HEALTH

What causes Epilepsy? Know its Symptoms, Causes & Treatment.

Introduction:

Epilepsy is a chronic disorder that affects the brain and causes recurrent, unprovoked seizures.

What are Seizures?
As we know, the human Brain is a complex structure made up of a delicate mix of nerve cells, electrical impulses and chemicals, known as neurotransmitters. The communication between Neurons or Brain cells is through electrical signals producing chemical messengers. Any damage that disrupts the workings of the brain can cause seizures. In a seizure, abnormal bursts of neurons start firing off electrical impulses, which can cause the brain and body to behave strangely. The severity of seizures can differ from person to person. It can be an odd feeling for someone with no loss of awareness, or it can be a “trance-like” state for a few seconds or minutes; while others lose consciousness and have convulsions (uncontrollable shaking of the body).
Causes:
Epilepsy most often begins during childhood but it can start at any age though it is often not possible to pinpoint why someone develops the condition. In some cases Epilepsy that occurs later in life is associated with damage to the brain.

Epilepsy can be caused by:
1. Cerebrovascular disease caused by a problem that affects the blood supply to the brain.
a. Stroke – When one part of the brain is damaged by a lack of blood supply (clot) or bleeding into the brain from a burst blood vessel (haemorrhage).
b. Subarachnoid haemorrhage where blood leaks out of the brain’s blood vessels on to the surface of the brain below the middle layer of the 3 brain coverings.
2. Brain tumours are growths occurring when cells in the brain multiply in an abnormal, uncontrollable way. It can either be cancerous (malignant) or noncancerous (benign).
3. Severe head injuries which require immediate medical attention because there’s a risk of serious brain damage.
4. Hereditary – gene inheritance.

SEIZURES TRIGGERS:
Certain things or conditions trigger Epileptic seizures. The trigger may be:
*Stress.
*Lack of sleep (sleep deprivation).
*Drinking alcohol.
*Some medications and illegal drugs.
*In women, monthly periods.
*Flashing lights (this is an uncommon trigger that affects only 5% of people with epilepsy, and is known as photosensitive epilepsy)
*Not eating well, low blood sugar.
*Specific foods, excess caffeine or other products that may aggravate seizures.

It is better to maintain a seizure diary to help find out what might trigger your seizures. Each time you experience a seizure, record it and make a note of what you were doing. Over the time, you might notice some things that seem to trigger your symptoms & can avoid them.

Epilepsy Categories:
There are two main categories of Epilepsy:
1. Idiopathic (or primary) epilepsy – No apparent cause for epilepsy other than family history can be found, suggesting that the condition is inherited. Research is on for finding out defects in certain genes that may affect electrical transmission in the brain.
2. Symptomatic (or secondary) epilepsy – There is a known cause for a person’s epilepsy (refer causes).

SYMPTOMS:
Repeated seizures form the main symptoms of Epilepsy. These can occur when you are awake or asleep. Depending on the area of the brain affected there are many different types of seizure.
1. Partial (or focal) seizures – Only a small part of the brain is affected.
Simple partial seizures: The patient remains fully conscious & there is a feeling of déjà vu, an unusual taste or smell, feeling of fear or joy, pins or needles, stiffness or twitching.
Complex partial seizures: The patient becomes unconscious and cannot remember the event. There is smacking of the lips, rubbing of the hands, moving of the arms, fiddling with objects, chewing or swallowing, unusual postures, and picking at clothes.
2. Generalized seizures – where most or all of the brain is affected.
Absence seizures: They mainly affect children, but can also occur in adults. The patient loses awareness of their surroundings, usually for up to 15 seconds. The patient stares vacantly into space with fluttering of the eyes or smacking of the lips.
Myoclonic seizures: The arms, legs, or upper body jerks or twitches, as if you have received an electric shock only lasting for a fraction of a second.
Clonic seizures: The symptoms will last longer, normally up to two minutes with same sort of twitching as myoclonic jerks.
Atonic seizures: These seizures cause all your muscles to suddenly relax & there is a chance you may fall to the ground and risk injury.
Tonic seizures: The muscles suddenly become stiff causing you to lose balance and fall over.
Tonic-clonic seizures: These convulsions are named grand mal & can have two stages. The body will initially become stiff and then arms and legs will begin twitching. All consciousness is lost, and some people will wet themselves. The seizure normally lasts a few minutes, but can last longer.
3. Unclassified seizures – that do not fit into these categories.
4. Status Epilepticus: It lasts more than 30 minutes and the person does not regain consciousness in between. This is a medical emergency and requires treatment as soon as possible.

DIAGNOSIS:
Epilepsy cannot be diagnosed quickly. Until more than one seizure is experienced, in most cases, it cannot be confirmed. EEG and MRI are the usual tools employed.
Electroencephalogram (EEG)
In an EEG test, through electrodes placed on your scalp unusual brain activity associated with epilepsy can be detected by measuring the electrical activity of your brain.
EEG may be carried out even while you are asleep (sleep EEG). You may be given a small, portable EEG recording device to monitor your brain activity over 24 hours (ambulatory EEG).
Magnetic resonance imaging (MRI) scan
In an MRI scan strong magnetic fields and radio waves are used to produce detailed images of the inside of your body. MRI’s tend to be useful in cases of suspected epilepsy because it can detect possible causes of the condition, like defects in the structure of your brain or the presence of a brain tumour.

TREATMENT:
Even though not everyone with Epilepsy will need to be treated, the treatment is used to control seizures.
1. Medicines: Epilepsy is generally treated at first with Anti-epileptic drugs (AEDs). Nearly 70% of people with the condition are able to control their seizures with AEDs. The most commonly used AEDs are Sodium Valproate, Carbamazepine, Lamotrigine, Levetiracetam, Oxcarbazepine, Ethosuximide & Topiramate.
2. Surgery: If the medicines show no effect to control Epilepsy, you are usually referred to a specialist Epilepsy center where the possibilities of surgery to remove the part of your brain causing seizures without causing much brain damage are evaluated.
3. Vagus Nerve Stimulation (VNS): When the possibilities of surgery are ruled out, implanting a small device under the skin of your chest is an alternative. The device sends electrical messages to the Brain. This is called Vagus Nerve Stimulation.
4. Deep brain stimulation (DBS): Electrodes are implanted into specific areas of the brain to reduce the abnormal electrical activity associated with a seizure in the DBS technique.

HEALTH

Risk factors for brain and spinal cord tumors?

A risk factor is anything that affects your chance of getting a disease such as a brain or spinal cord tumor. Different types of cancer have different risk factors. Some risk factors, like smoking, you can change. Others, like your age or family history, can’t be changed.

Most brain tumors are not linked with any known risk factors and have no obvious cause. But there are a few factors that can raise the risk of brain tumors.

Radiation exposure

The best known environmental risk factor for brain tumors is radiation exposure, most often from radiation therapy to treat some other condition.

Family history

Most people with brain tumors do not have a family history of the disease, but in rare cases brain and spinal cord cancers run in families. In general, patients with familial cancer syndromes tend to have many tumors that first occur when they are young.

 

Neurofibromatosis type 1 (NF1)

This genetic disorder, also known as von Recklinghausen disease, is the most common syndrome linked to brain or spinal cord tumors. People with this condition have higher risks of schwannomas, meningiomas, and certain types of gliomas, as well as neurofibromas (benign tumors of peripheral nerves). Changes in the NF1 gene cause this disorder. These changes are inherited from a parent in about half of all cases. In the other half, the NF1 gene changes occur before birth in people whose parents did not have this condition.

Neurofibromatosis type 2 (NF2)

This condition, which is much less common than NF1, is associated with vestibular schwannomas (acoustic neuromas), which almost always occur on both sides of the head. It is also linked with an increased risk of meningiomas or spinal cord ependymomas. Changes in the NF2 gene are responsible for neurofibromatosis type 2. Like NF1, the gene changes are inherited in about half of cases or may occur before birth in children without a family history.

Tuberous sclerosis

People with this condition may have subependymal giant cell astrocytomas (SEGAs), which are low-grade astrocytomas that develop beneath the ependymal cells of the ventricles). They may also have other benign tumors of the brain, skin, heart, kidneys, and other organs. This condition is caused by changes in either the TSC1 or theTSC2 gene. These gene changes can be inherited from a parent, but most often they develop in people without a family history.

 

Von Hippel-Lindau disease

People with this condition tend to develop benign or cancerous tumors in different parts of the body, including hemangioblastomas (blood vessel tumors) in the brain, spinal cord, or retina, as well as tumors of the inner ear, kidney, adrenal gland, and pancreas. It is caused by changes in the VHL gene. Most often the gene changes are inherited, but in some cases the changes happen before birth in people whose parents don’t have them.

Li-Fraumeni syndrome

People with this condition are at higher risk for developing gliomas, along with breast cancer, soft tissue sarcomas,leukemia, and adrenal gland cancer, and certain other types of cancer. It is caused by changes in the TP53 gene.

Other syndromes

Other inherited conditions are also linked with increased risks of certain types of brain and spinal cord tumors, including:

  • Gorlin syndrome (basal cell nevus syndrome)
  • Turcot syndrome
  • Cowden syndrome

Some families may have genetic disorders that are not well recognized or that may even be unique to a particular family.

Immune system disorders

People with impaired immune systems have an increased risk of developing lymphomas of the brain or spinal cord (known as primary CNS lymphomas). Lymphomas are cancers of lymphocytes, a type of white blood cell that fights disease. Primary CNS lymphoma is less common than lymphoma that develops outside the brain.

A weakened immune system can be congenital (present at birth), or it can be caused by treatments for other cancers, treatment to prevent rejection of transplanted organs, or diseases such as the acquired immunodeficiency syndrome (AIDS).

Unproven effects on brain tumor risk

  • Cell phone use
  • microwave ovens
  • Radar
  • Satellite stations
  • Vinyl chloride (a chemical used to manufacture plastics)
  • Petroleum products
  • Exposure to aspartame (a sugar substitute),
  • Exposure to electromagnetic fields
  • Infection with certain viruses
HEALTH

Blood pressure / Hypertension

Blood pressure

Blood pressure is the force exerted by the blood against the walls of blood vessels, and the magnitude of this force depends on the cardiac output and the resistance of the blood vessels.

Hypertension is having a blood pressure higher than 140 over 90 mmHg, a definition shared by all the medical guidelines. This means the systolic reading (the pressure as the heart pumps blood around the body) is over 140 mmHg (millimeters of mercury) or the diastolic reading (as the heart relaxes and refills with blood) is over 90 mmHg.Based on American Heart Association (AHA),

  1. Normal blood pressure is below 120 systolic and below 80 diastolic
  2. Prehypertension is 120-139 systolic or 80-89 diastolic
  3. Stage 1 high blood pressure (hypertension) is 140-159 systolic or 90-99 diastolic
  4. Stage 2 high blood pressure (hypertension) is 160 or higher systolic or 100 or higher diastolic
  5. Hypertensive crisis (a medical emergency) is when blood pressure is above 180 systolic or above 110 diastolic.

Symptoms

  1. headaches
  2. shortness of breath or nosebleeds                                                

Causes of hypertension

  1. Physical inactivity
  2. A salt-rich diet through processed and fatty foods
  3. Alcohol and tobacco use.
  4. Age
  5. Size
  6. Lifestyle

Tests

To measure your blood pressure, your doctor or a specialist will usually place an inflatable arm cuff around your arm and measure your blood pressure using a pressure-measuring gauge.

Treatments

Changing your lifestyle can go a long way toward controlling high blood pressure. Your doctor may recommend you eat a healthy diet with less salt, exercise regularly, quit smoking and maintain a healthy weight.

In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure.Your blood pressure treatment goal depends on how healthy you are.

HEALTH

Parkinson’s Disease

Parkinson’s Disease – (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50. Early symptoms of PD are subtle and occur gradually. In some people the disease progresses more quickly than in others. As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD.


Parkinson’s disease is caused by the progressive impairment or deterioration of neurons (nerve cells) in an area of the brain known as the substantia nigra. When functioning normally, these neurons produce a vital brain chemical known as dopamine. Dopamine serves as a chemical messenger allowing communication between the substantia nigra and another area of the brain called the corpus striatum. This communication coordinates smooth and balanced muscle movement. A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements.

 

signs and symptoms

Parkinson’s disease symptoms and signs may vary from person to person. Early signs may be mild and may go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides.

Parkinson’s signs and symptoms may include:

Ø  Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson’s disease is a tremor of your hand when it is relaxed (at rest).

Ø  Slowed movement (bradykinesia). Over time, Parkinson’s disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.

Ø  Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause you pain.

Ø  Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.

Ø  Loss of automatic movements. In Parkinson’s disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.

Ø  Speech changes. You may have speech problems as a result of Parkinson’s disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.

Ø  Writing changes. It may become hard to write, and your writing may appear small.

Can Parkinson’s Disease Be Prevented?

To date, there is no known prevention or cure for Parkinson’s disease. But, there are several treatment options, including drug therapy and/or surgery that can reduce the symptoms, and make living with the disease easier.

HEALTH

Alzheimer’s disease

Alzheimer’s is a type of dementia that causes problems with memory, thinking and behaviour. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline. A neurodegenerative type of dementia, the disease starts mild and gets progressively worse.

Causes of Alzheimer’s disease

Like all types of dementia, Alzheimer’s is caused by brain cell death. It is a neurodegenerative disease, which means there is progressive brain cell death that happens over a course of time. The total brain size shrinks with Alzheimer’s – the tissue has progressively fewer nerve cells and connections.

Symptoms of Alzheimer’s disease

For doctors to make an initial diagnosis of Alzheimer’s disease, they must first be satisfied that there is dementia – guidelines spell out what dementia consists of. It involves cognitive or behavioural symptoms that show a decline from previous levels of “functioning and performing” and interfere with ability “to function at work or at usual activities.”

The symptom are listed below

  • Worsened ability to take in and remember new information
  • Impairments to reasoning, complex tasking, exercising judgment
  • Impaired visuospatial abilities
  • Impaired speaking, reading and writing
  • Changes in personality and behaviour

Stages of Alzheimer’s disease

The progression of Alzheimer’s can be broken down into three basic stages

  • Preclinical (no signs or symptoms yet)
  • Mild cognitive impairment
  • Dementia

Treatment and prevention of Alzheimer’s disease

There is no known cure for Alzheimer’s disease – the death of brain cells in the dementia cannot be halted or reversed. There is, however, much backing for therapeutic interventions to help people live with Alzheimer’s disease more ably.There are no disease-modifying drugs available for Alzheimer’s disease but some options may reduce its symptoms and help improve quality of life.

HEALTH

Depression

depression

Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behaviour, feelings and sense of well-being. People with depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in activities that were once pleasurable, experience overeating or loss of appetite, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal reaction to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.

 

Symptoms

  • Feelings of sadness, fearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches.

Causes

  • Biological differences
  • Brain chemistry.
  • Hormones.
  • Inherited traits.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:

  • Anxious distress
  •   Mixed features
  •   Melancholic features
  •  Atypical features
  •   Psychotic features
  •   Catatonia
  •   Peripartum onset
  • Seasonal pattern

 

Treating Depression

A depressed person needs immediate psychiatric help and close monitoring. Support from family and friends are extremely important to rehabilitate a deep depressed patient.