Nervous system disorder stands for any disease or disorders that affect the functioning of the brain and spinal cord. The mind commands all perception, thought and action, but moods, thoughts and perception are also affected by various disturbance or malfunction of the nervous system.
About 60 million people worldwide suffer from epilepsy. Every year about 30 to 50 new cases of epilepsy per 100,000 people are discovered. The gender breakdown is 48% female and 52% male. Mainly epilepsy occurs in two phase of life: during childhood and after the age of 55.
Epilepsy is a recurrent, proximal, sudden, transient disturbance of cerebral function characterised by disturbance of movement, sensation, behaviour or consciousness.
It is Idiopathic and Familial predisposition is common and its Precipitating causes are Fever, fatigue, fasting, pain, trauma, emotional disturbance, noise, bright; flickering, premenstrual tension, shock, alcohol, drug use.
SECONDARY CAUSES They are subdivided into following subdivisions.
Tumour, hydrocephalus, subarachnoid haemorrhage, meningitis, encephalitis, cysticercosis, head trauma, cerebro-vascular accident, hypertensive encephalopathy, stokes-adams syndrom.
EXTRACRANIAL CAUSES Eclampsic toxaemia, uraemia, hepatic failure, hypocalcaemia, cerebral malaria, tetanus, alcohol, carbon, monoxide poisoning.
Paroxysmal cerebral dysrhythmia: repeated, sudden, paroximal, excessive high voltage discharges within, brain substance.
Cause– inability of brain to control voltage and frequency of nervous activity and cerebral rhythm.
(i) Disordered metabolism of cerebral neurons in which abnormal discharge originates.
(ii) Nature of metabolic disturbance is unknown. Metabolism of nerve cells in activity is accompanied by changes of electrical potential, which can be recorded on ECG.
TYPE OF EPILEPSY-
(i) Grand mal seizures
(ii) Petit mal seizures
(i) Jacksonian seizure
(ii) Psychomotor seizure
GRAND MAL SEIZURES
Characterised by following stages:
PRODROME– Irritability, restlessness, euphoria, depression, lethargy, duration is variable.
AURA – Precedes convulsions, duration is for few seconds, vague sensations, abdominal pain or discomfort, sensation of butterflies in abdomen, headache, dizziness, yawing, numbness, fear.
TONIC PHASE– Duration is 10-30 seconds, spasmodic muscular contractions, epileptic cry (hollow sound due to glottis spasm), stiffness of body, cyanosis, unconsciousness, blood pressure low
Posture during epilepsy: Head retracted, back arched, Arms adducted; Elbows, wrists flexed, Legs and feet extended.
Eyes: Widely open, Pupils dilated, Cornea insensitive
CLONIC PHASE– Duration is 1-2 mint, series of sudden, short, shock-like, jerky muscular movements, alternate flexion; extension of limbs, rolling of eyes, jerky respiration, biting of tongue, frothing at mouth, involuntary passage of urine, stool; DTRs absent, plantar response extensor
At end of phase- Breathing starts, Cyanosis disappears, Consciousness return, DTRs normal, plantar response flexor.
POST-ICTAL PHASE– Headache, Confusion, Stiffness of limbs, Sleepiness
PETIT MAL SEIZURES
Absence seizures which is characterised by:
Sudden interruption in Activity and Train of thought, Fixed, staring eyes; Dull, vacant look; Drops things from hand; stops speaking; Unresponsive; Remains perfectly still for few moments like-
Does not move
Does not fall
Does not drop anything he is holding and Then resumes interrupted activity
Akinetic or drop attacks
Sudden loss of posture; Falls down unaware; Picks himself again in a minute; Does not know why he was on ground
Nodding spasm is Loss of posture confined to parts above waist
Salaam spasm is Loss of posture confined to parts above waist
Muscle contractions which is Bilateral, Sudden, Strong, Involuntary and Characterised by-
Blinking of eyes
Nodding of head
Jerking of limbs.
May drop down, but is conscious, fling away object held in hand, Also common between attacks of grand mal seizures, Increase in frequency and severity immediately before attack.
Associated with: Impaired consciousness and Average intelligence.
Associated with: Cerebral lesion in motor cortex
Distribution: Usually unilateral
Twitching in thumb
Twitching intermitted or rhythmic
Twitching progress to Other fingers, Angle of mouth; Wrist, forearm; Arm, shoulder; Legs; all twitch simultaneously.
Associated with Temporal lobe lesion
Duration is for few seconds, Abdominal pain, Sensation of butterflies in abdomen, Dizziness, Flashes of light, sudden changes in mood, Fear, Panic attack, Depression, Confusion, Hallucinations.
Acoustic: Spoken speech
Psychic: Sense of familiarity with unfamiliar things
Olfactory: Unpleasant odour
Gustatory: Unpleasant taste
Duration is for 2 minutes, Brief unconsciousness, No loss of posture, Semi-purposive movements, Unilateral jerking of limbs, Elevation of arm, Licking, Lip smacking, Chewing and clamping movements of jaw, Empty swallowing, Fiddling with objects, Incoherent speech.
Headache and sleepiness
It is a medical emergency
Poor compliance with treatment
Continuous series of convulsive seizures
Persist for a sufficient length of time,i.e. more than 10 minutes
Repeat frequently enough, i.e. more than 3
No recovery of consciousness between seizures
Last from 24-48 hours
As longer the seizure persists, more difficult to control.
Obtaining authentic history from the patient and the witness
Establishment of the cause
Past medical history or family history
Duration of seizures
Adequacy of therapeutic measures,
Age of patient.
CT scan and MRI brain
Blood glucose both fasting and post-food
Calcium and phosphorus levels
Imaging: CT scan and MRI (also MRI angiography) is indicated to evaluate the structural changes in brain
Electroencephalogram (EEG) is suggested for non conclusive status.
Variable, Spontaneous cessation of attack is common, Petit mal attack usually disappear at puberty
Prognosis is good with:
Well planned treatment and Good patient compliance
Poor prognosis indication:
Partial seizures, Neurological, Multiple seizure in first year of disease, positive family history, Psychiatric or social problems, Abnormal EEG.
Prognosis of status epilepticus depends on:
Duration of seizures, Promptness, Adequacy of therapeutic measures, Underlying cause, Age of patient.
TREATMENT with HOMEOPATHY
Epilepsy with violent distortions of body
It is one of the best medicine for Epilepsy where the attacks of convulsion are marked by a violent, distorted body shape. The distortions are most frightful. There is present a marked Opisthotonus which refers to the condition where the spine bends backward with the head and heels touching the ground. The person is totally unconscious. The face may be blue and the jaw appears locked. Cicuta is also used in epilepsy following head injury. It can be used for convulsions occuring in children during dentation, in women during and after delivery and also for convulsions due to worms.
Epilepsy with Petit Mal seizure
This remedy is for children with Petit Mal seizures. The main symptom is frequent brief episodes of seizures in a short time period. The triggering factor for the seizure is strong emotions, including fear. Any subjective feeling predictive of the onset of a seizure prior to an attack is absent (absence of aura).
Epileptic convulsions triggered by bright light
It is medicine for the convulsion arises after exposure to bright light or shining objects. The consciousness is preserved and jerking of muscles of upper body part is experienced by the patient.
Aura for seizure attack is felt in knees
When the seizure attack is preceded by an aura in the knee. The symptoms marked during the attack are clonic spasm that usually begins in finger or toes and soon covers the entire body. Jerking of muscles is also noticed. The triggering factors for the attack include fright and anger. In females, Cuprum Met is used for treatment of convulsion during pregnancy, after delivery and around the menstrual period.
Epileptic fit during sleep
It is a medicine of great help in providing cure for Epilepsy seizures where the attacks are present during sleep. The aura is felt in genital area. It also works well for females who have attacks of seizures during menses.
deep sleep following epileptic attack.
The other symptoms include picking at bed clothes and playing with hands and muscular twitching and fits during fever (Febrile seizures).
Belladona and Nux Vomica are the medicines that are very beneficial in cases of Febrile seizures. Belladona is the ideal mode of treatment when there is fever with marked heat. The head is extremely hot with jerking of muscles. Nux Vomica is of great help when extreme chilliness is present with seizures.
Epileptic fits as per the triggering factor
Chamomilla is the medicines that are of great help for treatment of epileptic fits triggered due to anger outbursts. For fits after a fright then Opium, Aconite are ideal remedies. In cases where alcoholic drinks trigger the attack, the most appropriate medicines are Ran Bulb and Nux Vomica.
Epileptic fit arising from head injury
For Epilepsy cases that mark their origin to head injury, Hypericum, Nat Sulph and Cicuta are the medicines that offer the best mode of our treatment.
Epileptic fit arising from brain tumours
During tumours in brain are Plumbum, Cicuta and Conium.
Epilepsy during dentition
Chamomilla, Kali Bromatum and Aethusa have proved their worth in treatment of epileptic fits during dentition. Chamomilla is best suited when anger triggers a fit during dentition. Kali Bromatum is the ideal remedy when there is a jerking of muscles. Aethusa is selected when the symptoms are clenched thumbs, fixed pupils and locked jaw. Eyes are turned downwards.
Epileptic fits due to supressed eruptions
Zincum, Agaricus and Cicuta are remedies that work well when the history of suppressing eruptions is ruled out prior to onset of convulsion history.
Petit Mal Seizures: Artemisia, Belladona, Zincum, and Hyoscyamus.
Clonic Seizures: Agaricus and Cuprum are the medicines for Clonic Seizures. Agaricus is a great nervous remedy. It is a beneficial remedy when there is a jerking of a single muscle group or the whole body. Cuprum is ideal when the problem starts in toes or fingers and spreads to the entire body.
Cicuta and Plumbum are the good medicines for Tonic Seizures. Cicuta and Plumbum bring about a marked rigidity in body during tonic convulsions.
Bark, leaves and fresh fruit is used to handle a variety of problems. These problems include parasites, rheumatism, stomach difficulties, skin diseases, tumours, psychological problems, and convulsions.
The tree is holy to Buddhists, and can be used ritually and medicinally. Distinct Ficus species all over the world have been utilized to treat epilepsy.
The roots of a tree handle a variety of physical and psychological problems such as discomfort, irritation, nervousness, headache and epilepsy. The extract of the rootcontain phenobarbitone, which is an anti-convulsant drug.
Kava is known to have a sedative effect and thus it is advantageous for individuals with epilepsy.
It has anti-convulsive effects. Using valerian in the short term is probably safe. Nevertheless, it may cause some unwanted effects as headache, uneasiness and sleeplessness.
Magnesium is a helpful element in the condition of epilepsy, and according to various surveys it is considered as a triggering factor of epileptic seizures in certain individuals.
DO’S OF EPILEPSY
Cushion the person’s head and remove the dangerous obstacles.
Turn the person on his side.
Time the seizures.
loosen tight clothing, especially ties and collars.
DONT’S OF EPILEPSY
Don’t be panic, stay calm.
Put anything in the person’s mouth to prevent biting of tongue and grinding of teeth.
Hold the person down.