Medical brain notes 7

  EPILEPSY You must have seen some patient somewhere, having recurrent involuntary seizure or jerks, with or without impaired consciousness. This may be a case of Epilepsy: You would have noticed people attending to such persons in a very funny manner for observing curiously without helping the person correctly. This chapter deals with the problem: its causes, its correct approach and the myths associated with it. Epilepsy means frequently occurring convulsions or seizures. A single episode of convulsion cannot be called epilepsy. Epilepsy is a disease of the brain in which excessive electrical impulses are produced in the brain for a short period of time resulting in tremors or seizures. One in every hundred persons suffers from epilepsy and thus over l o million people in our country are afflicted with this disease. According to a survey, 4 out of every 100 persons h ave suffered from a convulsion at least once in his lifetime e.g. convulsion during high fever. In 70 to 75% cases...

  The main causes of Epilepsy are as follows : 1.          Trauma during birth of the child or lack of oxygenation perinataly. 2.          Road accidents or any other head injury.Brain Tumor. 3.          Decreased circulation in the brain. 4.          Brain infections or fever of brain (e.g. brain TB). 5.          Hereditary factors. 6.          Hypoglycemia (reduced sugar). 7.          None of the above known causes (e.g. idiopathic).

  There are three types of epilepsy : 1.          Generalized seizure. 2.          Partial seizure. 3.          Psychogenic-Hysteria. These three are further divided as follows : 1. Generalized Seizure :   i.                 Grandmal epilepsy or seizure of the entire body: In this type of epilepsy, loss of consciousness, screaming, frothing from the mouth, tremors, tongue biting may occur and sometimes urine and stool are also passed unconsciously. After regaining consciousness, the patient remains in a semiconscious state for some time or goes to sleep He may be paralyzed temporarily.Sometimes a patient may get an inkling of the impending seizure, this is known as Aura. ii.                 Petitmal: In this typ...

  Treatment of Epilepsy : After investigating the causes of the disease, planning proper treatment is essential. Any precipitating situations, which may aggravate the disease, should be avoided. Thus late nights, tension, fasting or excessive physical or mental stress should be avoided. Proper medication taken for a considerable period of time can definitely control the disease. Main drugs (Conventional drugs) used for Epilepsy are: Phenobarbitone:  (e.g. Gardenal, Beetal)   Phenytoin:  (e.g. Dilantin, Eptoin) Carbamazepine : (e.g. Zeptol, Tegrital, Carbatol,Zen, Mazetol) Valproate: (e.g. Encorate, Valparin, Epilex)   As per the new technology, now slow release formulation drugs are available in Carbamazepine and Valproic acid e.gTegrital - CR, Valtec - CR respectively. This helps to maintain adequate blood level all through out the day, by taking drugs only twice a day. The important side effects of antiepileptic drugs are discussed in chapter No. 23. Depending...