Diseases and Disorders

An Overview of Epilepsy: A Seizure Disorder

Maha Kirmani


Introduction

Epilepsy is classified as a seizure disorder derived from the brain. Epilepsy is diagnosed when a patient receives two or more recurring seizures that weren’t influenced by previous neurological trauma [1]. While epilepsy is classified as a seizure disorder, not all seizures are derived from epilepsy. These seizures can be induced by infections, traumas, or fevers. The disorder brings the individuals many life challenges. An epileptic may have difficulty driving, operating machinery, or playing sports. We will discuss the history of, types of, and the causes of epilepsy, and its modernized surgical treatments.

 

History of Epilepsy

Epilepsy is a well-known disorder both in historical and modern contexts, even being referenced in the Bible. History indicates that the Babylonians were the first people group to record occurrences of epilepsy in their society. They believed the seizures were derived from demonic possession of the individual and the different types of seizures signified the presence of a diverse array of demons.

In 400 BC, the Greeks also recorded incidents of epilepsy within this society and classified the disorder as the “sacred disease”. They believed epilepsy was a curse bestowed on the individual by the goddess Selene.  The legend dictated that the afflicted one would spend a night in her temple and wait for the deity to summon them in their dreams, where she would then tell them how to remove the curse.

The Romans treated epileptics poorly and often isolated them from society. They also initiated the first treatment for epileptics, which involved providing them blood of a recently murdered individual. Gladiators were the preferred sacrifices[1].


Types of Epilepsy

There are two common epileptic seizures: generalized seizures and tonic-clonic seizures. A generalized seizure involves a sudden discharge of neurons on both sides of the brain. The origin is localized, but the neural dysfunction spreads to other regions fairly quickly. There are many types of generalized seizures. The tonic-clonic seizure usually occurs  when there is a large discharge of neurons in both cerebral hemispheres [3]. This seizure often encompasses convulsions and can cause the individual injury if they aren’t in a safe place. Another generalized seizure is the atonic seizure.this specific seizure causes the person to fall down, due to loss of muscle tone.

A partial seizure is another type of epileptic seizure. There are two main partial seizures: simple partial seizures and complex partial seizures. Simple partial seizures are short seizures that make the patient experience unusual sensations in an olfactory, visual, or auditory capacity. During complex partial seizures, patients may experience olfactory or visual hallucinations, sudden recall of memories, and sensations of Déjà vu [2].

 

Causes

Epilepsy is most commonly a result of head injuries, stroke, brain tumor, and infections such as meningitis . About 50%-70% of the cases of epilepsy are idiopathic. Brain damage derived from traumatic head injuries may leave a “scar” on the brain and the location of the scar is normally where the epileptic seizures start [3]. There is no defined cause for epilepsy as many factors can trigger the disorder.  Epilepsy can be triggered by a lack of sugar, stress, and even lack of sleep.

 

​Treatment Options 

Vagus Nerve Stimulation: VNS is an adjunctive (add-on) therapy. It is primarily utilized for those who suffer from drug-resistant epilepsy. This therapy implants a device located on the left side of the chest. The device is a pacemaker-like generator that is programmed to stimulate the vagus nerve. This device is woven around the vagus nerve to lessen the number of seizures. VNS therapy is beneficial for epilepsy, as it can reduce the number of seizures for an epileptic and enhance their quality of life [4].

 

Responsive Neurostimulation

 Responsive Neurostimulation treats uncontrolled partial-onset seizures. This innovation provides neurostimulation, actively monitors brain signals, and provides stimulation for abnormal electrical events. RNS is usually known as the pacemaker for the brain. This device is implantable and is connected to two small lead wires that are placed in up to two areas of the brain where the seizures start. RNS is a relatively new advancement that could aid many epileptics . While this treatment is not considered a cure for epilepsy, it reduces the number of seizures for most patients [6].

 

Stem Cell Therapy

Stem cells are cells that haven't differentiated, that, when injected, can replicate and differentiate into the cells it’s surrounded by. Stem cells are utilized to replace damaged tissues. There is great potential for stem cells in treating epilepsy, as they can replace abnormal cells that cause epilepsy [7]. This advancement is still in its early stages and is currently being experimented on rats.

 

Eslicarbazepine Acetate-Aptiom (Brand Name)

Aptiom is an anticonvulsant that decreases nerve impulses that cause pain and seizures. It is used specifically for partial-onset seizures. This drug has a stronger mechanism of action meant for patients whose treatments haven’t been effective. There are a variety of drugs that are anti-convulsant, but Aptiom is one of recent drugs that have been released as an anticonvulsant. 

Surgeries

There are three main surgical options for people with epilepsy:

 

Conclusion

Epilepsy is a disorder that affects about 65 million people in the world presently. But, as the research progresses, the potential for improved treatment also increases, leading to better quality of life for all those affected by it. 

 

Glossary [8]

Babylonians: A resident of ancient civilization Babylonia

Neurons: A nerve cell that sends nerve impulses

Cerebral hemispheres: The two parts of the cerebrum (left and right) in the brain of a vertebrate

Stroke: The result of which a clot forms in a blood vessel in the brain.

Brain tumour: Abnormal cell forms to become a tumor in the brain

Meningitis: An infection that infects the membranes covering the brain and spinal cord


References


  1. History of epilepsy. (n.d.). Retrieved July 24, 2019, from Epilepsy Canada website: https://www.epilepsy.ca/history-of-epilepsy.html

  2. CURE. (2017). Retrieved May 22, 2017, from http://www.cureepilepsy.org/aboutepilepsy/facts.asp

  3. American Epilepsy Society. (n.d.). Retrieved May 22, 2017, from https://www.aesnet.org/epilepsy_101

  4. Vagus Nerve Stimulator (VNS) Implantation | Children's Hospital Pittsburgh. (2017). Retrieved May 22, 2017, from http://www.chp.edu/our-services/brain/neurosurgery/epilepsy-surgery/services/vns-implantation

  5. Responsive Neurostimulation. (2017). Retrieved May 22, 2017, from http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/responsive-neurostimulation

  6. How the RNS® System Works | NeuroPace, Inc. (2017). Retrieved May 22, 2017, from http://www.neuropace.com/the-rns-system/

  7. Foundation, E. (2016, June 08). The Use of Stem Cell Therapy in Epilepsy. Retrieved May 22, 2017, from http://www.epilepsy.com/article/2016/6/use-stem-cell-therapy-epilepsy

  8. Dictionary by Merriam-Webster: America’s most-trusted online dictionary. (n.d.). Retrieved March 7, 2020, from https://www.merriam-webster.com/

  9. What is epilepsy? Types of epilepsy and seizure | mnc. (2019, December 26). https://miamineurosciencecenter.com/en/conditions/epilepsy/

  10. Aptiom (Eslicarbazepine acetate tablets): Uses, dosage, side effects, interactions, warning. (n.d.). RxList. Retrieved March 7, 2020, from https://www.rxlist.com/aptiom-drug.htm

Maha Kirmani

Maha Kirmani


I am currently a sophomore Neuroscience major and passionate about research and innovation in the field of neuroscience. I am a member of the B.R.A.I.N.S and Sfn Chapter at my school. I am a squash enthusiast and love to read and travel.