The brain as the headquarters controls human body activities by sending out normal electrical signals, and epilepsy is a clinical syndrome caused by repeated abnormal discharges in the brain. Epileptic seizures occur when brain cells are overexcited and send out chaotic electrical signals rapidly or even explosively.

When it occurs, there may be some strange sensations (such as smelling strange smells, distorted vision, etc.) or symptoms such as muscle stiffness, twitching, or even loss of consciousness. Most people return to normal within a few minutes.

What Types of Epilepsy Are There?

Epilepsy can be divided into three categories according to the cause:

• Idiopathic epilepsy: epilepsy of unknown cause, which may be closely related to genetics.
• Secondary epilepsy (symptomatic epilepsy): refers to a type of epilepsy with a known cause, often with clear structural damage or functional abnormalities of the central nervous system.
• Cryptogenic epilepsy: refers to a type of epilepsy that is presumed to be secondary epilepsy based on clinical manifestations, but a clear cause cannot be found with current examination methods.

What Are the Symptoms of an Epileptic Seizure?

Common symptoms of partial seizures include:

• Stiffness or twitching of limbs and facial muscles often occurs on one eyelid, corner of the mouth, or hands, and sometimes affects one side of the face or limbs.
• Numbness and pins and needles in the limbs often occur on the tongue, corners of the mouth, fingers, or toes.
• Pale face and body, flushing, sweating, piloerection, mydriasis, vomiting, borborygmi, polydipsia and urination feeling, etc.
• There may be some weird feelings before the attack, such as smelling a strange smell, distorted vision, rising stomach gas, mood changes, feeling scared or familiar, which we call aura.
• During an attack, you do not respond when others call you, and you appear to be restless, moving around, or repeatedly doing the same action, such as chewing, smacking your lips, etc. This is medically called automatism.
• If the abnormal discharge spreads from a local area to the entire brain, a generalized seizure will occur, and generalized tonic-clonic seizures are more common.
• When the attack ends, some people can recall what happened, while others have no idea what happened.
• The duration of an attack varies from person to person and can last from seconds to minutes. Most people do not have any symptoms during the period between attacks, but if there is a tumor, infection, or trauma in the brain, in addition to epileptic seizures, there may be other symptoms, such as vision loss, fever, diarrhea, etc.

Generalized seizures have the following main forms:

• Generalized tonic-clonic seizure: The patient will lose consciousness early and fall. Later, the main symptoms will be stiffness of the body, shaking of the limbs, and biting the tip of the tongue, accompanied by respiratory arrest, dilated pupils, spitting, etc., or accompanied by Incontinence of urine and feces, and then gradually regaining consciousness, this process usually lasts 5 to 15 minutes.
• Tonic seizure: Mainly characterized by muscle stiffness, the patient will be fixed in a certain position, and may be forced to raise his hands, hold his head, or turn his eyes upward, often accompanied by a pale complexion.
• Clonic seizures: Mainly characterized by repeated and regular muscle twitching, occurring in symmetrical parts of the limbs or on one side of the limbs, accompanied by loss of consciousness, and can last from one minute to several minutes.
• Absence seizure: During the attack, the patient will experience a brief loss of consciousness. The patient may suddenly stop the ongoing movements, have empty eyes, and have no awareness of the surrounding environment. It may be accompanied by muscle shaking and nystagmus. This seizure usually ends quickly and lasts 5 to 10 seconds.
• Myoclonic seizure: Symptoms of sudden and rapid jerking of the upper body, upper limbs, or lower limbs, as if receiving an electric shock. But consciousness is often unaffected.
• Atonic seizure: manifested by sudden muscle relaxation and weakness, causing the patient to suddenly fall to the ground without warning, or the head to droop. Often accompanied by loss of consciousness.

What Are the Causes of Epilepsy?

The cause of epilepsy is not yet completely clear. Common causes include brain trauma, brain tumors, stroke, intracranial infection (such as meningitis, encephalitis, etc.), parasitic infection (such as cysticercosis infection), etc.

However, more than 60% of patients with epilepsy have unknown causes, and some may be related to genetic factors.

What Treatments Are Available for Epilepsy?

The treatment of epilepsy is still based on drug therapy, and the treatment principles mainly focus on three aspects: controlling epileptic seizures, avoiding treatment side effects, and maintaining or restoring quality of life. The specific processing methods are as follows:

• There is no need to start anti-epileptic drug treatment immediately after a single epileptic seizure, and observation can be continued. If there are more than two seizures within six months, drug treatment should be given once the diagnosis is clear.
• Commonly used anti-epileptic drugs include enzyme-inducing anti-epileptic drugs (phenytoin, carbamazepine, phenobarbital, primidone, etc.) and anti-epileptic drugs with weak enzyme-inducing properties (oxcarbazepine, topiramate, etc.).
• During drug treatment, it is best to use a single drug. If the effect is not good, then use combination therapy, such as pregabalin or levetiracetam. It may increase drug side effects.
• In addition, there are some non-drug treatments, such as surgery, vagus nerve stimulation, etc., that can assist treatment.
• Surgery: When drug treatment is not effective, surgical treatment can be considered. Commonly used methods include temporal lobectomy, amygdala hippocampectomy, and brain pacemaker treatment.
• Vagus Nerve Stimulation: Simply put, it uses a device to send electrical energy to the brain, which can help reduce epileptic seizures.

Can Epilepsy Be Prevented?

Idiopathic epilepsy cannot be prevented. However, preventive measures can be taken against known causes of secondary epilepsy. Specific measures are as follows:

• Preventing head injuries is the most effective way to prevent post-traumatic epilepsy.
• Adopting appropriate perinatal care, such as regular prenatal check-ups and choosing the appropriate mode of delivery, can reduce new cases of epilepsy due to birth injuries.
• Maintain environmental hygiene, dispose of exposed feces and other stolen goods promptly to eliminate parasites in the environment, pay attention to personal hygiene, wash hands before meals and after using the toilet, and do not drink raw water to avoid infection and help reduce the risk of neurocysticercosis, etc. factors causing epilepsy.
• Avoid antibiotics that may induce epileptic seizures, such as ofloxacin, norfloxacin, etc.

Conclusion

The causes of epilepsy are complex. Some are related to factors such as brain trauma and cerebrovascular disease, and some may be related to genetics. However, the causes of most epilepsy are not yet clear.

At present, the treatment of epilepsy is still based on drug treatment. After standard treatment, most patients can control epileptic seizures and have a good prognosis.