Neurological Disorder Epilepsy Neurological Disorder

Epilepsy -- a Neurological Disorder

Epilepsy is a neurological disorder which causes frequent seizures due to abnormal electricity activity within the brain. Epilepsy is considered a brain disorder disturbing the brain function which ultimately affects behaviour and cognition. This paper highlights some common symptoms of epilepsy. It also explains different treatments deployed for reducing seizure activity in epilepsy. Each treatment portrays a different way of taking control over the seizures and points out a path towards leading a balanced life.

Epilepsy -- A Neurological Disorder

Epilepsy is a neurological disorder which is characterised by repeated spontaneous seizures of any type which cause problems with speech, vision, movement, awareness and muscle control. Epilepsy cannot be considered as an intellectual disability or mental illness. This paper explains the common symptoms associated with epilepsy. It highlights three different types of treatments for epilepsy and presents a comparative analysis regarding them. The treatments discussed in this paper include the use of cognitive therapy for epilepsy, the role played by antiepileptic drugs in treating epilepsy and the significance of relaxation therapies in reducing the risks associated with epilepsy. The article also explains the pros and cons pertaining to each of the three treatments and the extent to which all three treatments lend a hand in overcoming the effects of epilepsy.

Common Symptoms of Epilepsy

The sole visible symptom of epilepsy is seizures which vary in their intensity and affects human behaviour and cognition. Seizures happen without any sort of warning and may become more frequent and worse with the passage of time. Some seizures make people fall to the ground, stiffen out the muscles, make one lose consciousness, or jerk out a little. Some seizures cause muscle twitches, turn on the head, cause any visual disturbance or make one sense strange smells too. Seizures are categorised into two types, namely partial and generalised.

Partial Seizures

Partial seizures take place within a specific area or location in the brain. These seizures are further divided as:

Simple partial seizures are the ones which do not affect one's consciousness and awareness

Complex partial seizures affects one's consciousness eventually making the person unresponsive

Partial seizures with secondary generalization begin with simple or complex seizure and gradually spread to the rest of the brain.

Generalized Seizures

Seizures involving the entire brain are referred as generalized seizures which can be further categorised as:

Generalised tonic clonic seizures are the ones which make a person fall to ground, cause stiffening of muscles and are associated with jerking muscle contractions occurring on arms, legs and neck usually.

Absence seizures relate to staring and subtle body movement, where one keeps on staring in space and then encounters a brief loss of memory.

Myoclonic seizures cause sudden brief twitches or jerks in the legs and arms.

Atonic seizures result in sudden loss of muscle tone making a person fall without any warning.

Tonic seizures are caused due to stiffening of muscles making the person fall on to the ground.

Cognitive Behavioural Therapy for Epilepsy

Cognitive behavioural therapy is considered as an effective treatment for reducing anger, anxiety, and depression in people suffering from epilepsy. Cognitive behavioural therapy involves a deep emphasis on thoughts and feelings and revolves around identification of common triggers like sleep deprivation, hyperventilation and alcohol. It trains the patient in relaxation techniques and adaptive coping skills required for reducing depression and anxiety (Macrodimitris et al., 2011). It teaches the people to think realistically about common difficulties and changes their thought pattern which gradually changes their way of reacting to certain situations. Several researches have recommended cognitive behavioural therapy to be a more effective treatment in comparison to medication for epilepsy. According to some researches cognitive behavioural therapy has been considered highly effective in reducing depression among patients in comparison to usual epilepsy treatment and counselling. It is regarded as the best psychological intervention for identifying and managing seizure triggers (Ramaratnam et al., 2008). It is instrumental in managing mood and stress which ultimately reduces the likelihood of seizure occurring. It involves the replacement of negative thoughts, feelings and behaviours among patients with positive ones. This greatly reduces the probability of occurrence of seizures and in severe cases it caters in preventing the seizures from spoiling one's daily routine life. Cognitive behavioural therapy caters the patient with a sense of power and responsibility over the seizures and alleviates the emotional pressures like fear and anxiety which lead to the occurrence of seizures. It has been observed by several researchers that cognitive behavioural therapy has resulted in the drastic reduction of seizure frequency...

The core goal of epilepsy treatment revolves around having lasting treatment from seizures without any sort of adverse effects. The type of AED for a particular patient is selected after deeply examining the patient's seizure type or epilepsy syndrome and the degree of their tolerability conditions too. Majority of the epilepsy patients are treated for years and this requires taking into account the consequences pertaining to the long-term effects of AEDs.
Some common AEDs comprise of carbamazepine (CBZ), phenobarbital (PHB), and phenytoin (PHT). Fortunately, modern AEDs possess the distinctive feature of producing less enzyme induction and comprise of medicines like gabapentin (GBP), levetiracetam (LEV), lacosamide (LCM), lamotrigine (LTG), pregabalin (PGN), Valporate (VPA), topiramate (TPM), and zonisamide (ZNS). Carbamazepine AED depicts high-level evidence of e-cacy and acts as a mood stabiliser among patients as well. Gabapentin is basically a non-enzyme inducer, involves no interactions and caters with rapid titration and is also e-ective in neuropathic pain. Lamotrigine is found to be a high-level evidence of e-cacy in the elderly patients and is also an e-ective in bipolar depression. Apart from these, neurontin, lamictal, felbatol, topamax, cerebyx, keppra, trileptal, lyrica, depakote and zonegran are also some common antiepileptic drugs which work by modifying the sodium passageways and change the amount of neurotransmitters in the brain. VPA caters with an effective treatment for patients with idiopathic and symptomatic generalized epilepsy despite its disadvantages, particularly weight gain and teratogenicity, because the efficacy of VPA is unsurpassed by any modern suitable AED such as LTG and TPM.

AED for treating epilepsy is determined by seizure type, adverse-e-ect pro-le, and patient-speci-c features which comprise of age, sex (with special reference to childbearing potential), and comorbidities. Dose titration and dosing regimens also need to be carefully individualized for attaining the best results from AED treatment (Perucca & Tomson, 2011). Failure to achieve seizure freedom alarms for a prompt diagnostic reassessment and early consideration of the feasibility of epilepsy surgery in order to treat the patient immediately and effectively.

Biofeedback for Treating Epilepsy

Biofeedback is a self-training mind over body technique used for the treatment of epilepsy. Biofeedback is also referred as Neuro feedback and is considered as a form of treatment which focuses on training patients to assert changes in certain EEG rhythms to promote an elevated seizure threshold. Neuro feedback lends a hand in the reduction of seizure frequency. Since epilepsy involves instability of the brain which triggers the brain into seizure, Neuro feedback is instrumental in stabilizing those circuits which eventually reduces the occurrence of seizures. It actually normalizes or enhances EEG (electroencephalographic) activity by utilizing operant conditioning (Tan et al., 2009). The process of EEG neuro feedback involves the generation of a quantitative EEG for identifying abnormal brain rhythms and then targeting these with conditioning to make them more normal and which eventually helps in controlling seizure activity. Biofeedback helps in controlling body functions by providing information about them to conscious awareness. They actually cater seizure control through the reduction of stress and controlling of hyperventilation (Sterman, 2010).

Comparative Analysis for the Suggested Epilepsy Treatments

The method of using Antiepileptic drugs for the treatment of epilepsy is characterized by unpredictability of efficacy, adverse drug reactions, and optimal doses in individual patients. Antiepileptic drugs (AEDs) are instrumental in exacerbating anxiety. Moreover, they are also bene-cial in mood-stabilizing and anxiolytic e-ects, yet AEDs like valproate, tiagabine, gabapentin, and pregabalin are found to be associated with variable success rates. Some AEDs also tend to increase anxiety in some patients with epilepsy and thus seizure aggravation is considered as a major limitation pertaining to the use of AEDs for treating epilepsy. The most notable side effects associated with the use of antiepileptic drugs comprise of impaired vigilance, attention and psychomotor speed (Schmidt, 2009).

Considering the use of Biofeedback for the treatment of epilepsy its core benefit is that it helps in controlling various aspects of the body and also eliminates the need for some medications, or at least reduces the patient's dependency on them to a great extent (Tan et al., 2009). However, EEG biofeedback treatment for epilepsy requires co-operation, commitment, strong will and obstinacy of the patient because it is closely related to the degree of effectiveness of the treatment. Moreover, this methodology fails in severe cases, e.g. patients with selected cognitive disorders, consciousness disorders, psychical disorders, etc. In some particular complicated cases, the lack of full standardization (devices, methods, etc.) also make difficult confrontation of two or…