An Epileptic Seizure Essay

Epileptic seizures: when the neurons in the brain become disrupted by a sudden, large excitement of surrounding neurons producing abnormal messages. I knew none of this when I was diagnosed with epilepsy at the age of four years old. All I understood was I was repeatedly waking up in a hospital bed with my family over me. This disease wasn’t something you could prepare for, rather it would flare up at seemingly the most unwanted times.

The nature of this disease made me seem perfectly normal to many of the other kids, little did they know that I was being terrorized by my brain without even knowing it.An Epileptic Seizure Essay.  As I became slightly older people would ask me if I remembered what happened during my seizures and I would quietly respond that I didn’t. Questions like these made me fear I had something wrong with me and that I’d never experience that childhood euphoric feeling of “fitting in. ” The first time I had a seizure I remember lying in bed watching television with my parents. I would continue to lie in bed that day, only it wasn’t in my house. Instead four-year-old me lied quietly in a hospital bed, lullabied by the sound of the heart monitor. It was then I infamously recalled hearing the word “epilepsy” come out of the doctor’s mouth. I had no idea what it meant for me, all I could understand was that something wasn’t right. After this first incident I was prescribed medication I later learned was called “Depakote. ” This is a drug that helps alter chemistry in your brain tissue in order to prevent seizures. Although this may sound extremely helpful, it came with some unintended side effects. Not to mention, it was a large pill prescribed to a young girl so every night my mother would have to crush it up on top of yogurt or ice cream to serve to me. Aside from that and upon looking back at my childhood I realized this medicine was the reason many teachers described me as a “day-dreamer. ”

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Since this medication alters brain chemistry, it can cause confusion and lack of concentration. I found it difficult to pay attention in class, retain information and sometimes to even hold conversations. This made academics a lot harder for me and forced me to have to work harder than other kids in order to get the same results. I didn’t know this was a side effect of the medicine, so again I felt defeated and as if I wasn’t normal. However, I didn’t let any of this stop me. I knew that if I ever wanted to beat this disease that I’d have to stay strong and do what was needed.An Epileptic Seizure Essay.  I continued taking the medication I hated so much. I continued attending EEG screenings to map electroactivity in my brain, which forced me to stay up all night. I continued to study harder and try my hardest to focus to maintain quality grades. Most importantly though, I continued to keep my head up. I knew I needed to stay positive during this situation in order to make the best of it and I really feel like I have accomplished that.

I thankfully “grew out” of my epileptic seizures at the age of thirteen despite doctors telling me that “there was a high medical chance I wouldn’t beat it. ” This meant I couldn’t drive a car, get my license or operate any sort of machinery. I would have to live the rest of my life knowing there was a chance that I would have one of those unpredictable seizure episodes. However, through my dedication to beat this disease and maybe a little bit of luck, epilepsy wasn’t able to defeat me. Honestly, in a way I’m thankful to have gone through an abnormal childhood experience because it taught me the values of hard work and perseverance. Most importantly, it taught me to be humble and thankful about everything I have been given in my life.

Epilepsy is the oldest known brain disorder dating back as early as 2080BC (Cascino et al., 1995). It was first identified as a disease by Dr Jon Hughlings Jackson in 1880 who defined it as “An occasional, sudden, massive, rapid and local discharge or the grey matter” (Scott, 1978). This definition has been confirmed 50 years later by Electroencephalography. A more recent definition was devised stating “Epilepsy is a neurological disorder in which the nerve cell activity in your brain is disturbed, causing a seizure during which you experience abnormal behaviour, symptoms and sensations, including loss of consciousness.”(Scambler, 1989) An Epileptic Seizure Essay.

Worldwide, it is estimated that there are 65 million people living with epilepsy with almost 80% of the cases reported occurring in the developing world (Ngugi et al., 2010). Within the UK, the prevalence is between 1 in 40/70,000 which equates to 3% of the population will develop epilepsy in their lifetime.

Recurrent seizures are the hallmark characteristic of an epileptic. If an individual has one seizure early in their lives then none thereafter, they are said to have had an epileptic seizure but do not suffer from epilepsy. (Duncan et al., 2006)

Seizures

A seizure is abnormally excessive neuronal activity localised to a particular area of the brain known as the cerebral cortex causing a disruption to normal brain function. These cortical discharges will transmit to the muscles causing convulsions or commonly referred to as a fit.

Figure 1 – Generalised seizure with neuronal activation in both hemisphere

Classifying seizures is done based on the site of the brain which the seizure begins. This will be either; Partial – where the onset of seizure is localised to one part of the hemisphere (fig. 1), Generalised – where the onset of the seizure is across both hemispheres (fig. 2) or Secondary generalised – where a partial seizure later spreads to involve the majority of the 2 cerebral hemispheres (Duncan et al., 2006). 

Figure 2 – Partial seizure with neuronal activation in one hemisphere

The International League Against Epilepsy (ILAE) have defined 6 main types of seizures: Clonic, Tonic, Tonic-Clonic, myoclonic, absence and atonic (Solodar, 2014), with all having the shared characteristic of syncope.

Tonic-clonic seizures (grand mal seizures) are the most common and typically last 30 seconds with an initial back arching motion (tonic phase), followed by severe shaking of body limbs (clonic phase) in which sufferers can become incontinent and bit their tongue (fig. 3).

Myoclonic seizures consist of muscle spasms throughout the body, while absence seizures only display mild symptoms such as a slight head turn or repetitive eye blinking (Engel and Pedley, 2008).

Causes of Epilepsy

Majority of cases are termed idiopathic, meaning there is no known reason for the disorder in that individual. The difference in causes amongst the general population can be seen in figure 4.

Genetic factors can causes epilepsy as can environmental factors. In general it is a combination of the two which go on to cause someone to become epileptic. Over 500 genes have been identified to be linked to the disorder if mutated with some making individuals more sensitive to environmental conditions that can initiate seizures (Sanchez-Carpintero Abad et al., 2007).

Some symptomatic causes of epilepsy include; brain tumours, strokes, low oxygen during birth, head injuries during birth or during a person’s lifetime, infections such as meningitis or anything which causes damage to the brain (Chang and Lowenstein, 2003).

Figure 4 – Causes of epilepsy amongst the general population

Conclusion

Epilepsy is a condition which has a host of causes as have been highlighted. It is the category of seizure within the brain an individual has which will determine the type of seizure they have and the altered body state which is displayed. This can be a very distressing disorder for sufferers as they are unable to control when they have a seizure and could occur at a very dangerous time such as whilst driving.An Epileptic Seizure Essay.  The effective management via medication, surgery or lifestyle changes can reduce a person’s chance of suffering future seizures. Unfortunately in the majority of cases, the cause is unknown. This makes it highly difficult to target the disease for a cure, therefore minimising the probability of a seizure is the next best thing.

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References

CASCINO, G., HOPKINS, A. O. & SHORVON, S. D. 1995. Epilepsy, London, Chapman & Hall Medical.

CHANG, B. S. & LOWENSTEIN, D. H. 2003. Epilepsy. N Engl J Med, 349, 1257-66.

DUNCAN, J. S., SANDER, J. W., SISODIYA, S. M. & WALKER, M. C. 2006. Adult epilepsy. Lancet, 367,1087-100.

ENGEL, J., JR. & PEDLEY, T. A. 2008. Epilepsy : a comprehensive textbook, Philadelphia, Pa. ; London, Wolters Kluwer/Lippincott Williams & Wilkins.

NGUGI, A. K., BOTTOMLEY, C., KLEINSCHMIDT, I., SANDER, J. W. & NEWTON, C. R. 2010. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia, 51,883-890.

SANCHEZ-CARPINTERO ABAD, R., SANMARTI VILAPLANA, F. X. & SERRATOSA FERNANDEZ, J. M. 2007. Genetic causes of epilepsy. Neurologist, 13, S47-51.

SCAMBLER, G. 1989. Epilepsy, London, Tavistock / Routledge.

SCOTT, D. 1978. About epilepsy, London, Duckworth.

SOLODAR, J. 2014. Commentary: ILAE Definition of Epilepsy. Epilepsia, 55, 491. An Epileptic Seizure Essay.

Figures

ENGEL, J., JR. & PEDLEY, T. A. 2008. Epilepsy : a comprehensive textbook, Philadelphia, Pa. ; London, Wolters Kluwer/Lippincott Williams & Wilkins. – figures 1 & 2

http://www.doctortipster.com/10291-generalized-tonic-clonic-epilepsy-seizures-grand-mal-seizures-clinical-presentation.html – figure 3

http://www.cureepilepsy.org/egi/about.asp – figure 4

An Epileptic Seizure Essay