Epilepsy was already written about three thousand years ago. We find the first reports about them in the Babylonian code of Chamurabis, which was written about 1900 years before the Common Era. Since the causes of epilepsy could not be explained at the time, it was assumed that the patient was possessed by an evil spirit. The great majority of people today no longer believe in ghosts and demons, and yet, up to our day, many have a questionable attitude towards those who suffer from this disease. For this reason and because epilepsy is one of the most common nervous diseases, it seems appropriate to write about this disease as well.
Symptoms & Signs
For several years we have observed that the number of patients suffering from epilepsy has increased steadily. There are very real reasons for this fact, which are primarily to be found in the increasing number of accidents among both adults and children. Most of today’s accidents are associated with head injuries. If the brain is also affected, then there is a causal condition for the later occurrence of epileptic seizures.
According to WHOLEVEHICLES, the epileptic seizure, the main symptom of this disease, always starts from a certain point in the brain. We call it the epileptic hearth (Focus). It should not be difficult for a layperson to imagine such a stove. Everyone knows that after a deep injury to the skin, a scar is created. Sometimes, especially after severe burns, such scars are drawn together like rays. Thickening often occurs in the center of the scar, which causes pain, especially when the weather changes.
Causes & Reasons
If you consider that such scars can also develop after injuring superficial areas of the brain and meninges, then it becomes understandable that they represent a foreign body that irritates the surface of the brain. This is not just about mechanical irritation, but also about circulatory disorders and changes in brain metabolism.
From this point, the seizure is triggered under certain circumstances. Hence the term “focus”, which comes about as a result of a head injury during an accident, but is very often the result of a complicated birth in which the child’s head was squeezed or the child suffered from a lack of oxygen. An active epileptic focus can to a certain extent spread to other, originally unaffected areas of the brain.
But it does happen that the organism narrows the area of this focus on its own and thus gradually eliminates it, just as the scar pain can disappear some time after a skin injury. It will now be understandable to everyone that in individual cases it is also possible to surgically remove the focus and thus cure the seizure sufferer of his illness. But we can also help where an operation does not promise ultimate success. In the majority of all epilepsy sufferers, the propensity for seizures, i.e. the activity of the epileptic focus, can be combated with the help of appropriate medication. But more about that later.
The electroencephalogram (EEG) we owe it. that we now know a lot more about the development of an attack than we did before. In a perfectly healthy brain, each cell has a specific function. It picks up nerve signals, processes them and passes them on to other cell groups. This regulated functioning of the brain cells can, however, be disturbed under pathological conditions. The cells fall into a synchronized, rhythmically pulsating activity that excludes all other functional mechanisms of the affected cells. The result is the person’s convulsions and unconsciousness.
With the help of the encephalograph, these pathological disorders of brain activity can also be registered as rhythmic, electrical discharges on the head surface, while the normal activity of the brain cells when awake is shown as an irregular jagged line by the brain current image (EEG). That is why the EEG is such an important method in the diagnosis of seizure diseases. Very often it enables us to detect disorders in the brain even if the patient has not yet had seizures. This gives the doctor the opportunity to take preventive action and prevent seizures from occurring.
Groups & types
At this point it should be mentioned that we divide the most important epileptic seizures into three groups: the major seizure, the minor and psychomotor seizure. In the first, the patient loses consciousness, often falls to the ground (hence the popular expression epilepsy), and develops muscle cramps, which express themselves very differently. This attack usually only lasts a few minutes and usually ends without complications. The small attack consists only of a brief loss of consciousness.
The patient does not react to his surroundings, questions, etc. for a few seconds and stares straight ahead. There are no cramps here. In the so-called psychomotor attack (psyche = soul, motor = moving), which can last several minutes, the person concerned also loses consciousness, but unconsciously automatically performs various movements that are sometimes quite complicated and can be relatively coordinated – he goes there and here, speaks incoherently, etc.
The disturbed activity of the brain cells can be caused by very different situations. For example, the attacks very often occur during sleep, where the brain cells are not “disturbed” by any activity induced by the outside world and therefore more easily fall into the automatic so-called pause rhythm. (Here the following should be added for the sake of understanding: The wakefulness of the human and animal organism is triggered and sustained by excitation impulses that are fed to the cerebrum via the nerve tract from the environment or the inside of the organism with the help of so-called sensory organs or internal receptors.)
The tendency of the nerve cells to rhythmic activity depends on the metabolism and can therefore also be influenced by metabolic agents. From this it is understandable that the second cause of epilepsy, in addition to the conditions explained above, is the increased susceptibility to seizures, which comes about due to the special metabolic situation in the brain.
Epileptic Seizure Medicines
The most important way in the treatment of epilepsy is always to combat the increased susceptibility to seizures. However, this can only be achieved if the patient regularly takes anti-epileptic medication for a longer period of time, often for years. When dosed correctly, the drugs will not do any harm. Therefore, the fear of possible poisoning or damage from such drugs is completely unfounded.
However, one thing is important: the dose must never be significantly reduced overnight, and you must not stop taking the drug suddenly. Both of these always result in a steep increase in the likelihood of seizures. Discontinuing drug treatment can even provoke a dangerous seizure. The patient should also never replace one drug with another without a doctor’s prescription. The effectiveness of the individual remedies is usually very different, so that changing from one drug to another is tantamount to reducing or increasing the dose.
The susceptibility to seizures can also be suppressed by eating if the person concerned prefers a mixed, low-salt diet that is low in carbohydrates but high in protein. He should therefore eat enough meat, drink milk every day and consume dairy products (cheese). Milk products in particular contain the amino acid methionine, which probably affects the metabolism in the brain cells in favor of their normal activity. Furthermore, someone who suffers from seizures should not drink excessively, because excessively large amounts of fluids can increase the likelihood of seizures.
Outlook & forecast
The prognoses of epilepsies are as different as their causes. Patients who suffer only one epileptic seizure often remain free of symptoms or consequential damage. If no further seizures occur within 3-4 years and the EEG no longer shows any abnormalities, the patient is considered cured.
If the patient has an underlying disease that triggers epilepsy, the prognosis depends on the underlying disease. If the disease can be cured, the seizures will usually go away as well. If epilepsy or the underlying disease is not curable, drug therapy usually leads to a reduction in the symptoms. Patients who suffer from brief seizures remain about 90% seizure-free. In particularly severe cases of epilepsy, therapy can achieve a significant improvement in symptoms within a year in 50-80% of cases.
A statistically reduced life expectancy only occurs in severe forms of epilepsy, such as symptomatic epilepsy. In idiopathic forms of epilepsy, where no clear cause of the seizures can be found, life expectancy is hardly restricted.
Prevent epilepsy
But one thing must be avoided at all costs: alcohol, even the smallest amounts. Even a glass of beer sometimes causes a severe seizure and the person concerned is not exposed to conflicts in the family or at work. You must lead a calm, steady life, free from situations involving anger, annoyance, excitement, and stress. On the other hand, work – whether physical or mental – does no harm, on the contrary, it has a beneficial effect, because it seems as if concentrating on a certain object, on a work, prevents the occurrence of seizures.
This is understandable when you consider that when you fulfill a duty that is deeply rooted in your consciousness, an abundance of external and internal impulses reach the cerebral cortex and trigger a coordinated excitation activity in the nerve cells. The risk of injury to the patient in the event of an attack occurring during work should not be underestimated, but neither should it be overestimated. At home, too, he can fall off the stairs or injure himself in other ways if he has a seizure. However, these cases are relatively rare. Of course, if an epilepsy sufferer has a seizure, he must never work where his own life or that of others is threatened.
He should therefore not be given a license to drive a car. It is also not allowed to use it to operate cranes, machines in mining and devices or apparatus that are under high voltage. It should be noted, however, that this sometimes depends on the company’s local conditions. The patient’s insight into such necessities is one side, the help of society for the person at risk of an attack to enable him to learn another profession, the other side of this problem. In this context it should be mentioned: A person who suffers from epileptic seizures should not always be viewed as sick by those around him. He is healthy in the time between attacks.
In the majority of cases, epilepsy also has no influence on the mental performance of the person concerned. Many geniuses and great thinkers suffered from this disease and still gave us some of the most beautiful works in world literature. In general, the environment plays a very important role in the effective treatment of epilepsy, the success of which in no case depends only on the doctors. The doctor makes the diagnosis, determines and controls drug therapy. Once a month, sometimes only once a year, he speaks to the patient for a quarter or half an hour. But in the long time in between, he lives and works with a smaller or larger number of people.
Behavior towards people with epilepsy
Therefore, both the attitude of society towards the patient and the attitude of the patient towards society have a great influence on his state of health. However, this is not always considered by the healthy. Many of them behave very negatively towards people suffering from seizures. They fear them, avoid them, or even treat them with disgust. After a while, the epilepsy sufferer usually reacts with hostility and suspicion to his surroundings, which of course has a very unfavorable effect on the course of his illness.
On the other hand, the friendly, understanding and calm demeanor of co-workers and friends can do a lot to improve the state of health and cure his illness.
Let us come to the last and most important question that is so often asked by patients or their family members. Is this disease curable? According to statistical test results, with the correct application of the usual healing methods, about one to two thirds of all epilepsy patients can be finally cured and the state of health of the third third can be significantly improved, so that the attacks only occur very rarely. Of course, these are just averages. If the patient has been treated professionally from the start, the number of those healed increases by up to half.
Medicine is therefore by no means defenseless in its fight against epilepsy. The methods of treatment are constantly being perfected. In the last 20 to 30 years our healing successes have multiplied, and it is not exaggerated optimism if we assume that this positive development will continue in the following years and that the help for epilepsy sufferers will continue to improve.
Aftercare
Epilepsy is one of the most common nervous diseases. The disease of the central nervous system (CNS) occurs in different forms and degrees of severity. These define the treatment approach and the follow-up options.
The success of treatment in around two thirds of patients make follow-up care superfluous. Only the drug dosages are monitored. In other epileptics, however, the seizures can be so severe that follow-up care is necessary. This sometimes takes place in a specialized aftercare center, in other cases in a clinic context. The aim is to improve the quality of life of epileptics. However, this is difficult in the case of severe epilepsy.
Some children with certain types of epilepsy have so many seizures per hour that they are mentally disabled. Follow-up care for pharmaco-resistant epilepsy and chronic epilepsy is precarious. Surgery sometimes offers a solution here. However, this procedure is controversial and usually the last resort of choice. Another solution is the administration of cannabis preparations.
In rare epilepsies like FIRES epilepsy, only a few specialists like the Kiel neurologist Dr. Andreas van Baalen will take care of the aftercare. The condition of children affected by FIRES can improve with a strictly monitored ketone diet. But it cannot be cured. The children who become ill at school are then severely disabled. Aftercare is supported by rehabilitation measures and health-improving measures such as physiotherapy.
You can do that yourself
Many people with epilepsy hesitate when it comes to telling others about the disease. You are afraid of being rejected by your employer or of having to live excluded from your circle of friends. Educating the social environment about epilepsy can reduce fear of the next seizure in those affected. The reassurance of being surrounded by people who know what to do in the event of an epileptic crisis has a calming effect on epileptics. The clinical picture and the frequency of the seizures does not change.
External circumstances, such as lack of sleep and stress, can increase the risk of having a seizure. That is why specialists recommend people with epilepsy to integrate enough rest periods into everyday life. Regular exercise is also recommended for more balance and healthier sleep.
In photosensitive epilepsy, it is possible to reduce the risk factors that cause a seizure. In three to five percent of epileptics with this type of epilepsy, seizures are triggered by visual stimuli. These can be reduced if those affected avoid video games, changing lighting effects, television and computer screens.
