Category: Epilepsy

It is imperative to differentiate between epilepsy and seizures; epilepsy is a complex neurological condition which increases the susceptibility of individuals having gratuitous and recurring seizures. A seizure is warranted when normal electrical brain function is temporarily interrupted by burst of abnormal electrical signals. (University, 2015) Fundamentally not all seizures are due to epilepsy however, epilepsy is characterised by recurrent seizures. Epilepsy affects 450,000 people in the UK which is approximately 0.5-1% of the population. The neurons in our brain possess a balance between synaptic inhibition and synaptic excitation, this balance of synaptic excitation and inhibition is modified with individuals who have suffer from epileptic seizures resulting in pathological synchronization of neurons in the brain. Glutamate is the main excitatory neurotransmitter which propagates the firing of an action potential, comparatively GABA in an inhibitory neurotransmitter which counteracts glutamate and reduces the activity of the neural cells. Potential causes of epilepsy include brain tumours, stroke, infection or head injury. (What is epilepsy, 2020)

Epilepsy can be classified into several subgroups. The two broad categories of epileptic seizures are generalised seizures and partial seizures. Generalised seizures are also known as generalised whole cortex bilateral seizures as the whole cortex is involved. Generalised seizures can be further subdivided into absence seizures and tonic clonic seizures. As the name implies tonic clonic seizures are manifested by a period of muscle contraction and loss of consciousness followed by a period of relaxation where the muscles will commence to jerk rapidly and rhythmically. Absence seizures where the patient will experience perhaps a staring episode or altered state, brief consciousness. Patients will not recall absence seizures and essentially the individual ‘blanks out’ for approximately less than 15 seconds (Appleton, 2019).

If consciousness is not lost, it can result in a partial seizure, as the name implies only one portion of the brain is experiencing a seizure. Partial seizures can also be called focal or localised seizures, they are all interchangeable. They have a location dependent aspect to them, if the seizure occurs in an area associated with language such as: Broca’s area, Wernicke’s area patients may experience visual or auditory hallucinations. However, some partial seizures can result in a loss of consciousness when they manifest the patient and spread, also referred to as secondary generalised seizures.

The fundamental way of managing epileptic seizure is through the utilisation of anti-epileptic drugs (AEDs). Antiepileptic (often referred to as anti-convulsant) drugs are incredibly diverse; these drugs essentially restore the balance between inhibition and excitation by reducing the glutamate concentration and increase the GABA concentration. Many AED’s act via several mechanisms of action, very few antiepileptic drugs act via a singular, specific pathway. Unfortunately, AEDs are unable to cure epilepsy, they just attempt to reduce the frequency of seizures from occurring. Although anti-epileptics are a lifeline for many individuals who suffer from epileptic seizures, approximately two thirds of patients are unresponsive to AED’s. Optimal therapy is profoundly desired whereby patients are prescribed the fewest types of anti-epileptic drugs at lowest dose possible and experience the fewest side effects. Various factors must be taken into consideration when selecting an anti-epileptic drug such as: type of seizure, cost, co-morbidities, efficacy, expected adverse effects. If medication has failed other interventions can be practised such as vagal nerve stimulation, surgery or for children a ketogenic diet.

Carbamazepine is considered to be a first generation of anti-epileptic drug. It is a sodium channel blockade and is the first line treatment for treat focal seizures for adults, children and young people. Sodium ions play a critical role in an action potential, when a stimulus travels down an axon, voltage gated sodium ion channels open, sodium ions diffuse into the negatively charged axon down their electrochemical gradient, when the threshold is reached, depolarisation occurs. Carbamazepine works by blocking voltage gated sodium ion channels, it has been suggested that carbamazepine bind to the alpha subunit of the voltage gated sodium ion channels, resulting in the sodium channels entering an inactivated state. Ergo inhibiting the orchestration of the action potential and inhibiting the release of glutamate into the synaptic cleft (Gambeta 2016). Thus, elevating the seizure threshold.

Sodium valproate is another primary medication which is has been utilised for multiple decades to treat epilepsy. Sodium valproate acts on the GABA synapse thus affecting potentiation of GABA activity., it is a GABA transaminase inhibitor, blocks GABA breakdown, enhances GABA concentration and enhances GABA release. It is utilised to treat tonic clonic seizures, and is given to patients

Levetiracetam is one of the newest AED’s available on the market and is commonly utilised as a first line treatment in seizures for individuals in palliative care. The specific physiological role of SV2A remains ambiguous (SILLS) however it is understood levetiracetam binds to SV2A. SV2A (synaptic vesicle glycoprotein 2A) is a ubiquitous synaptic vesicle protein located in the CNS . This interaction inhibits the release of neurotransmitters which are located in the vesicle and reduces synaptic excitatory activity. There is proof to imply that levetiracetam selectively binds to SV2A, with minute affinity for SV2B and SV2C which are members of the SV protein family.

Lamotrigine possesses several mechanisms of action thus making it very diverse. It can be used to treat tonic clonic seizures and partial seizures. Like carbamazepine, lamotrigine acts on the sodium ion channels preventing glutamate excitotoxicity and is 1st line therapy for adult, children and young people experiencing focal seizures. Moreover, lamotrigine also acts on the voltage gated calcium ion channels (Twombly et al. 1988; . The influx of calcium ions into a cell can regulate neuronal excitability.

Introduction

Epilepsy is a neurological disorder that has perplexed humanity for centuries. Its enigmatic nature has given rise to various myths and misconceptions, leading to stigmatization and marginalization of those affected by the condition. This essay aims to shed light on the history, remote causes, and current understanding of epilepsy, ultimately emphasizing the importance of education and empathy in creating a supportive environment for individuals living with epilepsy.

History of the Disease

The history of epilepsy dates back to ancient times, with references found in ancient Egyptian papyri and Mesopotamian texts. Early societies often attributed seizures to supernatural forces or possession by spirits, resulting in harsh treatments or isolation of those afflicted. It was not until the 19th century that pioneers like John Hughlings Jackson and Jean-Martin Charcot laid the foundation for modern epilepsy research. The introduction of electroencephalography (EEG) in the 20th century significantly improved diagnosis and paved the way for advancements in treatment and understanding.

Over the years, prominent figures in history have been associated with epilepsy, contributing to the societal perception of the condition. Ancient Greek philosopher Socrates and renowned military leader Julius Caesar are believed to have experienced epileptic seizures. However, their experiences have also contributed to misunderstandings and misinterpretations of epilepsy as a sign of weakness or mental instability. Despite these challenges, the dedication of medical professionals and the resilience of individuals living with epilepsy have fostered a deeper comprehension of the disorder and inspired ongoing efforts to improve the lives of those affected.

Remote Causes

While the exact causes of epilepsy may remain elusive in some cases, significant progress has been made in identifying remote factors that can trigger seizures. Genetic predisposition plays a crucial role, with certain gene mutations increasing the likelihood of epilepsy. Additionally, brain injuries resulting from trauma, infections, or strokes can also lead to the development of epilepsy. Other potential factors include prenatal damage, developmental disorders, and brain tumors. It is essential to recognize that not all individuals with these risk factors will develop epilepsy, and many cases still lack a clear etiology.

Environmental influences such as exposure to toxins or substances like alcohol and drugs may also contribute to the onset of seizures. Furthermore, psychological stress, sleep deprivation, and hormonal fluctuations can act as triggers for seizures in individuals with epilepsy. Understanding these remote causes can aid in preventive measures and personalized treatment approaches.

Conclusion

Epilepsy, an age-old condition, has come a long way from being perceived as a curse to a treatable neurological disorder. The historical journey of epilepsy demonstrates the progress we have made in deciphering its complexities. Despite the advancements, misconceptions and stigma continue to persist, highlighting the need for further awareness and empathy towards those living with epilepsy. Through continued research, medical breakthroughs, and public education, we can enhance the quality of life for individuals with epilepsy and work towards a society that fosters inclusivity and understanding. Let us unite in supporting and empowering those affected by epilepsy, embracing their uniqueness and embracing the diversity of the human mind.

Introduction

Known since the Middle Ages as the “falling sickness”, epilepsy has become one of the notorious diseases that are undeniably hard to get rid of.

Even in the present-day world, withal the scientific and technological advances that predetermined a breakthrough in medicine and, as a result, ended in discovering a number of avenues for treating the diseases that were previously considered incurable, epilepsy remains incurable.

However, numerous ways to make the disease less acute, as well as slow down its progress, seem to have proven efficient.

Although among the existing ways of treating epilepsy, including the pharmaceutical, therapeutic and alternative ones, the former seems the most trustworthy, the choice of the treatment method is largely predetermined by the specifics of the patient’s organism, as well as the progress of the disease, the way in which the symptoms manifest themselves, etc.

The Choice of Treatment Solutions and the Methods Comparison

As it has been mentioned above, the choice of epilepsy treatment methods has grown considerably over the past few years, which, however, does not mean that the specifics of the disease, as well as the clinical history, can be ignored in the choice of a treatment method.

At present, there are three basic options, i.e., cognitive, pharmaceutical and alternative ones. Evaluating each of the above-mentioned according to the existing measures of effectiveness is the first step on assessing their efficacy.

The Measures of Effectiveness: The Most Efficient Method

There are countless ways of checking the efficiency of the existing methods of epilepsy treatment.

The basic ones, however, seem to rely on five key elements, which are the validity of the method, its efficacy, the measurement of symptoms and the changes in the behavioral pattern, and the possibility of developing the same symptoms once again, i.e., the threat of recidivism.

That being said, the chosen methods of treatment, i.e., the use of Dilantin as the key pharmaceutical method, the educational approach as a specific kind of a cognitive method and the Vagus nerve stimulation as the key alternative treatment (McElroy-Cox, 2009), need to be evaluated according to their efficacy.

Validity

Unlike the other two methods of epilepsy treatment, the pharmaceutical one that involves the use of Dilantin seems to be valid enough in terms of its effect on the patient and the way in which it affects the disease.

As the executives at Pfizer say, Dilantin is “a valid substitute for therapeutic equivalence” (Pfizer makes a statement regarding Dilantin, 2008, 429), which means that the use of Dilantin is rather valid.

The educational approach can be considered a means to spread awareness of the specifics of the disease, so that it could be spotted and handled with at the earliest stages, which is valid enough.

Finally, the Vagus nerve stimulation is validated by a series of experiments conducted to prove the efficacy of the electric stimulation of the patient’s body (DeGrigorio, Shewmon, Murray & Whitehurst, 2006, 1214).

Efficacy

As it has already been mentioned, epilepsy is the kind of disease that does not vanish completely even after the most intense therapy, which is why the evaluation of efficacy of each type of treatthe ment specified above is going to be rather loose.

It is important to remember that each epilepsy case is individual and that one should make a decision concerning the treatment type only after considering all the factors concerning the disease and the patient.

However, according to the existing evidence, epilepsy seizures become considerably less frequent after the Dilantin medicine has been used.

The given choice seems rather justified, since the efficiency of the alternative treatment has not been proven efficient enough yet, and the educational one teaches rather what to do in case someone displays the signs of an epileptic seizure than how to treat epilepsy successfully.

Symptom Measurement

Another important aspect with the help of which the three specified methods can be compared to each other is the symptoms measurement that the give methods provide.

There is no secret that the evaluation of the symptoms severity, frequency and scale is crucial to defining the current stage of the disease progress, which, in its turn, predetermines the treatment schedule and intensity.

That being said, it is necessary to stress that the smaller the units of measurement are, the more precise the results will be.

As the definitions of the treatment strategies in question say, the key means of measuring he symptoms of epilepsy in each of the specified methods of treatment boil down to analyzing questionnaires and relying on the information derived from the conversations with patients.

Therefore, the three treatment methods come even in the given test.

Behavior Measurement

The behavior measurement, on the other hand, is something that cannot be checked with the help of a questionnaire, since it is highly unlikely that a patient is capable of providing an adequate objective evaluation of his/her behavior, especially the behavioral patterns that the patient follows in the course of a seizure.

Therefore, behavior measurement demands a more elaborate scale.

When dealing with the behavior measurement in epilepsy, however, it is worth keeping in mind that the notion of behavioral pattern transcends the differences in treatment approaches, which means that each of the specified types of treatment adopt the same approach to evaluating changes in the patient’s behavior.

For children, it is a common practice to use the Pier Harris Self-Concept Scale (McNeils, Johnson, Huberty & Austin, 2005), whereas adults’ behavior is evaluated with the help of continuous observational recording (Sutula, Sackellares, Miller & Dreifuss, 1981).

Recidivism

When evaluating the most efficient methods of treating epilepsy, it is necessary to check whether each of them guarantees that no instances of recidivism are going to occur; or, to be more exact, that the recidivism cases should happen as less frequently as possible, given the fact that epilepsy cannot be cured completely.

At this point, however, one must mention such parameter as predictability. With the pharmaceutical approach, it is more or less clear when the next fit is going to strike.

With the alternative treatment and the cognitive ones, on the other hand, one can never know when exactly the next epilepsy fit is going to happen. Therefore, the pharmaceutical approach seems superior in this case.

Regarding the Nature of the Treatments

Not only the properties of a specific method of treatment, but also its nature should be considered when evaluating its efficiency. Therefore, the three methods of treatment must be compared with a barometer of their origin.

The Cognitive Nature of the Educational Approach

Clearly being the descendant of the rapidly developing theory of knowledge (ToK), educational approach stems from the willingness to learn more about the problem. Although the causes are good enough, it is still clear that educational approach does not stem from the desire to cure people.

Hence, cognitive approach seems good only for raising awareness of epilepsy and how to treat epileptics.

The Pharmaceutical Nature of the Pharmaceutical Approach

Compared to the educational approach towards epilepsy, the use of Dilantin has a clearly pharmaceutical nature.

Although the use of Dilantin is not backed up by as profound theory as the educational one, it still has a number of advantages, one of which is the fact that Dilantin application has to do with a number of scientific and social science disciplines.

The nature of the given approach stems from the principles of people’s organism reacting towards specific chemical compounds, which means that key chemical and biological laws make the basis for the Dilantin creation.

Therefore, Dilantin seems to be the most reliable method of epilepsy treatment.

The Specifics of the Alternative Approach

Even though Dilantin has already been proven the most efficient medicine against epilepsy, the alternative approach should be given credit to as well. Relatively new, it can be considered an adjunctive therapy (Rogawski & Holmes, 2009).

The Rates of Symptoms Reduction With Each Method Applied

According to the existing statistics, the use of Dilantin proves efficient in most cases of epilepsy. While Vagus nerve stimulation helped less than 25% of patients, Dilantin helped more than 50% deal with seizures (Bromfield, Cavazos, & Sirven, 2006).

Educational approach, however, proves efficient in less than 5% of the cases, mostly because even knowing much about the disease, common people cannot provide the kind of help that doctors can.

Contemporary Attitudes Towards the Chosen Treatment Methods

The attitudes toward the specified methods are rather predictable and depend on how long the specified methods have been around, how many times they have been used and how successful they have proven to be.

Hence, it is quite understandable that the traditional pharmaceutical approach has gained the most support among doctors as the most trusted method. Specialists explain their choice as a result of comparing both the short- and long-term effects of the specified therapies (Fountain & Cole, 2010).

Conclusion

Judging by the data offered above, epilepsy remains a disease that cannot be treated fully; instead, it can be controlled with the help of various methods, starting from the ones that involve the use of various medications up to the methods that are aimed at changing the functions of the patient’s brain.

Although epilepsy cannot be cured completely, the pharmaceutical method proves to be the most efficient, according to the results of the study. It is worth mentioning, though, that each instance of epilepsy requires an individual approach.

Reference List

Bromfield, E. B., Cavazos, J. E., & Sirven, J. I. (2006). An introduction to epilepsy. West Hartford, CT: American Epilepsy Society.

DeGrigorio, C., Shewmon, A., Murray, D., & Whitehurst, T. (2006). Pilot study of trigeminal nerve stimulation (TNS) for epilepsy: A proof-of-concept trial. Epilepsia, 47(7), 1213–1215.

Fountain, N. B. & Cole, A. G. (2010). Pharmacologic treatment of epilepsy. NS Spectrums, 15(3), 4.

McElroy-Cox, C. (2009). Alternative approaches to epilepsy treatment. Current Neurology and Neuroscience reports, 9(4), 313–318.

McNeils, A. M., Johnson, C. S., Huberty, T. J., & Austin, J. K. (2005). Factors associated with academic achievement in children with recent-onset seizures. Seizure, 14(5), 331–339.

Pfizer makes a statement regarding Dilantin (2008). Web.

Rogawski, M. A. & Holmes, G. I. (2009). Nontraditonal epilepsy treatment approaches. Neurotherapeutics, 6(2), 213–217.

Sutula, T. P., Sackellares, J. C., Miller, J. Q., & Dreifuss, F. E. (1981). Intense monitoring inrefractory epilepsy. Neurology, 31(3), 243.

Introduction

Epilepsy is a common chronic neurological disease that is characterized by the presence of more than one unprovoked seizures in the individual. There is no cure for epilepsy, although it is possible to manage the seizures that characterize the disease, therefore enabling the patient to live a productive life.

This paper will provide a description of epilepsy and offer the current statistics on the diseases. The impacts of the disease on various body systems will be provided and a list of treatment options given.

Description of the Disease

By definition, epilepsy is “more than one unprovoked seizure caused by abnormal and excessive electrical activity in the brain” (Bernadette, 2008, p.38). The seizures are momentary disturbances of brain function that are caused by the spontaneous and excessive discharge of neurons in the brain. A diagnosis of epilepsy is made if a patient has an illness whose main characteristic is multiple uncontrollable seizures.

The seizures experienced can be categorized into two: partial and generalized. In partial seizures, epileptiform activity occurs in localized brain regions. This results in seizures being experienced in only parts of the body.

In generalized seizures, the entire brain is involved in epileptiform activity and, consequently, the patient experiences involuntary shaking involving the entire body. Classification of seizure disorders is crucial to the overall management of patients suffering from epilepsy.

For a large number of patients, the cause of epilepsy is unknown. However, genetics have been identified as an underlying cause of the disorder since genes affect brain functioning. Epilepsy can also occur as a side effect of some medical conditions that affect brain functioning. Hesdorffe (2013) states that patients who have suffered from brain tumors, head traumas and strokes are likely to develop epilepsy since these conditions affect brain functioning.

Current Statistics of those affected

Prevalence estimates suggest that 2.76 million individuals in the US are affected by epilepsy. Epilepsy is primarily confined to young children and the elderly. In the US, 460,000 children aged below 18 years suffer from this illness. Bernadette (2008) reveals that the prevalence of epilepsy among children is high making it one of the most common childhood illnesses.

This disease affects between 0.5 and 0.7% of children under the age of 15. However, the outlook for most children diagnosed with epilepsy is good for most childhood seizures resolve enabling children to live a normal life (Bernadette, 2008).

In children, the condition is not severe and the disease can be managed with proper medication. The World Health Organization (2012) reveals that with proper treatment, it is possible to manage seizures so that drug intervention might be removed without relapse in the child.

There is an increase in the prevalence of epilepsy among the elderly. A report by the CDC (2012) indicates that 1.4% of adults over the age of 55 suffered from active epilepsy while only 0.9% of adults aged between 18 and 54 had the condition.

Over the last few decades, the number of epilepsy patients has increased among the elderly. Zaccara (2009) observes that this prevalence can be attributed to the increasing age of the population. In older patients, constant medication is necessary to manage the condition.

How Epilepsy affects the Body System

As previously stated, epilepsy is a neurological disorder, meaning it affects the nerve system of the body. They human body functions since the brain is able to control the body through the extensive nerve system. Sadock and Kaplan (2008) reveal, “The brain generates electrical charges that are transmitted through nerve cells to communicate different messages to the body” (p.243). In essence, epilepsy causes a disruption in the normal functioning of the brain’s neurological system.

The brain is the primary organ affected by epilepsy. The neurons misfire due to an imbalance in the brain electrical chemistry. Involuntary messages are therefore transmitted to various muscles in the body due to the uncontrolled burst of electric current in the brain. A wide array of physical manifestations can be displayed due to this disruption in brain function (Hesdorffer, 2013).

Seizures can occur in people who do not suffer from epilepsy. However, the frequency of seizures in epilepsy patients is higher since their brains have a low seizure threshold. Slightly high excitements to the brain are therefore likely to result in seizing.

Seizures may lead to a change in the structure of the brain and this might have adverse effects on the mental capability of the patient. Changes in brain structure lead to individuals developing psychiatric conditions that might need separate attention.

As such, persons with epilepsy are predisposed to psychiatric difficulties. Sadock and Kaplan (2008) document that 30 to 50% of epilepsy patients suffer from psychiatric conditions at some point during the course of their illness.

Medication and Treatment

The major goal in epilepsy management is to achieve freedom from seizures. If unmanaged, the seizures in epilepsy might lead to the premature death of children. Hesdorffer (2013) reports that incidents of sudden unexpected death in epilepsy (SUDEP) can occur in children who suffer from seizures that are difficult to control. As such, the mainstay of treatment in all patients with epilepsy is anti-epileptic drugs (AEDs).

AEDs function by preventing or reducing the occurrence of seizures, therefore improving the patient’s quality of life. The most common type of medication for adult patients is sodium valproate and phenytoin (Sadock & Kaplan, 2008). These drugs are used to control the generalized seizures that are predominant among adult patients.

For young people with epilepsy, carbamazepine is the first choice drug. This line of drugs is used to control partial seizures. In addition to preventing seizures, the carbamazepine and valproate lines of drugs are helpful in controlling the symptoms of irritability and aggression associated with epilepsy.

The World Health Organization (2012) documents that epilepsy treatment options have an efficacy rate of 70%, meaning that a significant proportion of the patients are able to achieve improved quality of life after medication. However, there are incidents where patients do not respond to these drugs or the drugs are contraindicated or not tolerated by the body.

When this occurs, the physician might recommend newer drugs. A number of significant side effects are associated with the available epilepsy treatment options. Most AEDs cause mild to moderate cognitive impairment in the patient. Bernadette (2008) acknowledges that AEDs have significant side effects and epilepsy treatments try to achieve the best balance between preventing seizures and side effects of treatment.

Conclusion

Epilepsy is a chronic disease that leads to uncontrollable seizures by the patient. This paper has offered a description of the illness and provided statistics on the individuals affected by the disease. It has then noted that the disease can be managed through drugs with high success rates.

However, the prevalence of epilepsy is on the increase due to the rising number of older members of the population. It will therefore become more important to effectively manage this condition and ensure that patients enjoy a good quality of life.

References

Bernadette, W. (2008). Improving medicine taking in epilepsy. Paediatric Nursing, 20(9), 37-43.

CDC (2012). Epilepsy in Adults and Access to Care – United States, 2010. Web.

Hesdorffer, D. (2013). Research implications of the Institute of Medicine Report, Epilepsy Across the Spectrum: Promoting Health and Understanding. Epilepsia, 54 (2), 207-216.

Sadock, B.J. & Kaplan, J.B. (2008). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. NY: Lippincott Williams & Wilkins.

World Health Organization (2012). Epilepsy. Web.

Zaccara, G. (2009). Neurological comorbidity and epilepsy: implications for treatment. Acta Neurol Scand, 120(1), 1–15.

Epilepsy is a chronic, neurological, spectrum disorder that manifests through recurrent and uninitiated seizures, which can cause other health complications. The disorder is highly misunderstood, and as a result, patients are usually isolated, misjudged, and denied employment. Epilepsy is characterized by a wide range of causes, symptoms, and types of seizures. Government statistics have shown that the condition affects approximately 65 million people globally, with 3 million cases reported in the United States. Epilepsy is a chronic disease that causes seizures and that can be managed through medications, brain surgery, and a ketogenic diet.

Description of the Disorder

Epilepsy is characterized by unprovoked seizures that are either partial or generalized. As mentioned earlier, the disorder affects about 65 million people globally, and 3 million people in the United States (Pierce, 2018). It is more prevalent among young people and older adults. In addition, it is more common in males than females (Mayo Clinic Staff, 2019). Statistics show that 1 in every 26 people develop epilepsy at one point in their life.

Approximately 1 in 100 people in the United States report experiencing a seizure or an epilepsy diagnosis (Pierce, 2018). Seizures are more rampant among children and older people, and incidence varies with race and geographic region. In children, the disorder develops during the first year of life and its incidence decreases as the children approach puberty. The incidence of the disorder decreases and stabilizes, but increases after the age of 55. Risk factors among older people include stroke and Alzheimer’s disease.

Causes

The main cause of epilepsy has not been determined. However, research studies have identified several potential causes. These include traumatic brain injury, vascular diseases, brain tumors or cysts, infectious diseases, stroke, genetic disorders, and maternal drug use (Pietrangelo, 2017). Brain infections and a lack of oxygen during birth are also possible causes. In certain cases, research has shown that heredity is a causative factor.

The chances of developing epilepsy are higher in people with epileptic parents than in people with non-epileptic parents (Pierce, 2018). Research has suggested that in many cases, hereditary factors only play a minor role in the development of the disorder. A major consequence of genetics is the increased susceptibility to seizures due to certain environmental triggers (Spencer, 2017). The most common triggers for epilepsy are insufficient sleep, psychological stress, hormonal changes, missed medication, excessive alcohol consumption, and the use of recreational drugs (Mula, 2016).

Types and Risk Factors

Types of epilepsy that are associated with genetics include childhood absence epilepsy, juvenile absence epilepsy, autosomal dominant nocturnal frontal lobe epilepsy, familial temporal lobe epilepsy, and epilepsy with generalized tonic-clonic seizures (Pierce, 2018). The risk factors of epilepsy include age, dementia, family history, birth factors, cerebral palsy, brain tumors, autism spectrum disorder, history of head injuries, and seizures during childhood (Pietrangelo, 2017).

Signs and Symptoms

Signs of epilepsy include whole-body fatigue, headaches, staring spells, drowsiness, amnesia, and temporary confusion. The main symptoms are repeated seizures that differ based on the cause. They vary from person to person and can be divided into two groups, namely partial and generalized seizures. During a partial seizure, a patient does not lose consciousness, they experience dizziness, alterations of the senses, and twitching of limbs (Mula, 2016).

Classification of Seizures

The International League Against Epilepsy (ILAE) classifies seizures based on 3 key features, namely origin in the brain, additional features of seizures, and the level of awareness during an episode (Myers, 2016).

Based on origin, seizures can be focal, generalized, unknown onset, or focal to bilateral. Based on the level of awareness, seizures can be focal aware, focal impaired awareness, awareness unknown, or generalized. Some partial seizures involve the loss of consciousness, unresponsiveness, and blank staring. Generalized seizures affect the whole brain and can be grouped into various types: absence, tonic, myoclonic, atonic, clonic, and tonic-clonic seizures (Myers, 2016). Tonic-clonic seizures are characterized by loss of consciousness, shaking, loss of bowel control, and body stiffening (Mayo Clinic Staff, 2019).

Diagnosis

It is recommended that any occurrence of a seizure should be reported to a physician immediately. Some seizures are indications of underlying diseases that patients could be unaware of, and therefore, posing the risk of serious complications. Doctors determine the tests to conduct by evaluating a patient’s medical history and symptoms (Boling, 2018). In certain cases, physicians conduct neurological examinations to determine the motor abilities and mental functioning of patients. Certain blood tests are carried out to indicate the patient’s blood glucose levels, the presence of infectious disease, and the functioning of organs such as the liver and kidney (Boling, 2018). The tests used in diagnosis include CT scan, MRI, single-photon emission computerized tomography, and electroencephalogram (EEG) (Boling, 2018).

Treatment

Treatment plans depend on the severity of symptoms and the type of disorder. The most common treatment remedies include anti-epileptic drugs, brain surgery, vagus nerve stimulation, and ketogenic diets (Pierce, 2018). Anti-epileptic medications can either eliminate or lower the number of seizures (Boling, 2018). Patients need to take the drugs as prescribed by physicians to guarantee their effectiveness.

A vagus nerve stimulator prevents seizures while brain surgery alters the region of the brain that is associated with epilepsy (Spencer, 2017). Research is undergoing to determine the effectiveness of deep brain stimulation in the treatment of the disorder. Major medications used include valporic acid, lamotrigine, topiramate, ethosuximide, and levetiracetam (Pietrangelo, 2017). In children, a diet low in carbohydrates and high in fats is recommended for the reduction of seizures.

Prognosis

A report released by Mayo Clinic showed that the majority of epileptic individuals must undergo uninterrupted treatment to manage the condition (Spencer, 2017). Continuous treatment allows patients to live their lives normally and avoid injuries that might arise from sudden episodes. Epilepsy prognosis is influenced by several factors: the existing treatment plan, genes, pattern of seizures, age, and health history (Pierce, 2018).

Other factors that affect prognosis include preexisting neurological issues, vascular disorders, family history, and infections. The success of treatment is higher in children than in older people. Research suggests that the chances of complete recovery are higher in people who develop the condition before they attain the age of 12 (Pierce, 2018). Common complications associated with epilepsy include liver inflammation, emotional challenges, falls, and weight gain (Mayo Clinic Staff, 2019). The mortality rate is higher in adults because of the influence of underlying health conditions such as anoxia, stroke, CNS infection, and severe metabolic derangements.

Psychological Implications of Epilepsy

Parents and teachers have lowered expectations of children with epilepsy, which may be detrimental to their success. This sends a message that the children have lower potential compared to others who are non-epileptic. Therefore, they learn to accept the lessened expectations and embrace unrealistic beliefs regarding their potential (Spencer, 2017). The early diagnosis of epilepsy in children has been associated with personality and behavior challenges. The embarrassment and stigma that are associated with experiencing a seizure in public are constant sources of pain and shame for children (Pierce, 2018).

As a result, they become withdrawn and antisocial, and they suffer low self-esteem. People with epilepsy lose confidence because of the unpredictable nature of seizures. They can happen anywhere and at any time. Children might also exhibit symptoms such as anxiety, depression, aggression, and hyperactivity (Spencer, 2017). Parents are usually overprotective, and as a result, prevent their children from having experiences that promote healthy psychosocial development.

These effects can be addressed by educating the public regarding the causes of epilepsy, its symptoms, and the side effects of treatment remedies. Teachers and parents need to help children manage their disorders and understand the cognitive effects of medications (Spencer, 2017). In addition, psychotherapy and counseling can be used to resolve these issues in older people.

Social Implications of Epilepsy

People with epilepsy are usually victims of social stigma and prejudice because of the mystery that surrounds the disorder. Many individuals do not understand the condition and its manifestations. Or instance, in traditional societies, epilepsy was perceived as a form of possession by evil spirits. Epilepsy hinders people from living normal lives because of the risk of seizures (Pierce, 2018).

A diagnosis of epilepsy can have legal implications in two main areas. First, it can be used to determine an individual’s fitness to drive. Second, it can be used in the establishment of intent in cases involving criminal activities that occur during a seizure. Different jurisdictions have varying laws that regulate the awarding of driving licenses to people with epilepsy. Denial of a driver’s license is widespread because people who experience seizures can be a danger to themselves and others on the roads.

The diagnosis of epilepsy has severe consequences on families because the negative experiences faced by an epileptic person extend to other members. Family factors such as domestic violence, divorce, and abuse worsen the condition due to a lack of sufficient physical and psychological support. Family members should help their loved ones to manage the condition by taking them to doctor appointments and administering drugs.

Public attitudes and misconceptions about epilepsy negatively affect people with the disorder. For example, many people avoid relationships and social interactions for fear of being judged (Spencer, 2017). In workplaces, employers might view and treat them differently. In that regard, their well-being is affected because they cannot speak freely and they are misunderstood and underestimated (Pierce, 2018). This challenge can be mitigated through the implementation of policies that promote equality and prevent bullying, the creation of work environments that aid in the management of epilepsy, and the education of employees and employers regarding the disorder.

Vocational and Educational Considerations

People with epilepsy face numerous challenges at school and in the workplace. Discrimination from colleagues and peers, lack of support, and dependency on others are major obstacles to their happiness. Rates of absenteeism are high and students perform poorly due to low rates of school attendance. Employees need to understand the conditions of their employees and offer support because the Americans with Disabilities Act (ADA) considers epilepsy as a disability. Teachers should help epileptic children catch up with others after being absent from school as poor attendance increases academic difficulties and lowers performance.

Vocational Rehabilitation Considerations

Vocational rehabilitation counselors can help epileptics obtain skills that employers consider when hiring. These include the assessment of people’s knowledge and skills, educating people on strategies to mitigate disabilities, career advice, and managing specialized training programs. These skills can help individuals lead productive lives, both professionally and personally. Counselors should consider the severity of their patients’ disabilities, course, and stability to determine the knowledge and skills that they need (Spencer, 2017).

They should also consider the functional limitations and abilities associated with specific abilities because different types of seizures have varied manifestations and effects. One of the main outcomes of vocational rehabilitation is to prepare people with epilepsy for employment (Spencer, 2017).

Rehabilitation counselors help epileptics find appropriate jobs that accommodate their disabilities. Moreover, they train them to communicate effectively so that they can educate other people about their conditions and highlight their capabilities rather than their disabilities (Pierce, 2018). Employers should talk to candidates with epilepsy to understand their disorder and how it might affect their work.

Conclusion

Epilepsy is a neurological disorder that is characterized by seizures that originate from the brain. It affects approximately 65 million people in the world and it is most prevalent among men, children, and older people. The major symptom is recurrent seizures that can be either generalized or partial. Epilepsy is caused by brain injury, infectious diseases, stroke, genetic disorders, vascular diseases, brain tumors or cysts, maternal drug use, brain infections, and a lack of oxygen during birth. Treatment is mainly aimed at eliminating or lowering the incidence of seizures. Treatment options include medications, brain surgery, a ketogenic diet, and vagus nerve stimulation.

Epilepsy lowers the self-esteem and self-confidence of patients because of the stigma and shame associated with seizures. Rehabilitation counselors can help epileptics gain skills that are needed for employment. The challenges that people with epilepsy face can be mitigated through counseling, psychoanalysis, and the creation of awareness regarding the disorder.

References

Boling, W. W. (Ed.). (2018). Diagnosis and surgical treatment of epilepsy. New York, NY: MDPI.

Mayo Clinic Staff. (2019). Epilepsy. Web.

Mula, M. (Ed.). (2016). Neuropsychiatric symptoms of neurological epilepsy. New York, NY: Springer Science.

Myers, M. S. (2016). Symptoms of diseases with suggested herbal treatment opinions. New York, NY: MS Myers.

Pierce, S. (2018). Diseases and disorders: Epilepsy, coming to terms with chronic seizures. New York, NY: Lucent Press.

Pietrangelo, A. (2017). Everything you need to know about epilepsy. Web.

Spencer, D. C. (2017). Navigating life with epilepsy. New York, NY: Oxford University Press.

Identified need and the mission statement

EACF operates a medical service and client case management services program that is offered to residents of Central Florida. The aim is to promote awareness of disability and epilepsy victims through education and prevention programs. The need for this program is as a result of the fact that epilepsy is highly misunderstood, despite being the oldest recognized neurological disorder. Epilepsy is a devastating condition that affects more people than cerebral palsy, muscular dystrophy, cerebral palsy, or even active cancer patients when pooled together.

EACF is dedicated to “improving the quality of life of persons affected by epilepsy/seizure disorders” (Carmen, 2011, p. 3). “EACF identifies, defines and advocates the needs of persons with epilepsy/seizure disorders, and plan and implement its strategies to meet those needs” (Carmen, 2011, p. 3). In order to increase the community’s response and the needs of persons with epilepsy, the program aims at educating and providing information to employers, educators, the medical community, the general public and the families of the victims. The agency ensures that epilepsy persons acquire diagnosis, treatments, and rehabilitation services as well as timely and accurate information with the aim of ensuring that they maintain their productive roles in the society.

EACF’s proposal directly tackles the agency mission by “improving the quality of life of persons with epilepsy, client advocacy, meeting the needs of persons with epilepsy, and informing/educating the community of these needs, along with disability awareness” (Carmen, 2011, p. 4).

Project Description

The community based skill training and work assignment will be carried out by the agency’s trained employment controller. The training program is aimed at enhancing self-sufficiency. The extended program is slated to commence from July 16, 2012 so as to give ample time for completion of additional training and sourcing of funds. “EACF currently has programs addressing epilepsy education, medical care, social service counseling, and pre-GED and GED training. The proposed program extension would work in conjunction, complement and enhance existing EACF programs” (Carmen, 2011, p. 6).

EACF programs includes but not limited to “Community Based Employment, Life Skills Training and Basic Financial Planning with Employment Placement for Continued Success for Persons with Epilepsy and Disabilities” (Carmen, 2011, p. 56).

The following services will be offered to the clients in the following year:

1. Disability /epilepsy and the indispensable obligations of the job.
2. Disability /epilepsy disclosure.
3. Making out the work values and setting professional goals.
4. Fundamental financial planning/budgeting skills training and personal financial needs.
5. Interrogation, follow-up and what employers would like.
6. Transportation to training and transportation to work.
7. Resources for pointing out job skills training, employers and C.V writing.

In addition, this program will involve the area human resource directors in successful community peers, participant’s presentation and successful community peers who will be engaged in motivating and mentoring the participants of the program. Community peers will also help optimize the productivity of the volunteers as well as the available agency resources. Multi-media equipment will be used to support the participants through the existing agency’s resource center.

Some of the individuals who are targeted in this project will include but not limited to:

1. Future and current EACF’S programs clients as well as the service providers, referrals from the areas physicians and disabled persons seeking the agency’s intervention.
2. Those who cannot secure employment as a result of disablement which prevents them from acquiring relevant experience.
3. Those who have not been able to retain their jobs in the past due to problems emanating from their physical conditions.

First year costs

The total funds requested during the first year amounts to $958,000. The EACF match amounts to $1000, 000. The agency will plug the budgetary gap through additional fund raising activities such as through corporate and individual fund raising efforts.

Future year costs

State, county and private fundraising, in addition to federal funding will be considered to ensure that the program is finished. More proposals were submitted, and as a result, $30,658 were generated in 2011 and additional $9,605 are expected to come from the foundation funding.

Measures of success

1. Case manager action plan will be availed to each participant with the aim of assisting them with medications and medical services. This will as a result increase the client’s epilepsy stabilization and reduction.
2. Employment Program Action Plan (EPAP) will be provided to each participant to monitor the success.
3. The number of all those who will participate in the program will be recorded, in addition to their post/pre testing for skills and knowledge.
4. Checklist and measurement tools will be used to establish the participants achievements and activities.

Required changes

The primary annual goal will be determined by attainment of 110+ total program participants, and an employment anticipation of 75+ persons. The secondary measure of success includes the participants’ successful completion of the program with increased self-worth, self esteem, as well as the ability to retain their permanent jobs, in addition to the ability to cope and understand their condition. Of additional importance is that the employers should understand the issues surrounding disabled persons employment in a better perspective.

Budget

Reference

Carmen, P. (2011). Business Proposal. New York, NY: Prentice-Hall International, Inc.

Epilepsy

Epilepsy refers to a collection of neurological illnesses that are symbolized by epileptic seizures. Ching et al. (2013) define epileptic seizures as occurrences that range from short-lived and almost imperceptible to elongated durations of vigorous trembling. Epileptic seizures may lead to one suffering from physical injuries. One can hardly identify the immediate cause of epileptic seizures. Nevertheless, the doctors cite stroke, brain injuries, birth defects, and a brain tumor as some of the factors that cause epilepsy (Ching et al., 2013). There are numerous types of epilepsy. The most common types are temporal lobe epilepsy, focal motor epilepsy, grand mal, and unremitting epilepsy. This paper will comprise a brief description of diverse kinds of epilepsy followed by an in-depth discussion of unremitting epilepsy and its possible treatment.

Types of Epilepsy

Focal Motor Epilepsy

Focal motor epilepsy refers to an electrical interruption that starts in a section of the brain that coordinates movement. Focal motor epilepsy leads to corresponding movement signs. It affects the body muscles. Engel (2013) holds that the muscles affected depend on the precise site of the part of the brain under electrical disturbance. Doctors associate focal motor epilepsy with muscle contraction, limb twitching, irregular impulsive eye movements and muscle inflexibility.

Temporal Lobe Epilepsy

Temporal lobe epilepsy is a persistent neurological state that is distinguished by periodic, wanton epileptic convulsions that start at the temporal lobe of the brain. The attacks entail sensory alterations. For instance, one may claim to smell a strange scent that does not exist. Additionally, temporal lobe epilepsy may cause memory disturbance. According to Engel (2013), temporal lobe epilepsy is the most prevalent type of localization or fractionally related epilepsy. At least 60% of epileptic patients suffer from temporal lobe epilepsy. Temporal lobe epilepsy can be classified into either medial temporal lobe epilepsy or neocortical temporal lobe epilepsy. The medial temporal lobe epilepsy originates from the hippocampus. Over 80% of temporal lobe epilepsy is associated with medial temporal lobe seizures (Engel, 2013). Temporal lobe epilepsy may occur as a result of head trauma, brain malformation, meningitis, and injuries during birth. The medial temporal lobe epilepsy is resistant to medication. The only way to treat medial temporal lobe epilepsy is through surgery.

Grand Mal

Grand mal epilepsy is also referred to as generalized tonic-clonic epilepsy. Epilepsy is associated with unconsciousness and vicious muscle stiffening. Grand mal is the form of epilepsy that comes to people’s minds whenever they hear about epilepsy. As per Kaarkuzhali (2016), grand mal epilepsy occurs as a result of unusual electric activity in the entire brain. It may also arise as a result of other conditions like stroke, high fever, and low blood sugar. In most cases, grand mal epilepsy occurs only once. However, there are instances where patients suffer from recurrent grand mal seizures. Such patients require using anti-seizure drugs on a regular basis to prevent epilepsy from occurring in the future. Grand mal epilepsy occurs in two phases. The first step is known as the tonic stage (Kaarkuzhali, 2016). In this phase, the victim becomes unconscious and suffers from impulsive muscle contraction. The tonic phase may last for at least ten seconds. The second stage is known as a clonic phase. It entails the rhythmic contraction of muscles (Kaarkuzhali, 2016). The clonic phase may last for at most two minutes. The signs associated with grand mal epilepsy include screaming, confusion, severe headache, and fatigue among others.

Unremitting Epilepsy

Unremitting epilepsy is also referred to as status epilepticus. It relates to a unique form of epilepsy where multiple seizures occur within a short duration. Unlike other types of epilepsy, unremitting epilepsy cannot be cured through active inhibitory means (Chen, Naylor & Wasterlain, 2007). Unremitting epilepsy cannot cease impulsively before weariness and brain damage occurs. Unremitting epilepsy occurs in three stages. The steps include impending status epilepticus, established status epilepticus and subtle status epilepticus. The impending status epilepticus refers to incessant convulsions or random attacks without a complete resurgence of awareness amid convulsions taking over five minutes. On the other hand, established status epilepticus refers to electrographic spasms that take over thirty minutes without complete recovery of awareness amid convulsions. The transition from impending status epilepticus to established epilepticus is perhaps a gamut, and can only be estimated using time variables. Subtle epilepticus refers to the “burned-out stage of status epilepticus during which both the motor and electroencephalographic (EEG) expression of seizures becomes less florid” (Chen et al., 2007, p. 8).

Unremitting epilepsy is a life-threatening health condition and can kill if not addressed promptly. It may affect individuals who have ever suffered from other forms of epilepsy. Further, unremitting epilepsy may affect people who suffer from brain problems. The problems may include infections, trauma, and stroke (Chen et al., 2007).

Symptoms of Unremitting Epilepsy

There are two forms of unremitting epilepsy, which are unremitting convulsive and nonconvulsive epilepsy. Regular routines of twitching and stretching of legs and hands characterize relentless convulsive epilepsy (Chen et al., 2007). On the other hand, a comparatively long period of transformation in an individual’s degree of awareness without significant contraction and extension of the arms because of convulsion bustle characterize the unremitting nonconvulsive epilepsy. The two forms of unremitting epilepsy are diagnosed through numerous blood tests, testing the blood sugar, electroencephalogram, and head x-ray among other methods.

Treatment

The most common approach to treating unremitting epilepsy is the administration of benzodiazepines drugs. The drugs include diazepam and lorazepam. Ching et al. (2013) claim that intravenous lorazepam is useful in managing seizures. On the other hand, intramuscular midazolam helps to control seizures among victims who are at home. In the absence of lorazepam or in a situation where it is hard to use intravenous, one can administer diazepam. In the Netherlands, the doctors recommend the use of clonazepam as the first choice. The primary advantage of clonazepam over diazepam is that it remains useful for a long duration.

Apart from the use of benzodiazepines, the doctors may conduct invasive brain surgery or use vagal nerve stimulation (VNS) (Ching et al., 2013). The treatment approach entails implanting a device on the vagal nerve with the objective of minimizing the inception of unremitting epilepsy. Doctors have found vagal nerve stimulation to be effective in reducing unremitting seizures in patients.

Conclusion

Epilepsy is a collection of neurological diseases, which are distinguished by epileptic seizures. A person with epilepsy may suffer from physical injuries if left without care. Doctors maintain that it is hard to identify the cause of epilepsy. Nevertheless, they recognize a stroke, brain injuries, birth defects, and brain tumors as some of the causes of epilepsy. The various types of epilepsy include focal motor epilepsy, temporal lobe epilepsy, grand mal, and unremitting epilepsy. Multiple seizures that occur within a short period characterize unremitting epilepsy. The two forms of unremitting epilepsy are convulsive and nonconvulsive epilepsy. The illness can be treated through the use of benzodiazepines. Additionally, the doctors may use the vagal nerve stimulation technique in the case an invasive brain surgery proves ineffective.

References

Chen, J., Naylor, D., & Wasterlain, C. (2007). Advances in the pathophysiology of status epilepticus. Acta Neurologica Scandinavica, 115(1), 7-15.

Ching, J., Khan, S., White, P., Reed, J., Ramnarine, D., Sieradzan, K., & Sandeman, D. (2013). Long-term effectiveness and tolerability of vagal nerve stimulation in adults with intractable epilepsy: A retrospective analysis of 100 patients. British Journal of Neurosurgery, 27(2), 228-234.

Engel, J. (2013). Seizures and epilepsy (2nd ed.). Oxford: Oxford University Press.

Kaarkuzhali, K. (2016). Epilepsy. Annals of Internal Medicine, 164(3), 9-15.

Introduction

Technological innovation has improved various processes including healthcare intervention systems. Epilepsy is no exception as medical experts have developed automatic detection machines for analysis of electroencephalogram (EEG) to sense electrical processes in the brain using electrodes to instantiate seizure [1]. Programmed seizure recognition is essential for closed-loop receptive cortical activation processes. This review evaluates various literature on recent technology on epileptic extraction, seizure detection, and prediction strategies. Machine learning techniques are quick and accurate in epileptic seizure detection.

Epileptic Extraction Methods

The two key phases of developing an automatic epilepsy detection system are feature selection and classification. The classifier issues a proper class code to the derived function vector after feature extraction decreases the proportions of the input indicator by preserving descriptive features. In a recent study, Niknazar et al. proposed successful feature extraction strategies for automatic epileptic EEG wave recognition [2]. To distinguish epileptic EEG signals in the sample, two successful feature extraction strategies were introduced. Various machine learning models were used to differentiate epileptic seizure and non-seizure signs. The standard epilepsy EEG database given by the University of Bonn was applied in the study [2]. The detection accuracy was assessed by a 10-fold cross authentication procedure. Decision Tree (DT), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Nearest Neighbor (NN) classifiers are included. The tests were replicated 50 times and for the detection of natural and epileptic EEG signs, 1D-LGP and LNDP function extraction strategies with ANN Classification algorithm achieved average precision of 99.82 percent and 99.80 percent, respectively [2]. The classification findings outperformed several current approaches as 1D-LGP and LNDP were useful extraction strategies for classifying epileptic EEG activities.

Automatic epileptic seizure detection can be efficient in preventing any related issues. In a recent research, Niknazar et al., evaluated EEG-based technology proposed for early detection of seizure to identify the most efficient ones for sensing seizure [1]. The authors extracted seizure tracking properties from intracranial EEG waves obtained through intrusive pre-surgical epilepsy screening of patients with drug-resistant focal seizures at a University Hospital in Freiburg’s. Time, intensity, and process space domain features, and similarity/dissimilarity attributes, were factored. The quantitative research approach, ANOVA, was used to examine the output of each function [1]. Various performance analyses were completed on reports from networks in the seizure-onset region and measurements from channels beyond the seizure-onset area. Correlation elements that quantify variable characteristics of the EEG indicator and the varying dynamics of seizures could distinguish ictal states from pre-ictal conditions (p < 0.01) [1]. Of these, the authors’ proposed function, Bhattacharyya-based dissimilarity indicator, passed a post-hoc examination, indicating that it could differentiate pre-ictal and post-ictal cycles from ictal phases. Bhattacharyya-based dissimilarity sensor was then used to track epileptic seizures, indicating no major change in function output between SOZ-in and SOZ-out reports [1]. Statistical analyses were used to assess the discriminative effect of EEG seizure identification features. As a consequence, the best features to choose for an accurate seizure monitoring device optimized for patients with drug-resistant temporal lobe epilepsy, was the similarity/dissimilarity scales.

Epileptic Seizure Detection Method

Seizures may have an adverse effect on patients mental, social, and physical life. Thus, their diagnoses are largely reliant on laborious manual curation by skilled physicians using EEG signals. The majority of current EEG-based seizure detectors are patient-dependent, requiring a trained detection algorithm for each user. Hence, a new patient can only use it after numerous episodes of the seizures, making it ineffective. In a study, Yang et al. investigated patient independent sensor of epileptic events using CHB-MIT Scalp EEG. To assess the topological trends of the EEG activities, an innovative function extraction technique known as MinMaxHist is suggested [3]. The EEG detectors are then parameterized using MinMaxHist and other feature extraction techniques. Later, a systematic set of function scanning and identification optimization tests are performed, and eventually, an improved EEG-based seizure classification method of 30 functions is introduced, with overall values for precision, Matthew’s correlation coefficient, tolerance, accuracy, and Kappa [3]. The system with MinMaxHist technologies had a 0.0464 higher classification than the model excluding MinMaxHist functions. The suggested technique outperformed existing approaches in precision and efficiency.

Seizure detection from EEG activity can aid neurologists in analyzing the statuses of epileptic patients. The diversity of epileptic seizures makes it difficult to distinguish the sequence of epilepsy signs from natural ones. Wulandari et al. address the characterization of seizure and non-seizure disorders of epilepsy centered on EEG signal spectrum characteristics [l4]. Empirical Mode Decomposition was applied in extracting these functions. These characteristics were loaded into the Support Vector Machine as data. The authors suggested combining the first 4 IMFs to derive frequency functions, which they tested on two data sets containing only waves from extracranial EEG [4]. The findings match those of Ynag et al. indicating that for SVM kernel activities, the metrics of precision and accuracy using the multiple features of the first selected IMFs outpaced those using single IMF features.

A technology that could alert all patients and physicians to the imminent epilepsy occurrence would vastly improve patients’ life. Deriche et al. performed research on epilepsy detection suggesting that time and frequency (TF) analysis be used to extract factors capable of distinguishing between regular and abnormal EEG residues [5]. The parameters were derived from the EEG detector Time Frequency vector through Singular Value Decomposition. The results reveal that, regardless of the classification model used, most conventional classification strategies yielded excellent seizure identification results when combined with the suggested TF functionality. The results are consistent with those of Wulandari et al., who found that the novel innovative technology features improve the seizure detection techniques.

Accurate epileptic seizure detection improves a patient’s response to attacks and overall quality of life. Dash et al. conducted an iterative filtering breakdown EEG alerts to improve seizure detection accuracy. The authors evaluate the suggested approach using Indian digital databases. [6] They apply the iterative filtering decay approach to derive sub-elements from the EEG signal. The approach attains an accuracy of over 99% in seizure detection. The findings clearly match those of Wundari et al. and Deriche et al. that innovative seizure detection techniques are more accurate in detecting epilepsy. Acharya et. use the convolutional neural network to assess EEG signals. In particular, they employed a 13-layer convolutional neural system on dataset from five patients. The technique attained an average accuracy of about 90%, which is a good score [7]. The findings match those of the previous researchers Wundari et al., Deriche et al., and Dash et al. that novel epileptic seizure detectors are accurate.

More researchers investigate the effectiveness of automated detection approaches in assessing seizures. For instance, Sudalaimani et al. also proved the accuracy of innovative seizure detection approached through the use of sub-frequency EEG data from a previous signal [8]. Sharma et al. found an over 78% accuracy in a proposed system; a wavelet decomposition [9]. Zazzaro et al. found a 99% accuracy of a trained classifier through indicator processing matching the findings of Sudalaimani et al. and Sharma et al. [10]. Ullah et al. tested two augmentation systems on a university dataset whose findings confirmed the suitability of the approach in detecting epilepsy [11]. Lastly, Nkengfack et al. also tested a full dispensation network of analysis for seizures. The findings supported the efficiency of the suggested processing chain with an accuracy of 96.25 to 100 percent [12]. Overall, the studies provide matching findings on the efficiency of novel proposed seizure detection systems on recognizing epileptic attacks.

Epileptic Seizure Prediction Methods

Various authors also investigate the role of machine learning method in predicting seizures. Savadkoohi et al. used EEG signal to assess brain electrical activities [13]. They examined the best approach to identify meaningful characteristics from an epileptic EEG. The findings revealed that SVM had a minimal edge over KNN. In another study, Wei et al. converted EEG into two-dimensional figures for multi-network fusion [14]. A sustainable recurring network was suggested to offer a spatiotemporal extensive learning framework to detect seizures. The findings match those of Savadkoohi et al. that the novel prediction model is accurate with a 93.4% precision. Tsiouris et al. used Long-Short Term Memory (SLTM) as that of Wei et al [15]. The findings showed increased seizure prediction using the SLTM as compared to conventional approaches replicating the findings of Wei et al. San-segundo et al. also evaluated various EEG signals using public databases. The findings indicated improved accuracy in detecting seizure. Overall, the reviews attest the importance of machine learning methods in predicting seizures.

Conclusion

Machine learning methods are efficient in early and accurate seizure detection. In this study, various empirical researches are evaluated to understand the application and accuracy of the strategy. Most researches prove that indeed, automated machine detection approaches are efficient in enhancing epileptic seizure detection to improve the patients’ quality of life. In particular, the proposed technologies include EEG, Long-Short Term Memory, KNN, and other automated detection systems. The findings support machine learning in quick seizure recognition to avoid associated dangers.

Reference List

H. Niknazar., S.R. Mousavi., M. Niknazar., V. Mardanlou., B. N. Coelho. “Performance analysis of EEG seizure, detection features.” Epilepsy Research, vol. 167, pp. 1-8, 2020, Web.

A. B. Jaiswal, and H. Banka. “Local pattern transformation-based feature extraction techniques for classification of epileptic EEG signals.” Biomedical Signal Processing and Control vol. 34, pp. 81-92. 2017, Web.

S. Yang., B. Li., Y. Zhang., M. Duan., S. Liu., Y. Zhang/. X. Feng., R. Tan., L. Huang., F. Zhou. “Selection of features for patient-independent detection of seizure events using scalp EEG signals.” Computers in biology and medicine vol. 119, pp. 1-13, 2020, Web.

D. P. Wulandari, N. G. P. Putri, Y. K. Suprapto, S. W. Purnami, A. I. Juniani, W. R. Islamiyah. “Epileptic seizure detection based on bandwidth features of EEG signals.” Procedia Computer Science vol. 161, pp. 568-576, 2019, Web.

M. Deriche, S. Arafat, S. Al-Insaif, M. Siddiqui. “Eigenspace time frequency-based features for accurate seizure detection from EEG data.” IRBM vol. 40, no. 2, pp.122-132, 2019, Web.

D. P. Dash, M. H. Kolekar, K. Jha. “Multi-channel EEG based automatic epileptic seizure detection using iterative filtering decomposition and Hidden Markov Model.” Computers in biology and medicine vol. 116, pp. 1-11, 2020, Web.

U. R. Acharya, S. L. Oh, Y, Hagiwara, J. H, Tan, H, Adeli. “Deep convolutional neural network for the automated detection and diagnosis of seizure using EEG signals.” Computers in biology and medicine vol. 100, pp. 270-278, 2018. Web.

C. Sudalaimani, N. Sivakumaran, T. T. Elizabeth, V. S. Rominus. “Automated detection of the preseizure state in EEG signal using neural networks.”biocybernetics and Biomedical engineering vol. 39, no. 1, pp. 160-175, 2019. Web.

M. Sharma, S. Patel, and U. R. Acharya. “Automated detection of abnormal EEG signals using localized wavelet filter banks.” Pattern Recognition Letters vol. 133, pp. 188-194, 2020. Web.

G. Zazzaro, S. Cuomo, A. Martone. “Eeg signal analysis for epileptic seizures detection by applying data mining techniques.” Internet of Things, Mar. 2019. Web.

I. Ullah, M. Hussain, E. Qazi. “An automated system for epilepsy detection using EEG brain signals based on deep learning approach.”Expert Systems with Applications, vol.107, pp. 61.71, 2018. Web.

L. C. D. Nkengfack, D. Tchiotsop, R. Atangana, V. Louis-Door, D. Wolf. “EEG signals analysis for epileptic seizures detection using polynomial transforms, linear discriminant analysis and support vector machines.” Biomedical Signal Processing and Control vol. 62, pp. 1-14, 2020, Web.

M. Savadkoohi, T. Oladunni, L. Thompson. “A machine learning approach to epileptic seizure prediction using Electroencephalogram (EEG) Signal.” Biocybernetics and Biomedical Engineering vol. 40.no. 3, 1328-13411, 2020, Web.

X. Wei, L. Zhou, Z. Zhang, Z. Chen, Y. Zhou. “Early prediction of epileptic seizures using a long-term recurrent convolutional network.” Journal of neuroscience methods vol. 327, pp. 1-10, 2019. Web.

K. M. Tsiouris, V. C. Pezoulas, M. Zervakis, S. Konitsiotis, D. D. Koutsouris, D. I. Fotiadis. “A long short-term memory deep learning network for the prediction of epileptic seizures using EEG signals.” Vol. 99, 24-37, 2018. Web.