INTRODUCTION:
Seizures are short bursts of spontaneous movement that might affect either a portion of the body (partial) or the entire body (generalized), and they can occasionally be followed by a loss of consciousness and control over bowel or bladder function. Around 50 million people worldwide suffer from epilepsy, a chronic, noncommunicable brain condition
Excessive electrical discharges in a cluster of brain cells cause seizure episodes. Such discharges can occur in many areas of the brain. The smallest muscular twitches or concentration lapses can be seizures, as can violent convulsions that last for a long time. The frequency of seizures can also vary, from fewer than one per year to many per day.
Symptoms:
Seizures can have a variety of characteristics, depending on where in the brain the disruption initially appears and how far it develops.
Temporary symptoms include loss of awareness or consciousness as well as impairments in movement, mood, or other cognitive processes, as well as changes of sense (including vision, hearing, and taste).
Both physical issues (such as fractures and bruises from seizures-related traumas) and psychological issues, such as anxiety and sadness, are more common in people with epilepsy. Similar to this, patients with epilepsy have a risk of dying prematurely that is up to three times greater than that of the general population, with rural regions and low- and middle-income nations having the greatest rates of early mortality.
Global Illness:
A large amount of the global illness burden is accounted for by epilepsy, which affects around 50 million individuals globally. Between 4 and 10 per 1000 persons are thought to be affected by active epilepsy at any given moment, defined as having ongoing seizures or needing treatment.This is probably because endemic diseases like malaria and neurocysticercosis are more common, road traffic accidents and birth injuries are more common, and there are differences in the medical infrastructure, the availability of preventative health programs, and access to care. Nearly 80% of epilepsy sufferers reside in low- and middle-income nations.
Causes:
The fundamental cause of epilepsy is known as its etiology, which must not be confounded with the electro clinical entity known as epilepsy syndrome. The etiology must be addressed as soon as the patient is admitted to the doctor’s care since it not only aids in more accurate categorization but also has a significant impact on the choice of therapy, how well the patient responds to it, and the prognosis as a whole. In the last two decades, improvements in genetics and imaging have been made.
Although many underlying diseases can cause epilepsy, the exact cause of the condition is still unknown in about 50% of cases worldwide. The causes of epilepsy are classified into the following categories: structural, genetic, infectious, metabolic, immune, and unknown. Examples include:
- Congenital abnormalities or genetic diseases with associated brain malformations
- Severe head injuries, strokes that reduce the amount of oxygen to the brain
- Infections of the brain like meningitis, encephalitis, or neurocysticercosis
- Genetic syndromes, and brain tumors are all prenatal or perinatal causes of brain damage.
Treatment:
Seizures are manageable. With the proper administration of anti-seizure medications, up to 70% of patients with epilepsy might go seizure-free. After two years without seizures, stopping anti-epileptic medication may be an option, but it should be done with consideration for pertinent clinical, social, and private issues. The two most reliable indicators of seizure recurrence are a known etiology for the seizure and an abnormal electroencephalography (EEG) pattern.
- The “treatment gap” refers to the possibility that around three-quarters of epileptics in low-income nations do not receive the necessary care.
- Anti-seizure medications are not widely available in many low- and middle-income nations. According to a recent study, fewer than 50% of generic anti-seizure medications are typically available in the public sector of low- and middle-income nations. This can make it difficult to get treatment.
- Most epileptic patients may be diagnosed and treated at the basic healthcare level without the need for advanced technology.
- WHO pilot projects have indicated that training primary health-care providers to diagnose and treat epilepsy can effectively reduce the epilepsy treatment gap.
- Surgery might be beneficial to patients who respond poorly to drug treatments.
Conclusion
More 50 million people worldwide suffer from epilepsy, which is characterized by recurring seizures brought on by disturbed brain activity. These seizures, which have a variety of symptoms, provide a higher mortality risk as well as physical and psychological difficulties. Global inequities continue despite medical advancements, highlighting the need for easily accessible care. For people affected by epilepsy, improvements in primary healthcare and our understanding of its causes give hope for a brighter future.
