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6. Causes of Epilepsy

The causes of Epilepsy cannot be ascertained in about 50% cases. However, following are the common causes of Epilepsy-

• Parasitic infection-Neurocysticercosis
• Brain tuberculosis
• Head injuries
• Brain tumors
• Paucity of sugar in blood, use of intoxicants, insomnia, glaring lights & watching T.V. for long hours.

Neurocysticercosis
Normally, human intestine is free of any worm infestation. When a man eats partially cooked pig (pork) meat with larva of tapeworm (cysticercus), sometimes this infected larva passes through stomach and develop into large worm which is 2 to 6 metre long and lives in human intestine. It is flat and tape like, hence the name.

In general, developing countries have poor sewage system. Vegetables and fruits are usually grown in such infected soil. Whenever we eat such vegetables and fruits without proper washing these eggs of tapeworm reach our stomach. Then the embryo from the egg (opchosphice) is released in intestine due to hatching. It penetrates the intestinal wall and reaches different body parts including brain by blood vessels. In brain, it causes neurocysticercosis.

Important points

• Human tape worms in the intestine develop by eating infected partially cooked pork meat which contains larva. This larva doesn't penetrate the intestine but develops into a tape worm in intestine.
• Neurocysticercosis develops usually not by eating pork but by infection of unwashed raw salads and vegetables grown with infected soils. The egg readily pierces the intestine wall due to certain cutters present inside and reaches body tissue through blood circulation.
• Patients suffering from neurocysticercosis usually don't have tapeworm in their gut.
• Elimination of pigs from human dwelling areas and proper hygiene in food habits are required to control and eliminate cystecercosis. This will also bring down the incidence of Epilepsy.
  

7. Various tests related with Epilepsy

The following tests are carried out in the affliction of Epilepsy.

E.E.G. This test consists of a graphical representation of electrical pulses within the brain.

Video E.E.G. The information about Epilepsy is obtained by video monitoring.

CAT Scan This is a computerised x-ray of various sections of the brain. This is also known as C.T. Scan, which is an important and desirable test.

MRI Scan It is a more advanced test than CT scans. It is available in some large cities of India. In this method of test, the pictures of the brain are taken using magnetic waves.

SPECT In future SPECT will play an important role in diagnosis of epilepsy.

8. Treatment of Epilepsy

Before starting the treatment of Epilepsy, it is necessary to determine whether the affliction is Epilepsy or not. Later on the basis of the type of Epilepsy, age of the patient and certain other factors, medicines are prescribed according to the patient's individual needs. About 75% patients get cured if the medicines are taken regularly for a period of three to five years.

Some of the important conventional medicines are as follows:
Phenytoin, Sodium Valproate, Phenobarbitone, Carbamazepine

Some newer medicines are now also available such as Clonazepam, Clobazam, Lamotrigine, Gabapentin.

These are used in resistant epilepsies which are not be controlled by conventional drugs.

9. What to do if a Fit Occurs?

Some people get a prior warning of an attack of Epilepsy. Most of the time, an attack of epilepsy subsides within 2-3 minutes. During this period, the tongue may get bitten and urine might get discharged in the clothes.

In such a situation: Let the patient lie sideways and loosen up his clothes. In case of vomiting patient is made to lie sideways, otherwise he may aspirate the vomit into his windpipe

Do not try to open the clenched jaws, otherwise your finger may get bitten. Do not insert things like spoon etc. or else, the teeth may get broken.

When the attack subsides, do not insert anything in the mouth of the patient, till he/she gets fully recovered. During the occurrence of the attack, do not try to prevent the trembling of limbs. It may cause the fracture of bones.

However if the attacks persist, or patient is injured, get him/her admitted in the hospital immediately.

In the hospital, patient may require, iv diazepam, phenytoin, lorazepam or rectal diazepam.