Ques. 1 What is Epilepsy?
Ans. It is a condition on sudden paroxysmal disorder of cerebral function (dysrhythmia of the brain) marked by inhibition of functions of the higher centers of the cerebrum involving either a small area of a large part of it resulting in uncontrolled activity of this and other parts of nervous system.
- Symptomatic (or secondary) – where a definite cause is present.
- Idiopathic (or primary) – without an obvious cause.
Ques. 2 What are the causes of epilepsy?
Ans. Causes of Symptomatic Epilepsy ; I. General- Poisons- alcohol, lead, insecticides. Matabolic disorders, uraemia, hypoglycaemia etc. Cerebral anoxiants-asphyxia, heart block etc.
- Local : Vascular lesions – cerebral embolism. Trauma-birth injury, head injury. Inflammatory-encephalitis, meningitis, Congenital-tuberose sclerosis etc, Degenerative - presenile dementias.
Classification of Idiopathic Epilepsy:
Local – Temporal lobe Epilepsy, Jacksoniam Epilepsy, Grand mal Epilepsy with focal (partial) onset.
Generalised- Grand mal Epilepsy, Petit mal Epilepsy, Myoclonic seizure, Tonic seizure, Akinetic seizure.
Ques. 3 What is the Minor Epilepsy (or petit mal)?
This is an idiopathic type of epilepsy, occurring commonly in young age. The attacks are frequent, even several hundreds per day. (Without any of the discoverable organic disease of the brain or other known cause of fits.)
Clinical Features are :
Amnesia, which may be short.
Jerky movements of short duration, eyelids, face, arms.
Consciousness is restored rapidly and fully.
The frequency of attacks usually diminished with age.
Sudden loss of consciousness without aura and with little or no clonic or tonic movement.
Staring expression with eyes set straight ahead.
Ques. 4 Describe Grand Mal (or Major) Epilepsy?
Ans. The description of Epilepsy is :-
Onset : Any time but usually when the patient just falls asleep or gets up from bed.
Other possible factor : Due to some drugs, Alcohol; due to metabolic changes (viz. hepatic failure, uraemia hypoglycaemia etc.) Degenerative brain diseases; cerebral infarction; cerebral neoplasm etc.
Clinical Feature : Premonitary symptoms- Prior to the attack there may be a change of mood or behaviour for few days.
Exciting cause : Overwork, fatigue, hunger, excitement, alcoholic debauch, pyrexia etc. Age- Usually after 2 years to 20 years.
Attack- consists of six stages:
Clonic Phase- Lasts for about a minute. Short jerky movement of different muscles, asphyxia relieved, saliva mixed with air bubbles come out of the mouth. Breathing starts and cyanosis disappear.
Flaccid coma & sleep- Starts of relaxation of musclesPut an object such as hand-kerchief between the teeth to avoid tongue biting.
Ques. 6 Which Homoeopathic Remedies are useful?
Ans. The Homoeopathic Remedies which are useful are :-
OPIUM- Spasms begin with loud screams, then foam at mouth, trembling of limbs and suffocation. Eyes half open and turned up pupils dilated and insensible to light. After attacks deep, face red and hot.
BELLADONNA- Recent cases, with decided brain symptoms. Illusions of sight and hearing. Convulsion commence in upper extremities and extend to mouth, fauces & eyes. Foam at mouth. Involuntary micturition and defecation.
BUFO – Epilepsy following onanism. Attacks occur mostly at change of the moon, at time of menses, in sleep. Painful weariness of limbs.
HYOSCYAMUS – Epilepsy preceded by vertigo, sparks, before the eyes, ringing in ears, hungry gnawing, During attack face purple, eyes projectin, shrieks, grinding teeth; urination, After attack, spoor, snoring.
Ques. 7 Which Biochemic Remedies are useful?
Ans. The Biochemic Remedies are useful are :-
PHOS. – Epileptic fits, sometimes the results of vicious habits, which must be restrained.
SILICEA – Nocturnal epilepsy, esp. about the time of the new moon; feeling of coldness before the attack, spasms spreads from from the solar plexus upward. Exalted susceptibility to nervous stimuli, with exhausted condition of the nerves.
FERRUM PHOS. – Epileptic fits with rush of blood to head.
KALI PHOS – Epilepsy or epileptic fits with shrunken countenance, coldness and palpitation after the fit.
Differential Diagnosis :
Warning symptoms :
Epigastric or psychic arura; may be none.
Light headedness blurring of vision
Posture during onset :
Pulse & blood pressure :
Injuries & incontinence :
After attacks :
Drowsiness, headache, and mental confusion.
Generalised physical weakness,
Repeated attacks :
Provoking stimulus :
Type of convulsion :
Irregular & bizarre type, usually occur in presence of others, no unconsciousness no spasms.
Definite sequence of unconscious-sness. Spasm and clonic movement.
Corneal reflex :
Evokes vigorous contraction of the ocular & facial muscles.
Planter response :
Tongue bitting & incontinence :