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Epilepsy FAQs - Is Epilepsy related to mental illness?

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Is Epilepsy related to mental illness?
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Is Epilepsy related to mental illness?
Epilepsy is not related to mental illness. Because of the involvement Of the brain, Epilepsy has been mistakenly associated with psychiatric disorders. Epilepsy differs from psychiatric disorders in that seizures last for very brief periods and begin and end abruptly. Further, when not having seizures, people with Epilepsy need not have any changes in their mood or behavior and are normal persons able to carry out all activities of daily living and continue their studies or work.

Can Epilepsy affect intelligence?
Seizures can affect intelligence, so prompt diagnosis and rapid control of seizures is important. There is also a risk if seizures are prolonged and there is a significant reduction in oxygen in the brain during seizures. However, these are extremely rare occurrences. In the case of developmentally delayed persons with Epilepsy, it is most likely that the cause of the developmental delay is also the cause of the seizures. In most cases, people with Epilepsy have normal intelligence.

Why epilepsy happens?
The brain consists of millions of nerve cells, or neurones, and their supporting structure. Each neurone maintains itself in an electrically charged state. It receives electrical signals from other neurones, and passes them on to others. What actually happens is that a tiny quantity of a special neurotransmitter substance is released from the terminals of one neurone. This chemical excites an electrical response in the neurone next in the chain, and so the signal moves onward.

All the functions of the brain, including feeling, seeing, thinking and moving muscles depend on electrical signals being passed from one neurone to the next, the message being modified as required. The normal brain is constantly generating electrical rhythms in an orderly way. There is a cancellation of unwanted signals which does not allow the excitation to spread to unwanted parts of the brain for the activity under consideration. When this does not happen excitation of larger portion of neurones occur causing interference with brain function seen as epileptic manifestations.

In epilepsy this order is disrupted by some neurone discharging signals inappropriately. There may be a kind of brief electrical "storm" arising from neurones that are inherently unstable because of a genetic defect (as in the various types of inherited epilepsy), or from neurones made unstable by metabolic abnormalities such as low blood glucose, or alcohol. Alternatively, the abnormal discharge may come from a localized area of the brain (this is the situation in patients with epilepsy caused by localized structural changes such as head injury, or brain tumor or abnormal brain development).

Who can have epilepsy?
Practically, anyone can have excessive excitation of the brain cells leading to a seizure if there are precipitating conditions that reduce the threshold for electrical excitation such as fever, lack of sleep, alcohol, chemicals/drugs etc. In addition brain injury, strike, poisoning, metabolic disturbance in body’s chemical environment (such as heat or sun stroke) can cause seizures.

When unprovoked and repetitive we call it epilepsy. A single seizure may occur commonly in many persons and we do not cal it epilepsy but it is necessary to investigate even a single seizure Epilepsy is seen most commonly in childhood below the age of 10 years (50% of all onset of seizures), then becomes less in adolescent (70 % of all seizures have begun by 20 yrs), rare in adulthood and again is seen to rise after the age of 50 years.

How is epilepsy diagnosed?
Only a neurologist can diagnose epilepsy. To make a diagnosis, the neurologist may order a neurological exam, blood tests, an electroencephalogram (EEG), and other tests like a CT or MRI scan.

What types of doctors treat epilepsy?
In many cases, a person’s initial diagnosis of epilepsy is made by their primary care provider, family doctor, or an emergency department physician. To get the type of specialized care a complex condition like epilepsy requires, you should see a specialist. A variety of specialists treat epilepsy. These include adult and pediatric epileptologists, physicians who specialize in the diagnosis and treatment of epilepsy, and adult and pediatric neurologists, physicians who specialize in diagnosing and treating disorders of the nervous system, including epilepsy. Epilepsy treatment is often provided in a specialized Epilepsy Center, where a treatment team of specialists in multiple fields offer a full range of treatment options.

The ultimate goal of epilepsy treatment: seizure freedom with minimal side effects. The most common treatment is with antiepileptic drugs (AEDs). Your neurologist may prescribe one or many AEDs to find the best treatment option for you. Other treatment options include ketogenic diet, Vagal Nerve Stimulator (VNS), and surgery.

Can epilepsy be fatal?
Most people with epilepsy live a full life span. Nevertheless, the risk of premature death is increased for some, depending on several factors:
  • Sometimes epilepsy is a symptom of a more serious underlying condition; such as a stroke or a tumor that carries an increased risk of death.
  • People with some types of epilepsy who continue to have major seizures can experience injuries during a seizure from falling or hurting their head that may occasionally be life-threatening.
  • Very prolonged seizures or seizures in rapid succession, a condition called status epilepticus, can also be life-threatening. Status epilepticus can sometimes occur when seizure medication use is stopped suddenly.
  • Rarely, people with epilepsy can experience sudden death (SUDEP). These events are not well understood, although they are suspected sometimes to be due to heart rhythm disturbances during a seizure. Sudden death due to heart rhythm disturbances can also occur in the general population. The risk of sudden death is not increased for all types of epilepsy, but occurs more among people with major seizures, especially generalized tonic-clonic seizures that are not well controlled.
Is epilepsy a disease?
Epilepsy is not a disease. It is a symptom of a neurological disorder–a physical condition–which causes a malfunction of the electrical signals which control the operation of the brain. It is characterized by sudden, brief seizures whose nature and intensity varies from person to person.

How does our nervous system work?
Nerves throughout the body act like telephone lines, allowing the brain to communicate with the rest of the body via signals. This is our nervous system.From the moment we are born to the moment we die, this communications network controls our every thought, our every emotion, every step we take, every impression we get. Without it we could not plan, feel, move a muscle, nor distinguish between pleasure and pain.

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