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Anticonvulsants commonly referred to as antiseizure drugs or antiepileptic drugs are different group of pharmacological agents that is used in the treatment of epileptic seizures. It is also being used to treat bipolar disorders and borderline personality disorder.Anticonvulsants work by suppressing the excessive and rapid firing of neurons during seizures. It also prevents the spread of seizure within the brain.

Seizures are majorly divided into two types i.e. partial seizures and primary generalized seizures. In Primary generalized seizures there is widespread electrical discharge involving both sides of the brain at once whereas in case of Partial seizures starts by electrical discharge in one limited area of the brain.

Partial seizures fall into two categories:

  • Focal seizures without loss of consciousness i.e. simple partial seizures
  • Focal dyscognitive seizures i.e. complex partial seizures

Primary generalized seizures are of six types:

  • Absence seizures
  • Tonic seizures
  • Atonic seizures
  • Clonic seizures
  • Myoclonic seizures
  • Tonic-clonic seizures

Causes of epileptic seizures

In some type of epilepsy there is no identifiable cause. While in others the causes that may lead to the medical condition are:

  • Genetic influence
  • Head trauma due to any accident or traumatic injury
  • Brain conditions that has resulted in damage to the brain such as strokes or tumours
  • Infectious disease such as AIDS, viral encephalitis and meningitis
  • Developmental disorders such as neurofibromatosis and autism may result in epilepsy
  • Prenatal injury caused due to poor nutrition, infection in the mother, oxygen deficiency may be another cause

Signs and Symptoms

Epilepsy is caused due to abnormal activity in brain cells. It can affect any process that your brain coordinates. Some of the signs and symptoms include:

  • Temporary confusion
  • A staring spell
  • Loss of consciousness or awareness
  • Uncontrollable jerking movements of the arms and legs
  • Psychic symptoms  

Symptoms of seizures may depend on the type of seizures. In almost all the cases a person with epilepsy will have the same type of seizure each time. Hence, the symptoms will also be similar.

Preventive measures

Seek immediate medical help if any of the below occur:

  • The seizure lasts more than five minutes.
  • You have a high fever.
  • Breathing or consciousness doesn't return after the seizure stops.
  • You have diabetes.
  • A second seizure follows immediately.
  • You're experiencing heat exhaustion.
  • You're pregnant.
  • You've injured yourself during the seizure.

Myths busted

  • Do not restrain anyone having seizure. Seizure will end in few minutes. You can however protect the person from any injury.
  • During seizure you can’t swallow your tongue.
  • You can’t catch epilepsy from anyone.
  • Most of the people with epilepsy can do things that other people who do not suffer from the disease do.
  • Never force anything into the mouth of someone having seizure as the person may be hurt.
  • Epilepsy can be controlled but there is no permanent cure.

Diagnosis of disease

To diagnose your disease your doctor will review your medical history and also the various symptoms you are suffering from. You doctor may also recommend certain tests such as

  • Neurological examination: this test is suggested to test your behaviour, mental function, motor ability and various other areas that will help the doctor to diagnose your condition and also find out the type of epilepsy you are suffering from.
  • Blood tests: Blood samples may be taken to check for any signs of infection or genetic conditions or any other conditions that may be related to seizures.

Doctor may also suggest various other tests to detect any brain abnormality such as:

  • Electroencephalogram (EEG)
  • Computerized tomographies (CT) scan
  • Functional MRI (fMRI)
  • Magnetic resonance imaging (MRI)
  • Single-photon emission computerized tomography (SPECT)
  • Positron emission tomography (PET)
  • Neuropsychological tests

Treatment for epilepsy

  • Medication: At first doctors generally treat epilepsy with the help of epilepsy medication. While some people will experience decrease in the intensity and frequency of seizures by taking one anti-seizure medication, in case of others combination of medications may be involved. Doctors will chose medicine from anti-convulsants drug list as per symptoms to treat the patient.
  • Surgery: If seizures originate in a well defined area of your brain and does not interfere in the vital functions such as language, speech, vision or hearing or motor function then surgery may be recommended. When surgery is done your doctor will remove the area of the brain that is causing seizures.

If it originates in an area of brain that controls speech movements and other functions, you may be awake for a part of the surgery where doctors will monitor you and ask you questions.

In case seizures occur in a part that can’t be removed, then surgeons will make several cuts in your brain to prevent seizures from spreading in any other parts of your brain.

  • Therapies: There are certain therapies which are also used in the convulsant treatment. Such therapies may include:

-           Vagus nerve stimulation: here a device is implanted underneath the skin of your chest and wires from the stimulator are connected to the vagus nerve in the neck. The stimulator works by sending electrical energy through the vagus nerve and to your brain and is known to reduce seizures by 20 to 40 percent.

-          Ketogenic diet: Some times in order to reduce seizures doctor may suggest Ketogenic diet that is high in fats and low in carbohydrates. In this diet the body breaks down fats instead of carbohydrate.

Important things to know

  • Having seizures at certain times can lead to various circumstances that are dangerous such as falling down. Drowning, accidents, pregnancy complications and emotional health issues. Hence adequate precaution should be taken
  • Never stop taking medication without talking your doctor.
  • Take medications exactly as prescribed.
  • Always call your doctor before taking herbal medicines, over the counter drugs, other prescription medications or switching to a generic version of your medication
  • Notify your doctor if you notice any new or increased feelings of suicidal thoughts, depression or any unusual changes in behaviours or mood.
  • Tell your doctor in case you re suffering from any disease specially migraine. Inform him about any medicines that you are taking.

Side effects from anticonvulsants

Some of the common anticonvulsant side effects include:

  • Stomach upset or discomfort
  • Blurred vision
  • Allergic reaction
  • Fatigue
  • Dizziness
  • Weight gain
  • Loss of bone density
  • Skin rashes
  • Loss of coordination
  • Speech problems
  • Memory and thinking problems

More serious side effects include:

  • Depression
  • Suicidal thoughts and behaviours
  • Inflammation of certain organs, such as your liver
  • Severe rash

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