Epilepsy

Epilepsy is a neurological condition marked by recurrent seizures. This is caused due to abnormal electrical activity in the brain. The symptoms may vary depending on the type of epilepsy. However, the most common ones include lifestyle adjustment, dietary modulation, surgery, etc. For specialised epilepsy treatment, trust Gleneagles Hospital for a comprehensive solution.

Epilepsy is a neurological disorder that causes recurrent and unpredictable seizures. These seizures create emotional, physical, or social challenges for those living with them. Despite advancements in the field, the condition still remains misunderstood and stigmatised. Epilepsy requires proper management, which includes medical interventions, lifestyle adjustments, dietary adjustments, etc.

For those seeking expert care, consider Gleneagles Hospitals, as we have the best epilepsy doctors who offer a complete evaluation and personalised treatment plans to help patients manage seizures and improve their quality of life.

Epilepsy is a chronic neurological disease that causes repeated seizures due to abnormal brain cell activity. When the cells behave abnormally, they produce bursts of uncontrolled electrical activities that cause a seizure. They include changes in awareness, sensation, muscle control, emotions, etc. It can affect anyone, regardless of gender or race.

The message to and from the brain is transmitted via a continuous electrical impulse pattern in case of a burst of electrical energy—like an unpredictable lightning storm. This causes disruption in the brain that changes awareness, emotion, sensation, etc. There are several causes of the condition, and some may include genetic factors, brain injuries, strokes, infection, developmental issues, etc.

The symptoms of epilepsy widely depend on the type of seizures, which mostly include loss of sensation, uncontrollable jerking movements of the legs and arms, staring spells, tingling, etc. They can be diagnosed using neurological examination and tests such as electroencephalogram (EEG) to measure brain activity and brain imaging like MRI or CT Scans to detect abnormalities.

Focal Seizures: Focal seizures are also known as partial seizures that begin in a specific area of one hemisphere of the brain. They can be caused by localised brain abnormalities, such as brain injuries, tumours, infections, or congenital malformations. There are two types of focal seizures:

• Focal Aware Seizures – During this, the person remains conscious and is aware of the environment. Symptoms may vary depending on the affected area of the brain and can include sensory changes, such as tingling, visual disturbance, or unusual smells, in addition to motor symptoms like twitching or jerking of a limb.
• Focal Impaired Awareness Seizures – In these seizures, consciousness is altered, leading to confusion or a sense of detachment. There might be repetitive movements, such as lip-smacking or hand-gesturing, known as automatisms. 

Generalised Seizures:  Generalised seizures affect a wide network of cells on both sides of the brain at the same time. This leads to unconsciousness and various physical symptoms. There are several types of generalised seizures, such as:

• Tonic-Clonic Seizures – Characterised by muscle stiffening followed by rhythmic jerking movements.
• Absence Seizures – These involve brief lapses in awareness, often mistaken for daydreaming.
• Myoclonic Seizures – Causes sudden muscle jerk, which usually affects the arms and legs.
• Atonic Seizures – Results in a sudden loss in muscle tone. This leads to falls or head drops.
• Tonic Seizures – Involves stiffness in the muscle, usually in the back and arm. 

Progressive Myoclonic Epilepsy:  This is rare and often caused by genetic metabolic diseases, including mitochondrial encephalopathy and neuronal ceroid lipofuscinosis. Intellectual incapacity, muscle rigidity, and unsteadiness are possible symptoms in addition to seizures.

Reflex Epilepsy: In reflex epilepsy, the episodes are triggered by certain environmental stimuli. Seizures triggered by flashing lights are known as photosensitive epilepsy. The condition usually begins in childhood and is mostly outgrown by adulthood. Other environmental triggers are sound, such as ringing bells, certain songs, music, the sound of a person, etc. In adulthood, sometimes even thinking about small mathematical problems may also cause seizures.

Medications: Medications, such as anti-seizure medicines, are the most common treatment to control epilepsy. They work by calming the abnormal electrical activity in the brain that causes seizures. They do this by balancing the electrical signals and chemicals in the brain. Doctors prescribe these medications based on:

• Side effects of anti-seizure drug
• Other medical conditions (if any)
• Prior response to these medications
• Age, health, and patient’s condition
• Potential interactions with other medications

Monitoring is important to check if the medication is working properly. Side effects may include dizziness, mood changes, tiredness, etc. If any side effects occur, patients should consult a doctor immediately.

Note: Some anti-seizure medicines are linked to congenital disabilities. Patients should inform their healthcare provider if they are planning to start a family.

Special Diets:  Doctors may also recommend special diets to manage epilepsy, especially when medication alone does not work. Options include:

• Ketogenic Diet – High in fat, low in carbohydrates, with moderate protein. Effective for children with drug-resistant epilepsy.
• Modified Atkins Diet – High in fat, less strict than the ketogenic diet, and induces ketosis.
• Low Glycemic Index Treatment (LGIT) – Maintains steady blood sugar levels, helping stabilise brain activity. Medium-Chain Triglyceride Diet (MCT) – Uses MCT oils to produce ketones, offering flexibility and easier maintenance. 

Surgery:

• Resective Surgery – Removes the brain area causing seizures, usually effective when localised.
• Laser Interstitial Thermal Therapy (LITT) – Minimally invasive laser technique that destroys seizure-causing tissue.
• Corpus Callosotomy – Cuts the nerve fibres connecting the brain hemispheres to reduce seizure severity.
• Hemispherectomy / Functional Hemispherectomy – Radical surgeries for severe cases, usually in children. 

Neuromodulation:  For patients not suitable for resective surgery, devices may be implanted to regulate brain activity: 

• Vagus Nerve Stimulation (VNS) – Sends pulses via the vagus nerve to influence brain activity.
• Responsive Neurostimulation (RNS) – Detects abnormal brain activity and delivers stimulation to stop seizures.

Gleneagles Hospital is a top tertiary care multispecialty hospital renowned for advanced procedures in liver, neuro, heart, lung, and kidney transplants. We are equipped with advanced medical technologies such as 3 Tesla MRI, Da Vinci Xi Robot, and 24/7 facilities such as CathLab, emergency medicine, and pharma services. Our epilepsy treatment programs are known for incorporating tailored treatments based on the findings and test results.

We ensure comprehensive treatment options, which include personalised medication plans and dietary adjustments, in addition to using surgical methods to manage the condition. Our multidisciplinary team of neurologists, neurosurgeons, dieticians, and psychologists help patients live a healthy life ahead.