Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures.

Best medications for Epilepsy

Drug NameClassRouteStandard DosagePrice
KlonoPINBenzodiazepinesOral0.5, 2, 1 MGfrom$3.10
FelbatolAnti-epilepticsOral600, 400 MG/5MLfrom$19.50
TrileptalAnti-epilepticsOral600, 300, 150 MGfrom$7.90
KeppraAnti-epilepticsOral500, 250, 1000, 750, 100 MGfrom$10.00

<h2 id=\"intro\">Introduction</h2>\n\nEpilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures. It affects around 50 million people worldwide, making it one of the most common neurological diseases globally. An epileptic seizure occurs when there is a sudden, abnormal burst of electrical activity in the brain that temporarily affects how it works. This results in an epileptic attack, which can cause changes in behavior, movements, sensations, and levels of consciousness. Seizures can vary greatly in nature - from brief lapses of attention to severe and prolonged convulsions. Epilepsy itself is not a singular condition but a symptom of many different disorders that can affect the brain. \n\n<h2 id=\"types\">Types of Epilepsy</h2>\n\nThere are many different types of epilepsy, categorized either by the type of seizure or by the part of the brain affected. Focal (partial) seizures start in one area of the brain, while generalized seizures involve electrical misfiring across both sides of the brain. \n\nCommon focal epilepsies include:\n\n- Temporal lobe epilepsy - Starts in the temporal lobe and is often associated with aura symptoms like deja vu. Can cause impaired awareness during complex partial seizures.\n\n- Frontal lobe epilepsy - Originates in the frontal lobes and may result in unusual body movements like cycling motions. \n\n- Occipital lobe epilepsy - Starts in the occipital lobe and may cause visual hallucinations or illusions.\n\nSome generalized seizure types are: \n\n- Absence seizures - Characterized by staring spells for 5-30 seconds at a time. The person is non-responsive and unaware during these brief seizures. \n\n- Tonic-clonic seizures - Also known as grand mal seizures, these cause loss of consciousness, body stiffening, and jerking movements. \n\n- Atonic seizures - Lead to sudden loss of muscle tone, causing the person to go limp or collapse.\n\n- Clonic seizures - Consist of rapid, rhythmic jerking movements, often on both sides of the body.\n\n- Myoclonic seizures - Brief but intense muscle twitches, jerks or spasms.\n\n<h2 id=\"causes\">Causes of Epilepsy</h2>\n\nIn about half of epilepsy cases, the cause is unknown. But there are various factors that can increase the risk of developing epilepsy:\n\n- Genetics - Many types of epilepsy run in families. Specific genes affecting brain cell formation and synaptic transmission have been linked to some epilepsies. \n\n- Head trauma or injuries - Head injuries that lead to brain damage put a person at higher risk. Strokes, brain tumors, and infections like meningitis can also damage the brain and trigger epilepsy.\n\n- Developmental disorders - Conditions like autism, neurofibromatosis, and tuberous sclerosis have associations with epilepsy.\n\n- Prenatal factors - Infections, nutritional deficiencies, oxygen deprivation, and traumatic birth injuries can increase the risk of epilepsy in babies. \n\n- Other disorders - Conditions like Alzheimer's disease, multiple sclerosis, and some mitochondrial disorders are tied to higher incidence of epilepsy.\n\nIn many cases, the cause is a combination of genetic susceptibility and environmental triggers like head trauma or brain infections.\n\n<h2 id=\"symptoms\">Signs and Symptoms</h2>\n\nThe main symptom of epilepsy is recurrent, unprovoked seizures. Though seizure symptoms can vary widely depending on the type, some common signs include:\n\n- Loss or altered state of consciousness - This ranges from staring blankly to losing awareness of surroundings.\n\n- Uncontrolled jerking movements - Called convulsions, these can affect part or all of the body. \n\n- Sensory, emotional or psychic disturbances - May involve visual or auditory hallucinations, feelings of deja vu, unexplained fear or anxiety.\n\n- Involuntary muscle spasms - These may only affect one area like the face or arm.\n\n- Temporary confusion - Following a seizure, the person may be dazed and disoriented for up to an hour.\n\n- Weakness or paralysis on one side - Known as Todd's paralysis, this can last for minutes to hours after a seizure.\n\n- Loss of bladder/bowel control - In severe tonic-clonic seizures.\n\n- Biting the tongue - During convulsions, people may bite their tongue or cheek.\n\nA single seizure itself is not epilepsy - epilepsy is diagnosed when seizures recur without any immediate triggering cause like drug use or very high fever.\n\n<h2 id=\"diagnosis\">Diagnosis</h2>\n\nTo diagnose epilepsy, doctors take a full medical history looking for possible seizure episodes, triggers, and family history of seizures. A neurological exam evaluates reflexes, balance, coordination and mental functioning. If seizures are suspected, further testing may include:\n\n- Blood tests - To look for electrolyte imbalances, metabolic disorders, genetic conditions, and infections.\n\n- EEG - Records brain wave patterns. Abnormal electrical activity may point to epilepsy.\n\n- CT or MRI scans - Provide images of the brain's structure to detect tumors, bleeding, and developmental abnormalities.\n\n- Functional MRI - Maps brain activity to find affected areas during seizures. \n\n- PET scan - Measures brain metabolism to identify regions generating seizures.\n\n- Neuropsychological testing - Can assess how epilepsy has affected memory, language, problem-solving and thinking skills.\n\nOften long-term EEG monitoring in a hospital is needed to catch the electrical changes of seizures as they occur. These tests help determine the person's specific epilepsy type so the most suitable treatment can be prescribed.\n\n<h2 id=\"treatment\">Treatment</h2>\n\nThough not curable, epilepsy can often be well-controlled with proper management. The main epilepsy treatments are:\n\n- Medication - Also called anti-seizure or anticonvulsant drugs. These work to reduce abnormal electrical activity in the brain. Over 20 different seizure medications are available.\n\n- Vagus nerve stimulation - An implanted device sends regular, mild pulses of electrical energy to the brain via the vagus nerve. This may reduce seizures by 20-40%.\n\n- Ketogenic diet - A high-fat, low-carb diet that can help reduce seizures in some children with epilepsy. The diet alters metabolism to produce ketones, which inhibit seizures.\n\n- Epilepsy surgery - Removal of the part of the brain generating seizures, usually for severe focal seizures. Success rates are high but there are risks like impairment in speech or vision.\n\n- Medical devices - Implanted neurostimulators like the RNS system can sense seizure activity and deliver stimulation to stop them. Works best for focal seizures. \n\nIn many cases, a combination of anti-seizure medication and devices like the vagus nerve stimulator offers the best seizure control. Lifestyle adjustments like getting adequate sleep, avoiding seizure triggers like sleep deprivation, and taking medication consistently also help manage epilepsy.