Epilepsy is defined as a disorder of the brain characterized by an ongoing derangement towards recurrent epileptic seizures. An epileptic seizure is defined as an excessive burst of abnormally synchronized neuronal activity affecting small or large neuronal networks that results in clinical manifestations. Such clinical manifestations could be sudden, transient or usually of short duration.
Incidence of an unprovoked seizure is approximately around one in one thousand (0.1%) children every year.
Medical treatment of a first seizure is controversial. Recurrence of subsequent seizures has been observed approximately in more than 50% cases. Antiepileptic drug therapy after the first episode of seizure does not alter the long-term prognosis for episodes of epilepsy. Many
drugs may reduce the risk of second
seizure.
Why antiepileptic treatment?
The risk of having a third seizure after the two previous episodes is higher, and due to these reasons most neurologists advocate a treatment with antiepileptic
drugs after the second seizure. Neurolgists clearly suggest individualized treatment in
patients of epilepsy; as the recurrence risk is affected in such patients
depends on variable etiology. Patients with structural brain abnormality
are said to be high risk patients.
Brain Stimulation:
Seizure generation could be indirectly inhibited by stimulation of subcortical structures of
brain. There are several reports representing
that chronic anterior thalamic stimulation reduces seizure frequency in patients
with partial and generalized
seizures, in small clinical trials.
Stimulations of the centromedian nucleus was
beneficial in some studies. Direct cortical
stimulation has been observed to
shorten or terminate electrographic
discharges induced by stimulations
during brain mapping.
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