International Epilepsy Day 10th Feb 2020

International Epilepsy Day is an annual event celebrated on the second Monday of February, by over 120 countries around the world. The day is observed to raise awareness about epilepsy, a chronic disease affecting the brain and causing sudden attacks and seizures. On this day people come together to share the problems faced by the epilepsy patients, their relatives and care takers.
People discuss the social and medical aspects of the disease with doctors, psychologists and social workers. The events are initiated by the International Bureau of Epilepsy (IBE) in collaboration with the International League against Epilepsy (ILAE)
International Epilepsy Day – History
The announcement to celebrate an International Epilepsy Day was made on 4th January 2015 by the International Bureau of Epilepsy (IBE) and the first International Epilepsy Day was celebrated on Monday, 9th February 2015.
What is Epilepsy?
Epilepsy-a non-communicable condition, is a brain disorder that can affect a person of any age and which causes sudden abnormal electric discharges from brain surface.
The period of seizures could be brief or long and cause vigorous shaking or severe tightness of body or complete loss of tone, leads to fall. The seizure in most of the cases is almost instantaneous and could result in physical injury.
Moreover, the seizures have a tendency to reappear.
What Causes Epilepsy?
Some of the main causes of epilepsy include:
Low oxygen during birth
Head injuries that occur during birth or from accidents during youth or adulthood
Brain tumours
Genetic conditions that result in brain injury, such as tuberous sclerosis
Infections such as meningitis or encephalitis
Stroke or any other type of damage to the brain
Brain abnormal blood vessels
Abnormal levels of substances such as sodium or blood sugar
In up to 70% of all case of epilepsy in adults and children, no cause can be discovered.
What triggers an epileptic seizure?
Some people are able to identify things or situations that can trigger seizures.
A few of the most commonly reported triggers are:
lack of sleep
illness or fever
stress
bright lights, flashing lights, or patterns
caffeine, alcohol, medicines, or drugs
skipping meals, overeating, or specific food ingredients
Identifying triggers isn’t always easy. A single incident doesn’t always mean something is a trigger. It’s often a combination of factors that trigger a seizure.
A good way to find your triggers is to keep a seizure journal. After each seizure, note the following:
Day and time
What activity you were involved in
What was happening around you
Unusual sights, smells, or sounds
Unusual stressors
What you were eating or how long it had been since you’d eaten
Your level of fatigue and how well you slept the night before
You can also use your seizure journal to determine if your medications are working. Note how you felt just before and just after your seizure, and any side effects.
Bring the journal with you when you visit the doctor. It may be useful in adjusting your medications or exploring other treatments.
What are the symptoms of epilepsy?
Seizures (Fits) are the main symptom of epilepsy. Symptoms differ from person to person and according to the type of seizure.
 alterations to sense of taste, smell, sight, hearing, or touch
 dizziness
 tingling and twitching of limbs
 loss of awareness or consciousness
 staring blankly
 unresponsiveness
 performing repetitive movements
 muscle stiffness.
 loss of muscle control and can make you fall down suddenly.
 repeated, jerky muscle movements of the face, neck, and arms.
 stiffening of the body
 shaking
 loss of bladder or bowel control
 biting of the tongue
How is epilepsy treated?
Your treatment plan will be based on the cause of seizures, severity of symptoms, your health, and how well you respond to therapy
 Medical therapy
 Surgical therapy
Medications for epilepsy
The first-line treatment for epilepsy is antiseizure medication. These drugs help reduce the frequency and severity of seizures. They can’t stop a seizure that’s already in progress, nor is it a cure for epilepsy.
The medication is absorbed by the stomach. Then it travels the bloodstream to the brain. It affects neurotransmitters in a way that reduces the electrical activity that leads to seizures.
There are many antiseizure drugs on the market. Your doctor can prescribe a single drug or a combination of drugs, depending on the type of seizures you have.
Is surgery an option for epilepsy management?
Brain lesions-Tumours, Abnormal/ malformed blood vessels are the curable pathologies.
Lesionectomy:This surgery removes brain lesions -- areas of injury or defect like a tumour or malformed blood vessel -- that cause seizures. Seizures usually stop once the lesion is removed.
Medically Intractable Epilepsy- (Epilepsy surgery)
As many as 25% to 30% of epileptic patients fail to respond to adequate antiepileptic treatment. Medically intractable (or refractory) epilepsy is commonly conceived as that which occurs when satisfactory seizure control cannot be achieved with any of the potentially available effective anti¬epileptic drugs (AEDs), alone or in combination, at doses or levels not associated with unacceptable side effects
The type of surgery depends on the type of seizures you have and where in your brain they start
Epilepsy surgery:
Epilepsy surgery is a procedure that removes or alters an area of your brain where seizures originate.
Epilepsy surgery may be an option when medications do not control seizures, a condition known as medically refractory epilepsy or drug-resistant epilepsy.
The goal of epilepsy surgery is to eliminate seizures or limit their severity with or without the use of medications.
Types of epilepsy surgery:
The type of surgery depends largely on the location of the neurons that trigger the seizure and the age of the patient. Types of surgery include the following:
 Resective surgery/ Lobe resection:Most common epilepsy surgery
Brain, the cerebrum, is divided into four sections called lobes: the frontal, parietal, occipital, and temporal lobes.
Temporal lobe epilepsy, in which the seizure focus is within your temporal lobe, is the most common type in teens and adults.
In a temporal lobe resection, brain tissue in temporal lobe area is cut away to remove the seizure focus.
Medial Temporal resections: For lesions that are deep in the temporal lobe are resected.
Extratemporal resection involves removing brain tissue from areas outside of the temporal lobe.
Corpus callosotomy: The corpus callosum is a band of nerve fibres connecting the two halves (called hemispheres) of your brain.
In this operation, which is sometimes called split-brain surgery, cuts the corpus callosum. This stops communication between the hemispheres and prevents the spread of seizures from one side of your brain to the other. It works best for people with extreme forms of uncontrollable epilepsy who have intense seizures that can lead to violent falls and serious injury.
Hemispherectomy: Is a procedure to remove one side (hemisphere) of the folded gray matter of the brain (cerebral cortex). This surgery is generally reserved for children who experience seizures that originate from multiple sites in one hemisphere, usually the result of a condition present at birth or in early infancy.
Functional hemispherectomy: also primarily used in children, is the undercutting of the seizure-inducing hemisphere to sever its connections to the body's nervous system without the actual removal of brain tissue.
Other Therapies:
Deep brain stimulation:Treating seizures with brain stimulation via deep-brain structures such as anterior nucleus of the thalamus (ANT) is an option.
The use of an electrode — permanently implanted deep inside the brain — to release regularly timed electrical signals that disrupt abnormal, seizure-inducing activity.
Laser interstitial thermal therapy (LITT):MRI-guided laser-induced thermal ablation for epilepsy is an exciting new minimally invasive technology with an emerging use for lesionectomy of a variety of epileptogenic focuses (hypothalamic hamartomas, hippocampal sclerosis, cortical dysplasias, cortical malformations, tubers) or as a disconnection tool.
Vagus nerve stimulation:Particularly attractive to patients who are not candidates for resective surgery
Risks involved in Epilepsy surgery:
Different areas of the brain control different functions. Therefore, risks vary depending on the surgical site and the type of surgery.
Risks may include the following:
Memory and language problems that can affect your ability to understand and use language
Visual impairment where the fields of vision of your eyes overlap
Depression or other mood changes that can affect interpersonal or social function
Headache
Stroke