Description
- Epilepsy is characterized by recurrent, sudden attacks of disordered cerebral
function. These are brief attacks of altered consciousness, motor activity, or
sensory phenomena. Convulsive seizures are the most common form of attacks, but
any recurrent seizure pattern is considered epilepsy. 1
Causes
- It is not always possible to determine the cause of seizures.
- Brain injury to the child at birth or during pregnancy due to injury, infection
or systemic illness in the mother.
- Lead or alcohol poisoning.
- Childhood diseases such as meningitis, viral encephalitis, mumps, and measles.
- Head trauma, brain tumors, or stroke.
- Alteration of blood values hypo/hyperglycemia (high or low blood sugar), vitamin
deficiency, or dehydration.
Types
- Idiopathic epilepsy includes seizures of unknown origin. Symptomatic epilepsy
originates from known disease, accidents, or conditions.
- Seizures are divided into seven classifications tonic-clonic, complex-Partial,
Simple-Partial, Absence, Atypical Absence, Atonic, and Status Epilepticus. These
classifications are used as guidelines to determine the severity of a person's
seizure disorder.
- Some types of seizures (Petit Mal) may be outgrown with time.1
At Risk
- There is evidence that some forms of epilepsy are inherited while other forms
have various and often unknown origins.
Prevention and Management
General:
- Drugs and laser surgery are often prescribed by physicians.
- The ketogenic diet is high in fat and low in carbohydrate and protein, which
results in ketosis. In addition, fluids are limited, which helps contribute to
the diet's success. This ketotic state exerts an anti-epileptic effect, though
its precise mechanism of action is not completely understood. This diet seems to
be most effective for children.
- Patients on the ketogenic diet should be on nutritional supplements formulated
with the help of their physician.
Nutritional Influences:
- Epileptic patients often have lower than normal levels of folic acid in their
blood. Those taking certain anti-seizure drugs have even lower levels. Those patients
with lower levels may be helped by folic acid supplementation. 3
- Vitamin D may be recommended for children with epilepsy receiving antiepilepsy
drugs over 24 months. 4
- Selenium depletion is often present in the brain of epilepsy patients and may
be an important triggering factor for the origin of intractable seizures. 5
- Carnitine treatment may benefit high-risk, symptomatic patients and those with
free carnitine deficiency. 6
Additional Information
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Abstracts
Coulter DL. Carnitine deficiency in epilepsy: Risk factors and treatment.
J Child Neurol 1995 Nov;10 Suppl 2:S32-9. Numerous studies have shown
that plasma carnitine levels are significantly lower in patients taking valproate
than in controls. Free carnitine deficiency is not uncommon in these patients
and also occurs in newborns with seizures and in patients taking other anticonvulsant
drugs. Carnitine deficiency in epilepsy results from a variety of etiologic factors
including underlying metabolic diseases, nutritional inadequacy, and specific
drug effects. The relationship between carnitine deficiency and valproate-induced
hepatotoxicity is unclear. Carnitine treatment does not always prevent the emergence
of serious hepatotoxicity, but it does alleviate valproate-induced hyperammonemia.
These studies suggest that specific risk factors for carnitine deficiency can
be identified. Preliminary data suggest that carnitine treatment may benefit
high-risk, symptomatic patients and those with free carnitine deficiency. Carnitine
treatment is not likely to benefit low-risk, asymptomatic patients and those
with normal carnitine levels.
References
1 Tabers Cyclopedic Medical Dictionary. 16th ed. Philadelphia:FA Davis Company;
1985. p 120.
2 Tabers Cyclopedic Medical Dictionary. 16th ed. Philadelphia:FA Davis Company;
1985. p 120.
3 Froscher W. Folate deficiency, anticonvulsant drugs, and psychiatric morbidity.
Clin Neuropharmacol 1995 Apr;18(2):165-82.
4 Chung S. Effects of anti-epileptic drug therapy on bone mineral density
in ambulatory epileptic children. Brain Dev 1994 Sep-Oct;16(5):382-5.
5 Ramackers VT. Selenium deficiency triggering intractable seizures. Neuropediatrics
1994 Aug;25(4):217-23.
6 Coulter DL. Carnitine deficiency in epilepsy: Risk factors and treatment.
J Child Neurol 1995 Nov 10; Suppl 2:S32
