Epilepsy, a chronic brain disease that is not communicable and affects approximately 50 million people around the world, is one of the most common neurological conditions. Epilepsy is not contagious according to the World Health Organization. Although epilepsy can be caused by many diseases, approximately 50% of epilepsy cases worldwide are still undiagnosed.
Patients with epilepsy are often reluctant to disclose it because they don’t have driving licenses or jobs. Marriage is difficult and can be stressful for patients. Learn all about the causes of epilepsy, its symptoms and treatment, as well as when to consider surgery.
In an interview with HT Lifestyle, Dr Atma Ram Bansal, Associate Director – Epilepsy Programme at Institute of Neurosciences in Medanta Hospital explained, “Epilepsy is a brain disease where the brain circuits have abnormal firing. Multiple symptoms can result, including convulsions and seizures. This can occur for many reasons, depending on your age. In a newborn, it could be caused by a birth defect or oxygen problem during birth. In the slightly elder age group, it can be because of head injury or infection and at times it might be also due to a brain tumour.”
Dr. Atma Ram Bansal described epilepsy’s most common symptom as fits. This is when a person becomes episodically unresponsive, like a statue. It may also include jerking in their bodies, confusion, and sudden jerks in their body that cause them to drop objects or fall, especially in the morning.
Epilepsy can begin between 5 and 15 years old, and continue for 70 to 80 years. By birth, it is in just five to ten percent but there are different types of epilepsy, some which doesn’t need any treatment at all and some where patients get fits only while sleeping with mild jerks.
“60-70% of epilepsy can be treated with medicines. The type of epilepsy will dictate the length of treatment. In some patients, we need to give medicines for lifelong as well and in some cases, when the patient doesn’t respond to medications, we may have to perform surgery,” informed Dr Atma Ram Bansal.
He said that although there are not many good food sources for epilepsy patients it is possible to eat a healthy diet and avoid too many carbs. He revealed, “It can be treated or cured easily. 75 percent have a very good response to the medications and the rest can be treated with surgery.”
When is surgery necessary for epilepsy?
Dr. Atma Ram Bansal said, “If a patient doesn’t respond to medicines for 1-2 years and gets fits daily, every week, every month, every alternate month as well, the doctor may advise you to go for surgery depending upon your condition. Surgery is done in a very special type of epilepsy – where we need to find the root cause and which involves investigations like special video EG, special MRI and various other tests and then we find the reasons for epilepsy and that point is removed.”
Dr Khusbu Goel, Consultant Neurologist at HCMCT Manipal Hospital Dwarka, revealed, “We prefer first to treat with epilepsy medicine and when the patient has been given at least two or three medicines and they are not responding even after giving them appropriately chosen drugs and adequate trial have been done, we label them as drug-resistant epilepsy. We determine why the patient is resistant to drugs and sometimes, there are brain lesions.
She said, “In these cases, removal can help patients. Rarely are patients who have drug resistance and whose brains are normal. We do the pre-surgical assessment in these cases. In this case, we look for the legion using Video EEG and migraine electrode mapping. Focal cortical extension aids in this process. We first try the medicines because surgeries have their own pros and cons but in those cases where the medical trial has been given appropriately but the patient is not responding, we send the patient for surgery.”