Epilepsy

Epilepsy is defined as a disorder occurring due to disturbance in normal flow of electrical signals in brain. Epilepsy is also termed with the name of seizures and convulsions.

epilepsy

Epilepsy is a neurological disorder, in which there occur disturbance of the nervous functions. Epilepsy is term used for a disorder in which a person suffers from repeated attacks of seizures (convulsions).

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Seizure is a term used due to disturbed electrical impulses of brain person shows an abnormal behavior and attention.
In seizures due to disturbed electrical impulses in brain the neurons or nerve cells send deranged signals to different parts of body. And due to these deranged signals the part affected react abnormally such as people show strange behavior, emotions, and strange sensations.
Some people may lose normal conscious or have violent muscle spasm.

These deranged abnormal signals by brain are created due to some underlying disease or illness of the brain such as trauma to brain tissue, or abnormal brain development of fetus due to ill health of mother, or any other disease condition of brain as tumor.

PATHOPHYSIOLOGY
Seizures are the deranged manifestation of cerebral cortex part of brain.
Cortical neurons present in cerebral cortex part of brain have a net of electrical signals which help a person to perform his daily routine work.

Due to some sudden excitation force from outside body or any disease condition of brain the network of signals get disturbed. When this sudden imbalance affect the excitatory and inhibitory forces present in the network of cortical neurons leads to the formation of seizures.

Clinical manifestation in epilepsy depends on the area of brain involved.

Superficially there are mainly two types of seizures focal -onset-seizures and generalized-onset-seizures.

Mechanism working in brain to produce focal-onset-seizures is travelling of focal interictal epileptiform spike or wave in a wrong way. This charge of electrical impulse travel in single cortical neuron through PDS (paroxysmal depolarization shift) process.
In epilepsy when visual area of cortex show derangement then epileptic attack involves visual instability.

In epilepsy when or pharyngeal area( i.e. mouth, jaw, tongue) of cortex show derangement then epileptic attack shows sudden changes in these organs as clenched teeth, or twisting of tongue, or salivation excessive.

In cases of generalized seizures the mechanism of travelling of defected impulse is same but in this type of epilepsy multiple areas of cortex are involved at a time and patient reflects multiple body deficits during attack.

Defected impulses travel through multiple cortical neurons and whichever the neuron is involved that particular part is deranged.
Age / Sex of Epilepsy

Epileptic attacks can occur at any age group. Age group can involve from new born infant to an old age person. Any age group and any gender can suffer from this disorder.

Epilepsy is prevalent in 1 out of 100 persons.

35% cases of epilepsy show complex partial seizures. Countries where cystisercosis is more prevalent show history of more prevalence of partial seizure. Partial seizure cases are more prevalent in higher age groups.

Causes of Epilepsy

• Neoplasm’s of brain.
• Cortical malformations.
• Vascular malformation in the vessels of brain.
• Infections of central nervous system.
• Hypoxic-ischemic brain injury due to embolism in vessels supplying blood to brain.
• CNS inflammation due to immune response.
• Trauma to head.
• Stroke.
• Malformations in the cortical part of brain.
• Hippocampus sclerosis is also included as one of the cause.
• Inherited defects of cortex.

Signs and Symptoms of Epilepsy

• Clinical signs and symptoms of epilepsy depend upon the area of cerebral cortex affected.
• Onset of attack of seizure start with some particular signs which reflect that attack is going to occur and that collection of early signs are known as aura.
• Aura includes particular visual affect or particular smell.
• After the attack of seizure patient is tired and have a lot of weakness unable to perform work after attack and want rest. Some patients do not even remember what happened during attack.
• Sign and symptoms depend on the area of brain deranged.
• Partial seizures
• Simple partial seizures
• Consciousness is not lost.
• Jerking affects in arm or leg.
• Disturbance at visual plane that is flashing of lights.
• Abnormal smells during attack.
• Facial tic.
• This type of seizutre starts in face or hands.
• Complex partial seizures
• Loss of consciousness is present in this type or there may be slight alteration in consciousness.
• Patient makes sounds having no meaning.
• Jerking of one limb or both the limbs.
• Patient memory suddenly vanishes as where he was 5 minutes ago.
• Even after the attacks the patient is lost in his own world unable to answer the questions.
• Patient star at a particular thing with suspicion.

Generalized seizures include many type of seizures explained below-
• Febrile seizures
• Very common type of seizure in children who are below the age of five.
• Cause of the seizure is fever.
• Epileptic attack is associated with fever.
• Meningitis to be find out if present because if meningitis is present in child then condition is critical.
• Infantile spasms
• Occur in babies.
• Babies suddenly bend forward on neck.
• Infantile seizure occurs only for few seconds but attacks are repeated.
• Baby cries after attack.
Atonic seizure
• Also called with the name of drop attacks.
• It is called drop attacks because there is sudden loss of muscle tone.
• Patient does not loss conscious but fall to the ground due to loss of muscle tone.
Myoclonic seizure
• In this type of epilepsy there are small attacks of body jerks.
• There is no loss of conscious but the patient cannot hold the things in hand during attack
Absence seizure (petit mal)
• Occur in children and there is loss of conscious lasting for 30 seconds.
• There is fluttering of eyelids.
• Children are not aware of surroundings during attack.
• Patient forget what happened in attack.
• Tonic- clonic seizure (grand mal)
• Muscle spasm seen throughout the body, loss of consciousness and falling.
• Attack last for 2 minutes.
• Patient is tired and confused about.

Complications of Epilepsy

• If patient falls during attack fracture of bone can occur or injury to the part on which the patient falls.
• If patient is suffering from epilepsy and perform swimming, possibility of drowning is increased.
• Car accidents can occur if patient suffer from attack during driving.
• Epilepsy causes complications during pregnancy.
• Stress level increases during epilepsy.
• Some threatening conditions are status epilepticus; sudden unexplained death due to epilepsy is also seen.

How to Investigate Epilepsy ?

• Neurological examination of the patient. History taking plays important role in getting type of seizure and severity of attack.
• Blood tests are done that is
Serum  calcium.
Serum potassium.
Hb%
Serum glucose
•Other investigations include diagnostic tools i.e.
EEG (electroencephalogram)
CT (computerized tomography) scans.
MRI
Single photon emission computerized tomography.
Neuropsychological test.

How toTreat Epilepsy ?

Anti epileptic drugs are helpful.
Increase of dosage depends on the severity and recurrence of attack.
These epileptic drugs show some side effects and that are
• Decrease of bone density.
• Skin rashes.
• Gain in weight.
• Dizziness all the time.
• Loss of coordination.
• Speech problems.
Depression and inflammation of some organs like liver are rare complications but are very dangerous for patents.

Homeopathic medicines helps in treating Epilepsy ?

Cuprum metallicum
• Well indicated medicine for epilepsy.
• Aura of epilepsy starts in knees.
• Along with attack of epilepsy there is great weariness of limbs. Tired feeling in limbs.
• Cramping pain in soles of feet and calves.
• Cramps in palms.
• Twitching, jerking of limbs.
• Thumbs are clenched during attack.
• Clonic type of epilepsy beginning in the toes and fingers.

Artemisia vulgaris 
• Well indicated medicine for petit mal epilepsy.
• Epilepsy without aura.
• Epilepsy occurs after fright or other violent emotions.
• Epilepsy after masturbation.
• Patient suffers from several convulsions, close together.
• Very good remedy for epileptic condition and convulsive diseases of children and in girls at puberty.

Hydrocyanicum acidum
• Hysterical and epileptic convulsions.
• Patients have sinking sensation in the epigastrium.
• Patient suffers from spasmodic constriction in the larynx.
• Pain and tightness in the chest.
• Well indicated medicine for convulsions and paralysis.
• Very good remedy for collapse due to pulmonary disease not a cardiac collapse.

Silicea
• Well indicated medicine for spasms, epilepsy.
• Before the attack of epilepsy patient have sensation of coldness.
• Medicine plays very good role for diseases occurring due to bad effects of vaccination.
• Patient is intolerant to alcohol.
• Epilepsy, want of grit, moral or physical.
• Paralysis and weakness of forearms.
• Sweating from feet too profuse and fetid smell.

Calcarea arsenicum
• Epilepsy occurs after the rush of blood to the head.
• Aura is felt in the region of heart.
• Patient feels as if he is flying.
• Well indicated medicine for females at climacteric age.
• Well indicated medicine to fat women.
• Headache after the attack and mostly felt around the ears.

Diet / management of Epilepsy

• Yoga and meditation helps to keep calm
• Take enough sleep
• Always take proper medication such as anticonvulsants etc.
• Talk to patient make them emotionally stable and stress free
• Don’t skip meals, balance diet helps in healthy living
• Avoid using heavy machinery or heavy activities in cases one is epileptic
• Avoid alcohol
• Wear a medical alert bracelet in case of emergency personnel know how to treat you correctly.

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