Overview of Epilepsy and It’s Management

Now a days peoples are facing various types of stress in their life due to their hectic lifestyle and commonly peoples in the world suffering from many types of neurological disorder Epilepsy is one of the most common neurologic disorders of the brain which is growing now a days. Epilepsy is class of non-communicable neurological disorder diagnosed by recurrent epileptic seizures. Various factors like genetic factors as well as infection in brain, stroke, cancer, high fever can cause epilepsy. In a seizure, person may experience abnormal behavior, symptoms and sensation that includes loss of consciousness. There are various types of seizure and their different mechanisms by which brain generate seizures. Purpose of the review is to discuss history, etiology, pathophysiology, classification of epilepsy, symptoms, causes, diagnosis and management of epilepsy.


INTRODUCTION
The term epilepsy is derived from the Greek word 'epilam-banein', it means to attack or seize.Hippocrates explained that epilepsy was a disorder of the brain.[1] Epilepsy is a chronic medical disease, which is unpredictable, unprovoked, recurrent seizures that affect various types of mental and physical functions.It is affecting more than 3 million people in the U.S. [2] and about 50 million people worldwide.[3] "Epilepsy can be defined as recurrent seizure disorder characterized by abnormal electrical discharge from brain, often in the cerebral cortex".[4] Epilepsy is a chronic disease that causes repeated seizures because of irregular electrical signal produced by damaged brain cells.Seizures involved changes your awareness, muscle control, emotions, sensation and behavior.Epilepsy is known as seizure disorder.Epilepsy is a neurological condition in which person have two or unprovoked seizures that cause more than 24 hours apart.A seizure is a sudden increase of electrical activity in the brain that cause various symptoms, depending on parts of brain are involved seizures which can be genetic or a brain injury, but often their cause is unknown.[5] Epilepsy is commonly occurred in young children or people above 60 years of age; however, it can occur at any time.[6] All epilepsy syndromes are not lifetime-some forms are confined to specific stages of childhood.Generally, management of epilepsy consists Primarily of anticonvulsant medications.[7][8] Although these medications often control or reduce the frequency of seizures, some patients show little or no improvement and therefore surgery may be their treatment in difficult cases.[9] The objective of this review is to provide general considerations and management of epilepsy.

HISTORY
The history of epilepsy can be traced back to a 4000-year-old Akkadian tablet found in Mesopotamia; inscribed on it is a description of a person with "his neck turning left, hands and feet are tense, and his eyes wide open, and from his mouth froth is flowing without him having any consciousness" [10] Proof of epilepsy has also been found in ancient Egypt, as explained by the Edwin Smith Surgical Papyrus written circa 1700 BC.Egyptians proved that seizures can be occur by cortical disruption.Hippocrates was also one of the first to explain the concept of post-traumatic epilepsy; through his study and observations of head trauma, he observed convulsions which were always contralateral to the head wound.[11] ETIOLOGY: Seizures causes from a condition in the normal imbalance of excitation and inhibition within CNS as well as abnormal brain function.Due to so many properties control neuronal excitability, it is usual that this normal balance can disturbed in very different ways; thus, there are many reasons of seizures and epilepsy.[12] 1) Seizures may be occurring in children by very high fever, even if they are healthy, they have a structure defect or genetic risk factors.2) A person having trauma or injury, connected with up to 50% risk of epilepsy.
3) In aged patients, Alzheimer's disease and also stroke can cause epilepsy.

Primary Epilepsy / Idiopathic Epilepsy
Idiopathic epilepsy is most usual form of Epilepsy which may accounts for 50-60% of peoples with the medical condition.In this type of epilepsy there is no confirm fundamental cause.Although there is no fixed known reason for seizures in many patients, a genetic susceptibility to hypersensitivity of the neurons is considered as reason behind this.[14] 2. Secondary Epilepsy/ Symptomatic epilepsy On the contrary of primary epilepsy, in secondary epilepsy there are some fixed reasons behind the seizures.The causes include infection, head injury, hereditary syndrome, brain cancer, stroke, congenital abnormalities.[18] Some other reasons behind the symptomatic seizure may include, primary neurological disorder or anatomical deformity of brain, hemorrhage, infection to CNS, metabolic disorder, electrolyte imbalance, alcohol, abuse.
• Withdrawal seizures may cause if stopped abruptly after prolonged use.

In pediatrics <10 mg /kg / day Adult <400 mg / day Administration route: Oral and Iv Brand name: Belva, Depakote, Syonell, Convulex, Dyzantil Contraindications: Avoid in pregnancy CONCLUSION
Therefore, the choice of anticonvulsant medication is often based on its effectiveness against specific types of seizures and convulsions.While seizure control is generally good for most patients, the majority of people with epilepsy have refractory or drug-resistant epilepsy despite early disease treatment and adequate antibiotic use to take daily medication Representatives.For this reason, despite the cost, new drugs that are more effective in terms of side effects and tolerance compared to existing antiepileptic drugs are needed.Although many treatment options are available, we are committed to exploring new techniques.Many of these studies are expressing the genetic and molecular mechanisms of hyper excitability and promise to provide specific targets for new treatments.National Institute of Neurological Disorders and Stroke.Seizures and epilepsy: Hope through research.