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CASES MATERIA MEDICA GENERAL ARTICLES ABSTRACT MISCELLANEOUS Q & A

Miracle of one dose
NATIONAL JOURNAL OF HOMOEOPATHY 2003 Nov / Dec VOL V NO 6.
Dr C H Asrani
Dr Satish Kanojia
'Nat-sul

Epilepsy: General Understanding by Dr C H Asrani.
Epilepsy (seizure) is a physical condition caused by sudden, brief changes in the electrical activity of the brain. Patient’s consciousness, movements or actions are altered for a short time. A seizure may be convulsions, brief stares, muscle spasms, odd sensations, or episodes of automatic behavior and altered consciousness.

Incidence

  • About 1% of the population has epilepsy.
  • Every hour 20 Indians are diagnosed as having epilepsy.
  • More than twice as many Indians have epilepsy, as have Parkinson’s Disease, cerebral palsy, multiple sclerosis and muscular dystrophy combined.
Causes:
  1. Infections
  2. Trauma
  3. SOL
  4. Metabolic
  5. Idiopathic (largest %)
Types of Seizures
There are two main types of epileptic seizures: Generalized and Partial.
Generalized Seizures
These types of seizures begin with a discharge of neurons throughout the brain. Generalized seizures include:

  • Tonic-Clonic Seizures (also called "grand mal")
  • Absence Seizures (also called "petit mal")
Partial Seizures
These types of seizures begin with a discharge of neurons in just one part of the brain. Partial seizures include:

  • Simple Partial Seizures
  • Complex Partial Seizures
  • Myoclonic Seizures
  • Infantile Spasms
Seizures can demonstrate a wide range of variation:

  • They can be frequent or rare
  • They can last a second or several minutes
  • They can be severe or mild
  • A person can have more than one type of seizure
  • The pattern of seizures may change with time
Diagnosis
The following examinations, procedures and tests are used to verify a diagnosis of epilepsy:
  • Medical History - most important is to have history from an eye witness i.e. someone who has seen the seizure
  • Blood Tests-to rule out metabolic causes like hypoglycemia, hypomagnesaemia and hypocalcaemia
  • EEG (electroencephalographic recordings): An EEG translates the electrical activity of the brain into a series of wavy lines. Normal electrical activity in the brain makes a recognizable pattern. Abnormal patterns are "markers" for the risk of seizures. The abnormal patterns are known as spikes, polyspikes, sharp waves and spike/wave complexes. As important, abnormal patterns assist in identifying which part of the brain may be the source of the seizure and which medication may be most effective in treating the episodes.
  • Imaging (MRI, CT Scan) - useful in cases of SOL, abscess and trauma causing seizures.
Treatment of Epilepsy
Medications
For most people, anticonvulsants can help reduce the number of seizures, or prevent them completely. AEDs can manage up to 80% of seizure problems. People do not need to be on antiepileptic medication for a lifetime. When drug treatment ends, more than 60% of people will remain free of seizures, but the success rate for being able to discontinue any drug depends on the type of epilepsy a person has. Most people who go off antiepileptic drugs remain seizure-free.

Surgery
- As new imaging and seizure-recording techniques have been developed, it has become easier to identify areas of the brain where seizures begin. This development has led to greater success with the type of brain surgery called lobectomies. Other operations in greater use include corpus callosotomy (which stops seizure spread by cutting connections between one half of the brain and the other); multiple subpial transection (which serves nerve connections in vital areas that cannot be removed), and hemispherectomies, which remove one half of the brain in cases where brain disease is severe and isolated to that area.

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