stiffens (Tonic phase), then your body begins to twitch (Clonic phase). • Tongue-tipping, drooling, and urine/feces on clothing may occur. This usually lasts between 1-5 minutes. Atonic Seizures: • This is also called a 'Drop Seizure'. The body's muscles suddenly lose power and you fall to the ground, like a puppet with a broken string. Myoclonic Seizures: • A sudden jerking of an arm, leg, or entire body, as if struck by lightning. This lasts for a short time, about a second or two. |
What are the triggers for a seizure?
A person with epilepsy does not always have seizures. But certain things can increase the risk of having a seizure. We call these triggers . These can vary from person to person.
- Skipping medication: This is the main reason. If you don't take the medication prescribed by the doctor on time, there is a high chance of a seizure.
- Lack of sleep: Things like lack of sleep and overexertion can affect the brain.
- Stress: Seizures can also be caused by things like excessive pressure and anxiety.
- Illness and fever: When an infection enters the body and a fever develops, brain function can change.
- Bright light: Flashing lights, some video games, and television shows can affect some people.
- Alcohol and drugs: Alcohol use, especially during withdrawal, can cause seizures.
- Hormonal changes in women: Some women experience seizures with hormonal changes associated with their menstrual cycle.
- Certain medications: Some medications for colds and allergies (e.g., those containing diphenhydramine) may be contraindicated in people with migraines.
What are the causes of migraines?
In most cases, about 70% of cases, no specific cause can be found for migraines. However, there are several causes that have been identified.
- Genetics: If someone in the family has migraines, there is a small risk that others will also develop them. But it does not mean that they will definitely develop them.
- Head Injuries: Severe head injuries, such as from a car accident or fall, can damage the brain and cause a concussion.
- Brain infections: This condition can be caused by infections such as encephalitis and meningitis, which damage the brain.
- Stroke and Brain Tumors: When blood flow to the brain is interrupted due to a stroke or when a brain tumor develops, brain cells can be damaged and a seizure can begin.
- Complications during birth: Measles can also be caused by a lack of oxygen to the brain at birth, or by certain problems with brain development.
How is this diagnosed?
If you have a seizure, the first thing you should do is see a doctor. He or she will ask you and anyone who witnessed the seizure to describe what happened.
In addition, two main tests can be performed.
1. EEG (Electroencephalography): This involves attaching small sensors to your head and recording the electrical patterns in your brain. If you have epilepsy, it can detect some abnormal patterns.
2. Brain Scans: A test like an MRI (Magnetic Resonance Imaging) scan can check for signs of damage inside the brain, such as a tumor, a scar, or a stroke.
What are the treatments?
Measles is not something to be afraid of, as it is a condition that can be controlled to a large extent.
Anti-seizure medications
The main treatment is anticonvulsant medication. About 70% of patients can control their seizures completely with medication. Your doctor will choose the right medication for you based on your seizure type, age, and other medical conditions. The most important thing is to never stop taking your medication or change the dosage without your doctor's advice.
Diet Therapy
For some children, especially those who do not respond well to medication, a doctor may recommend a special diet, such as the ketogenic diet . This is a high-fat, low-carbohydrate diet.
Surgery
For people with seizures that are not controlled by medication and start in a single location in the brain, surgery is an option. This involves removing the abnormal part of the brain where the seizures start. While this is not possible for everyone, it can be very successful for the right person.
Times when we need to be careful
Usually, a seizure stops on its own within 1-2 minutes, but in some cases, you need to go to the hospital immediately.
When to go to the ETU (Emergency Treatment Unit) immediately:
* If the seizure lasts more than 5 minutes.
* If one seizure ends and another occurs before consciousness returns.
* If you have difficulty breathing during the seizure.
* If a seizure causes serious injury.
* If a pregnant woman or someone with diabetes has a seizure.
A word about SUDEP
This may sound scary, but it's important to know. SUDEP (Sudden Unexplained Death in Epilepsy) is when someone with epilepsy suddenly dies without any apparent cause. This is a very rare event. People who have poorly controlled seizures are at higher risk. The best way to reduce this risk is to take your medications exactly as your doctor prescribes and control your seizures.
Take-Home Message
- Epilepsy is not a mental illness or something to be ashamed of. It is a neurological condition of the brain.
- Most people can control their seizures very well with medication and live normal lives.
- It is essential to take the medicine your doctor has prescribed for you at the right time and in the right dosage. Never stop taking your medicine on your own.
- Identify your seizure triggers and avoid them as much as possible (e.g., sleep, stress management).
- If you have dementia, it's important to let your family and close friends know about it so they can help you in an emergency.
- If you have any questions, fears, or doubts about this, discuss them openly with your doctor.
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