Biology

Project

Certificate
This is hereby to certify that the original and
genuine work has been done to investigate the
subject matter and the related data collection.

The investigation has been completed solely,

sincerely, and satisfactorily by
Aryan Dehal of class XII-B, Bal Bharti Public
School Pitampura.
On the topic:

EPILEPSY

Principal Subject Teacher

(Mrs. Meenu Goswami) (Ms. Yogita Rajput)
 Acknowledgement
I would like to express my special thanks and
gratitude to my biology teacher Ms. Yogita Rajput.
Without her guidance and valuable support, this
project would not have been possible. This helped
me in doing a lot of research work and I came to
know about many new things.
Secondly, I would like to thank my parents and
friends who helped me a lot in finalizing this project
within the limited time frame.
 Contents
1.Certificate
2.Acknowledgement
3.Contents
4.Introduction
5.Facts And Stats
6.Causes of Epilepsy
7.Types of Epilepsy
8.Symptoms
9.Diagnosis
10.Treatment
11.Case study
12.Bibliography
 Introduction
Epilepsy: A central nervous system disorder in which
brain activity becomes abnormal, causing freezers or
periods of unusual behavior, sensations and
sometimes loss of awareness.

Epilepsy is a chronic disorder.

Seizure: A seizure is a paroxysmal alteration of

neurological function caused by the
excessive hypersynchronous discharge of neurons in
the brain. ‘Epileptic seizure’ is used to distinguish a
seizure caused by abnormal neuronal firing from a
non- epileptic event, such as a psychogenic seizure.
Epilepsy is the condition of recurrent, unprovoked
seizures. It has numerous causes each reflecting
underlying brain dysfunction. A seizure provoked by a
reversible insult (E.g. Fever, hypoglycemia) does not
fall under the definition of epilepsy because it is a
short lived secondary condition, not a chronic state.
The underlying mechanism of epileptic Seizures is
excessive and abnormal neuronal activity in the
cortex of the brain. The reason this occurs in most
cases of epilepsy is unknown.
Epilepsy is one of the most common neurological
conditions, with an incidence of approximately 50
new

cases per year 100,000 population about 1%of the

population suffers from epilepsy, and about 1/3rd of
patients have refractory epilepsy approximately 75%
of the epilepsy begins during childhood, reflecting the
height and susceptibility of the developing brain to
seizures.

Seizures are controllable with medication in about

70% of the cases, inexpensive anti-seizure
medications are often available. In those, whose
seizures do not respond to medication- surgery,
neurostimulation or dietary changes may then be
considered.
 Facts and stats
Worldwide, 50 million people have epilepsy. India is home
to an estimated population of 10 million epileptic patients.
At least 1 out of 100 or 200 people in India are suffering
from this neurological issue.. As many as 500 genes may
relate to epilepsy in some way.

 Strokes cause about of cases of epilepsy in older

adults when there is no other identifiable cause.
 About 40 percent of U.S. children with epilepsy
between 4 and 15 years old have another neurological
disorder. The most common are intellectual disability,
speech-language disability, or specific learning
disabilities.
 About 1.9 percent of epilepsy-related deaths in the
United States are due to prolonged seizures, a
condition known as status epilepticus.
 Seizures start in people over 65 years old almost as
often as they start in children.
 More than 1 million people in the United States have
epilepsy that is not well managed.
 About 80% of people with epilepsy live in low income
countries and don’t receive proper treatment.
 The cause of epilepsy is unknown ,about half of the
cases worldwide.
 Causes
Epilepsy is not contagious. Although many underlying
disease mechanisms can lead to epilepsy, the cause of the
disease is still unknown in about 50% of the cases
globally.

The causes of epilepsy are divided into the following

categories:- structural, genetic, infectious, metabolic,
immune and unknown.

Examples include:

1.Brain damage from prenatal or perinatal causes (loss

of O2 or trauma during birth low birth weight).

2.Congenital abnormalities or genetic conditions with

associated brain malformations.

3.A severe head injury.

4.A stroke that resists the amount of O2 to the brain.

5.An infection of the brain such as meningitis,

encephalitis or neurocysticercosis.

6.Certain genetic syndromes.

7.A brain tumor.

Other causes include =>

 Missing medication doses.

 Heavy alcohol use.
 Cocaine or other drugs, such as ecstasy.
 lack of sleep.
 Other drugs that interfere with seizure
medications.
 Types of Epilepsy
1)Generalized seizures =>

 Absence: Starting with brief laws of

consciousness, fluttering eyelids.
 Myoclonic: Sporadic or repeated, brief jerks of the
limbs.

 Clonic: Repetitive, rhythmic jerking movements of

head or Limbs.
 Tonic: Loss of consciousness, stiffness, and
rigidity of the whole body, can cause a fall if you
are standing.
 Atonic: Loss of Muscle Tone in head or body; can
cause a fall if you are standing.

2)Partial(focal) seizures =>

Focal onset seizures start in one area, or network of
cells, on one side of your brain. This seizure used to
be called partial onset seizure. There are two types of
focal seizures:
 Focal onset aware seizure means you’re awake
and aware during the seizure. Healthcare
providers once called this a simple partial seizure.
Symptoms may include:
o Changes in your senses — how things taste,

smell or sound.
o Changes in your emotions.

o Uncontrolled muscle jerking, usually in arms

or legs.
o Seeing flashing lights, feeling dizzy, having a

tingling sensation.

 Focal onset impaired awareness

seizure means you’re confused or have lost
awareness or consciousness during the seizure.
This seizure type used to be called complex
partial seizure. Symptoms may include:
o Blank stare or a “staring into space.”

o Repetitive movements like eye blinking, lip-

smacking or chewing motion, hand rubbing or

finger motions.

Symptoms
#Simple partial seizures are divided into 4 groups
according to the nature of their symptoms.

1.Motor : These include movement such as jerking,

stiffening, muscle rigidity, spasms and head turning.

2.Sensory : These involve unusual sensations

affecting any of the five senses. The term ‘aura’ is
used to describe only sensory symptoms with no
motor symptoms.

3.Autonomic : They often involve an unusual

sensation in the stomach termed “gastric uprising”.

4.Psychological : These are characterised by various

experiences involving memory, emotions or other
Complex psychological phenomenon.

Complex partial symptoms include impairment of

awareness. Patients seem to be “out of touch”, “out
of it” or “staring into space” during the seizures.
Symptoms may also involve some complex
symptoms called automatisms. These consist of
involuntary but coordinated movements that tend to
be purposeless and repetitive.
Common automatisms include lip smacking,
fidgeting, and walking around.

Partial seizures with secondary generalisations

symptoms => A partial seizure that involves into a
generalised seizure (generally tonic-clonic seizure).

Diagnosis
1.A neurological exam

2.Blood tests
3.Electroencephalogram (EEG):
This is the most common test used to diagnose
epilepsy. In this test electrodes are attached to your
scalp with a paste-like substance or cap. The
electrode records the electrical activity of your brain.

4.High Density EEG:

In a variation of an EEG test, doctors may
recommend high density EEG, which spaces
electrodes more closely than conventional EEG-
about a half a centimeter apart. High density EEG
may help your doctor to more precisely determine the
area which is affected.

5.Computerised Tomography scan (CT):

A CT scan uses X-rays to obtain a cross-sectional
image of your brain. CT Scan can reveal
abnormalities in your brain that might be causing your
seizures such as tumours, bleeding, and cysts.

6.Magnetic resonance imaging (MRI):

An MRI uses powerful magnets and radio waves to
create a detailed view of your brain. Doctors may be
able to

detect lesions or abnormalities in your brain that

could be causing your seizures.
7.Functional MRI (fMRI):
fMRI measures the changes in blood flow that
occur when specific parts of your brain are working.
Doctors may use a fMRI before surgery to identify the
exact locations of critical functions, such as speech
and movement, so surgeons can avoid injuring those
places while operating.

8.Positron Emission Tomography (PET):

PET scans use a small amount of low-dose
radioactive material that's injected into a vein to help
visualize active areas of the brain and detect
abnormalities.

9.Single-photon Emission Computerised Tomography

(SPECT):
This type of test is used primarily if you have had an
MRI and EEG that didn't pinpoint the location in your
brain, where the seizures are originating.
 A SPECT test uses a small amount of low dose is

radioactive material that is injected into a vein to

create a detailed, 3D maps of the blood flow
activity in your brain during seizures.

Treatment
1.Anti-epileptic drugs (AEDs)-
AEDs are the most commonly used treatment for epilepsy.
They help control seizures and about 70% of people.

AEDs work by changing the levels of chemicals in your

brain. They don't cure epilepsy but can stop seizures
happening.
Types of AEDs-
1.Sodium valproate
2.Carbamazepine
3.Lamotrigine
4.Levetiracetam
5.Oxcarbazepine
General common side effects of AED's include =>
Drowsiness Hair loss
Lack of energy Unwanted hair growth
Agitation Rashes
Headaches
Tremor

2.Brain surgery -:
Surgery to remove part of your brain maybe an option if-

1.AEDs aren’t controlling your seizures.

2.Tests show that your seizures are caused by a problem
in a small part of your brain that can be removed without
causing serious effects

If at least two medications have been ineffective in

controlling seizures, a doctor may consider recommending
epilepsy surgery. A 2013 study from Sweden found that
62% of adults and 50% of children with epilepsy had no
seizures for around 7 years after epilepsy surgery.

According to the National Institute of Neurological

Disorders and Stroke, some surgical options include:

 Lobectomy: During this procedure, a surgeon will

remove the section of the brain in which seizures start.
This is the oldest type of epilepsy surgery.
 Multiple subpial transection: During this procedure,
a surgeon will make several cuts to limit seizures to
one part of the brain.
 Corpus callosotomy: A surgeon will cut the neural
connections between the two halves of the brain. This
prevents seizures from spreading from one side of the
brain to the other.
 Hemispherectomy: In extreme cases, a surgeon may
need to cut out a hemisphere, which is one half of the
cerebral cortex of the brain.

For some people, undergoing surgery may reduce the

frequency and severity of their seizures. However, it is
often important to continue taking antiseizure medication
for several years following the procedure.

3.Vagus Nerve Stimulations -:

VNS is where a small electrical device similar to a
pacemaker is placed under the skin of your chest.
The device is attached to a wire that goes under your skin
and connects to a nerve in your neck called the Vagus
nerve, bursts of electricity are sent along the wire to the
nerve.
This can help control seizures by changing the electrical
signals in the brain.
VNS cannot stop seizures but can make them less
frequent.

4.Deep brain stimulation -:

DBS is similar to VNS, but the device placed in the chest is
connected to wires that run directly into the brain.
Bursts of electricity sent along these wires can help
prevent seizures by changing the electrical signals in the
brain.

5.Ketogenic diet -:
A Ketogenic diet is a diet rich in fats, and low in
carbohydrates and proteins. In children it is thought it may
make seizures less likely by changing the levels of signals
in the brain. It was one of the main treatments of epilepsy,
before AED were available, but isn't widely used in adults
because high fat diet is link to serious health conditions,
such as diabetes and cardiovascular diseases.

Bibliography
 www.slideshare.net
 https://clinicaltrials.gov
 www.biologycorner.com
 www.education.com
 www.healthline.com
 www.mayoclinic.org
 https://www.narayanahealth.org
 https://www.medicalnewstoday.com