Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures caused by abnormal electrical activity in the brain. Seizures vary in type and severity and can occur at any age. Epilepsy is one of the most common neurological disorders, affecting about 1% of the world's population.

Causes of epilepsy:

The causes of epilepsy fall into several categories, but in many patients the cause is unknown (idiopathic epilepsy). Possible causes include the following

Genetic factors:

• Some types of epilepsy are caused by genetic mutations. These genetic mutations affect the function of nerve cells, making them more prone to epileptic seizures. Genetic causes of epilepsy can run in families, but a family history of epilepsy does not necessarily mean that a person will develop the disease.

Brain damage:

• Traumatic brain injury (TBI) caused by an accident, fall or violence can cause epilepsy. This is called post-traumatic epilepsy and can develop immediately after the injury or years later.

Stroke :

• Stroke is the main cause of epilepsy in older people. Stroke occurs when blood flow to the brain is disrupted, damaging brain tissue and causing epileptic seizures.

Infections:

• Infections that affect the brain, such as meningitis, encephalitis and HIV, can inflame and damage brain cells and cause epilepsy.

Developmental disorders:

• Some conditions that affect brain development, such as autism spectrum disorders and neurofibromatosis, can increase the risk of epilepsy.

Tumors:

• Brain tumors, whether cancerous or benign, can disrupt the brain's electrical activity and trigger epileptic seizures.

Prenatal injury:

• Prenatal damage to the brain, such as oxygen deprivation (hypoxia), maternal infection or maternal malnutrition, can increase the risk of epilepsy in the child.

Metabolic or nutritional disorders:

• Conditions such as low blood sugar (hypoglycemia), dehydration and electrolyte imbalances can cause epileptic seizures, especially in vulnerable individuals.

Types of seizures:

Epileptic seizures can be divided into two main categories depending on where and how they start in the brain

1.Focal (partial) seizures:

Seizures start in a specific part of the brain. These can be further divided into

• Focal seizures (formerly known as simple partial seizures): the person is conscious but may experience unusual sensations, movements or emotions.
• Focal disorientation seizures (formerly known as complex partial seizures): consciousness changes or is disturbed, and the person appears confused or unresponsive.

2. Generalized seizures:

Involve both sides of the brain from the onset and usually affect consciousness. Types include:

 Absence seizures (small seizures): Characterized by short periods of staring or dizziness. These seizures usually last only a few seconds and are more common in children.

 Tonic-clonic seizures (large seizures): the best known type with convulsions, muscle rigidity and loss of consciousness. The patient may cry, collapse or become immobilized.

 Myoclonic seizures: short, shock-like contractions of a muscle or group of muscles. 

 Atonic seizures: sudden loss of muscle tone, resulting in collapse or falling.

Tonic seizures: sudden stiffening of muscles.

 Clonic seizures: repeated jerking movements.

Diagnosis of epilepsy:

A diagnosis of epilepsy usually requires a comprehensive evaluation that includes

History: a detailed history, including when the seizures started, seizure frequency and possible triggering factors.

Neurological examination: to determine the presence or absence of neurological problems.

Electroencephalography (EEG): EEG records the electrical activity of the brain and can detect abnormal patterns associated with seizures. Imaging studies:

Magnetic resonance imaging (MRI) or computed tomography (CT): can be used to look for structural brain abnormalities such as tumors, strokes or malformations.

Blood tests: Can help rule out conditions such as metabolic abnormalities that trigger epileptic seizures.

Epilepsy treatment:

Epilepsy is not always curable, but it can often be effectively managed with treatment. Treatment options include the following

Medication:

Anti-epileptic drugs (AEDs) are the most common treatment for epilepsy and can control seizures in about 70% of patients. Common AEDs include phenytoin, carbamazepine, valproate, levetiracetam and lamotrigine. The choice of medication depends on the type of seizure, the age of the patient and other factors.

Surgery:

If seizures cannot be controlled with medication (drug-resistant epilepsy), surgical treatment may be preferred. The surgery aims to remove or replace the part of the brain where the seizures started. Temporal lobectomy is one of the most common epilepsy surgeries.

Vagus nerve stimulation (VNS):

VNS involves implanting a device that sends electrical impulses to the vagus nerve in the neck. This stimulation can reduce the frequency and severity of seizures.

Ketogenic diet:

This high-fat, low-carbohydrate diet may be recommended for children with difficult-to-treat epilepsy. The ketogenic diet changes brain energy metabolism and helps reduce epileptic seizures.

Reactive nerve stimulation (RNS):

A device implanted in the brain detects abnormal electrical activity and provides electrical stimulation to prevent seizures from occurring.

Seizure triggers:

Certain factors and conditions can trigger seizures in people with epilepsy. Common triggers include

• lack of sleep
• Stress
• Alcohol or drug use
• Flashing lights or patterns (photosensitive epilepsy)
• Fever or illness
• Hormonal changes (e.g. during menstruation)
• Forgetting to take medication

First aid during a seizure :

It is important to know how to help a person when they have a seizure:

• Make sure the person is protected from danger by staying calm and moving nearby objects away from them.
• Have the person lie on their side to secure their airway, especially if they are having a tonic-clonic seizure.
• Do not hold the person or put anything in their mouth.
• Time the seizure: call an ambulance if the seizure lasts longer than 5 minutes or if the person has more than one seizure without regaining consciousness.

Prognosis:

The prognosis for epilepsy depends on the type of epilepsy, its cause and response to treatment. Many people with epilepsy can successfully control their seizures with medication and other treatments and lead a relatively normal life. In some children, especially those with absence seizures or benign epilepsy, epilepsy can go into remission. However, epilepsy is a lifelong condition and may require ongoing management.

Parkinson's disease

Parkinson's disease is a progressive neurological disorder that primarily affects movement. Parkinson's disease is caused by the gradual destruction or death of cranial nerve cells (neurons) in a region called the substantia nigra.

These neurons produce dopamine, a neurotransmitter that regulates movement and coordination. When dopamine levels decrease, the characteristic symptoms of Parkinson's disease develop.

The main symptoms of Parkinson's disease :

• Tremor: Often the first symptom to be noticed, tremors usually start in the hands, fingers or limbs, especially when the muscles are at rest. This is known as 'resting tremor'.
• Bradykinesia (slow movement): Voluntary movement slows down in Parkinson's disease. Simple tasks may take longer or movement may be more difficult to initiate.
• Muscle stiffness: muscle stiffness can limit range of motion, cause discomfort and make it difficult to perform activities such as walking or standing up.
• Posture and balance difficulties: As the disease progresses, posture may deteriorate and balance problems may increase, increasing the risk of falls.
• Gait changes: Many people with Parkinson's develop a shuffling gait with short steps. Over time, some experience a 'freezing of movement' where their feet feel as if they are stuck to the ground.
• Decreased facial expressions: Known as 'masked faces' or hypesthesia, people with Parkinson's may experience less spontaneous facial expressions and blinking.
• Changes in speech and writing: In Parkinson's disease, speech may become softer, monotonous or slurred. Handwriting may also become smaller or cramped.

Non-motor symptoms:

In addition to motor symptoms, non-motor symptoms can occur in Parkinson's disease, including

1. Sleep disorders: difficulty falling or staying asleep, vivid dreams, restless leg syndrome, etc.
2. Mood disorders: depression, anxiety and apathy are common.
3. Cognitive impairment: mild cognitive dysfunction may be present and may progress to dementia.
4. Autonomic dysfunction: problems with blood pressure, digestion, bladder control and sweating.

Causes and risk factors:

The exact cause of Parkinson's disease is unknown, but several factors are possible

1. Heredity: Heredity: About 10-15% of people with Parkinson's disease are associated with genetic mutations. Having a close relative with Parkinson's disease slightly increases the risk of developing the disease.
2. Environmental factors: Exposure to toxins such as pesticides, herbicides and heavy metals is associated with an increased risk of Parkinson's disease.
3. Age: Parkinson's disease usually develops in people over the age of 60, but in rare cases it can develop earlier (early onset Parkinson's disease).
4. Gender: Men are more likely to develop Parkinson's disease than women.

Diagnosis:

There is no specific test for Parkinson's disease. The diagnosis is based on history, symptoms and neurological examination. In some cases, imaging tests such as MRI or DaTscan (a specialized imaging test for dopamine function) may be performed to rule out other diseases.

Treatment:

There is no cure for Parkinson's disease, but treatment can reduce symptoms: 

  1.Medication: The mainstay of treatment is medication to increase dopamine levels in the brain:

• Levodopa: the most effective treatment, often combined with carbidopa to prevent side effects such as nausea.
• Dopamine agonists: Drugs that mimic the action of dopamine in the brain.
• MAO-B inhibitors: Drugs that prevent the breakdown of dopamine in the brain.

2. Deep brain stimulation (DBS): A surgical option for patients with advanced Parkinson's disease, in which electrodes are placed in specific areas of the brain to reduce symptoms such as tremors and rigidity.

3. Physiotherapy: Exercise can help improve balance, flexibility and overall mobility. Speech therapy may be needed to address speech and swallowing problems. Lifestyle changes: maintaining a healthy diet, maintaining physical activity and managing stress improve quality of life.

Prognosis:

The progression of Parkinson's disease is different for everyone. Parkinson's is a chronic degenerative disease, but many people live with Parkinson's for many years with the help of treatments to manage symptoms. Over time, motor and non-motor symptoms may worsen, but with ongoing medical care and treatment adjustments, quality of life can be optimized.

Anemia

 Anemia is a medical condition characterized by a lack of the number or quality of red blood cells (Rbc) or hemoglobin and a decrease in the ability to transport oxygen in the blood. This condition can lead to various symptoms and health problems due to insufficient oxygen reaching the body's tissues and organs.

Types of anemia :

1. Iron deficiency anemia: This is the most common type caused by a lack of iron necessary for the production of hemoglobin.
2. Vitamin deficiency anemia: It is caused by a lack of vitamin B12 or folic acid, which is necessary for red blood cell production.
3. Hemolytic anemia: Occurs when red blood cells are destroyed faster than they are produced.
4. Aplastic anemia: a rare condition in which the body stops producing enough new blood cells.
5. Sickle cell anemia: This is a genetic disease that causes red blood cells to become misshapen and disappear.
6. Thalassemia: it is a hereditary disease with abnormal hemoglobin production.

Reasons :

1. Nutritional deficiencies: Lack of iron, vitamin B12 or folic acid in the diet.
2. Chronic diseases: Conditions such as chronic kidney disease, cancer and rheumatoid arthritis.
3. Genetic disorders: inherited conditions such as sickle cell anemia and thalassemia.
4. Blood loss: from surgery, injury or chronic conditions such as ulcers or heavy menstrual periods.
5. Bone marrow and stem cell problems: aplastic anemia and some cancers.
6. Other causes: pregnancy, infections, certain medications and toxins.

Symptoms :

1. Fatigue and weakness
2. Pale or yellowish skin
3. Difficulty breathing
4. Dizziness or dizziness
5. Chest pain
6. Cold hands and feet
7. Headache
8. Irregular heartbeat

Diagnosis :

1. Complete blood count (CBC): Measures the number of red blood cells, white blood cells, and platelets.
2. Reticulocyte count: Measure the number of young red blood cells.
3. Hemoglobin electrophoresis: Defines different types of hemoglobin.
4. Bone marrow examination: Examine the production of blood cells.
5. Iron probe: measures serum iron, ferritin, total iron binding capacity and transferrin saturation.

Treatment :

1. Dietary changes: An increase in the intake of iron-rich foods (e.g. red meat, beans, lentils), vitamin B12 (e.g. meat, dairy products) and folate (e.g. leafy green vegetables, nuts).
2. Supplements: Iron, vitamin B12 and folate supplements.
3. Medication: Erythropoiesis-stimulating agent to stimulate red blood cell production.
4. Transfusion: for certain types, such as severe anemia or aplastic anemia.
5. Treatment of root causes: dealing with chronic diseases, infections or other factors.
6. Bone marrow transplantation: for some serious types, such as aplastic anemia.

Prevention :

1. Healthy diet: Ensure proper intake of iron, vitamin B12 and folic acid.
2. Regular examination: especially for people with chronic diseases or genetic predispositions.
3. Managing chronic diseases: Managing chronic diseases to prevent anemia as a complication.

When to see a doctor:

• Constant fatigue and weakness
• Difficulty breathing
• Pale or yellowish skin
• Other symptoms suggestive of anemia

Anemia can range Decently from mild to severe and can be a temporary or chronic condition. Proper diagnosis and treatment are important to manage the symptoms and address the root cause.