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The Spectrum of Epilepsy: Diagnosis to Advanced Therapeutic Solutions

                               

-        By Dr. Ramya Bandi, Consultant Paediatric Neurologist,

         Ankura Hospital for Women and Children

Epilepsy is a neurological condition characterized by/or tendency to have recurrent seizures, which result from abnormal electrical activity in the brain. These seizures can manifest in various forms, affecting awareness, muscle control, sensations, emotions, and behavior.

Approximately 12 million people in India, about 1% of the population, live with epilepsy, with higher prevalence in rural areas. Globally, epilepsy affects around 50 million individuals, contributing significantly to the global disease burden. Importantly, for up to 60% of individuals, the cause of epilepsy remains unknown, and around 30% of people with epilepsy do not respond well to medication treatments. People with epilepsy are 15-19 times more likely to drown than the rest of the population. One third of every 73 people with epilepsy experience depression and anxiety, the most common comorbidity of the disease.

Seizure is a symptom whereas epilepsy is a disorder. Seizure symptoms vary depending on the type and can include temporary confusion, staring spells, muscle stiffness, uncontrollable jerking movements, loss of consciousness, and psychological symptoms like fear or déjà vu. Some individuals may experience behavioral changes or symptoms of psychosis.

The causes of epilepsy are diverse and include structural brain damage from birth complications, genetic conditions, severe head injuries, strokes, brain infections, genetic syndromes, and brain tumors. However, the cause remains unknown in about 50% of cases globally. Thanks to advances in genetics, we are able to diagnose persons with no diagnosis earlier. Epilepsy can significantly impact the lives of those affected, and for women and children, the challenges may be compounded due to unique health considerations. Ankura Hospital for Women and Children, known for its comprehensive care approach, plays a crucial role in the diagnosis, treatment, and management of epilepsy in this demographic.

Women with epilepsy face specific concerns, particularly during pregnancy. Seizures and the use of anti-seizure medications can impact fetal development and maternal health. Ankura Hospital offers specialized care to women with epilepsy who are planning pregnancies or are already pregnant, providing a multidisciplinary approach to ensure optimal health outcomes for both the mother and child. The hospital’s expert team of neurologists and gynecologists work together to manage medications, address seizure triggers, and monitor the pregnancy closely.

Ankura Hospital also focuses on early detection and intervention for children with epilepsy. The hospital provides personalized care, considering each child's unique needs, which includes not only medical treatments but also emotional and psychological support. Given the high co-occurrence of depression and anxiety with epilepsy, Ankura ensures that mental health is a key part of the treatment process, offering counseling and support services for both children and their families.

Seizure triggers are events or circumstances that can precipitate seizures, such as stress, sleep disturbances, undue travel, alcohol use, hormonal changes, illness, flashing lights, and certain medications.

Diagnosis typically involves a physical examination, medical history review, and possibly blood work to rule out other conditions. Treatment options include anti-seizure medications, dietary therapies like the ketogenic diet, and in severe cases, surgery or implantation of medical devices to modulate brain activity.

Anti-seizure medications are effective in controlling seizures for 60-70% of people with epilepsy. The choice of medication depends on seizure type, medical history, potential interactions, side effects, age, health, and cost. For individuals who do not respond to medications, alternative treatments such as dietary therapies or surgery may be recommended.

Epilepsy management requires a personalized approach tailored to each individual's specific symptoms, medical history, and response to treatment. Ongoing research and advancements in medical science continue to improve understanding and treatment outcomes for people living with epilepsy.

As advancements in medical science continue to improve treatment outcomes, Ankura Hospital remains at the forefront, providing cutting-edge care for epilepsy patients. Through its collaborative, patient-centered approach, the hospital aims to enhance the quality of life for those living with epilepsy, particularly women and children, ensuring they receive the care they deserve for a healthy future.