Blantyre Institute of Neurological Sciences BINS

What is Epilepsy

Epilepsy is a disorder of the brain characterized by repeated seizures. A seizure is usually defined as a sudden alteration of behavior due to a temporary change in the electrical functioning of the brain. Normally, the brain continuously generates tiny electrical impulses in an orderly pattern. These impulses travel along neurons (the network of nerve cells in the brain) and throughout the whole body via chemical messengers called neurotransmitters.

In epilepsy the brain's electrical rhythms have a tendency to become imbalanced, resulting in recurrent seizures. In patients with seizures, the normal electrical pattern is disrupted by sudden and synchronized bursts of electrical energy that may briefly affect their consciousness, movements or sensations.

Causes

In most cases a cause for Epilepsy is not found

Other causes include

  1. Injuries to the brain from any cause (road traffic accidents, assaults, complications of difficult delivery of babies, etc)
  2. Brain tumors and other masses within the brain
  3. Strokes and other brain blood vessel problems
  4. Hereditary in rare cases
  5. Other brain development abnormalities

Treatment

When a person has a seizure, the goals of management are

  1. Control of the seizure the patient is having so that there is no harm to the patient
  2. Finding a cause for the seizure and treating it if it is treatable
  3. Prevention of seizures using medications whilst waiting to treat the cause or where the cause cannot be treated

SEIZURE MANAGEMENT

  1. Move patient away from fire, traffic or water
  2. Take away any objects that could harm the patient
  3. Loosen tight clothes, remove glasses
  4. Put something soft under the head
  5. Turn patient on his or her side, so that saliva and mucus can run out of the mouth
  6. Remain with the patient until he or she regains consciousness
  7. Let the patient rest and then resume whatever activity he was doing, if he feels like it

DRUG THERAPY

There are a number of medications which are used to treat seizures

Your doctor will recommend according to the type of seizure you are having

If one type of medication is not working when administered and taken correctly, a second type of drug may be added

Occasionally, a third type of drug may also be required

DRUG RESISTANT OR MEDICALLY INTRACTABLE EPILEPSY

In some patients we are unable to control their seizures despite appropriate use of two types of anti-epilepsy drugs. Some of such patients may be assisted by an operation which is aimed at removing the location in the brain where the seizures are starting from. This process requires a number of investigations in order to identify the place that needs the operation in the brain

Plans are in place to provide all modalities of Epilepsy treatment at Queen Elizabeth Central Hospital under the Blantyre Institute of Neurological Sciences (BINS)

Please contact us if you have a patient who continues to have seizures despite being on treatment