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Epilepsy: Diagnosis and Treatment in Delhi

Epilepsy — also referred to as a seizure disorder — is a long-term brain disorder that results in recurrent, unprovoked seizures caused by abnormal brain electrical activity. Epilepsy has numerous forms, and although the cause of the epilepsy in some instances can be determined, in most instances it is unknown.

Did you know? Epilepsy is prevalent, impacting approximately 1.2% of Americans (as reported by the CDC) and millions globally, including in India. It occurs in individuals of all ages, races, and genders.

What Are Seizures?

Seizures are caused by a sudden surge of electricity in the brain, which takes over the normal functioning of the brain for a temporary period of time. Seizures have different symptoms, depending on the region of the brain that is affected.

A few seizures result in short loss of awareness (e.g., blank staring), while others include involuntary jerking (convulsions).

Note: A single seizure doesn't necessarily mean you have epilepsy.

Epilepsy is diagnosed when you've had two or more unprovoked seizures at least 24 hours apart.

Symptoms of Epilepsy

Symptoms vary with the type of seizure and what processes in the brain are affected. Common symptoms are:

Brief confusion
A spell of staring
Stiffened muscles
Uncontrollable jerking of the arms and legs
Loss of consciousness
Psychological symptoms such as fear, anxiety, or déjà vu
Behavioral changes and psychotic symptoms can also occur in others.

Warning Signs of Seizures (Aura)

Some individuals with focal seizures have a warning sign or aura just before a seizure occurs.

They may include:

A strange sensation in the stomach or rising sensation
Sudden fear or anxiety
Déjà vu
An unusual taste, smell, or visual event (e.g., flashing lights)
Dizziness or hallucinations

Types of Seizures

Seizures are divided into focal seizures (which start in one area of the brain) and generalized seizures (affecting the entire brain).

1. Focal Seizures

Without loss of consciousness (Simple partial):

Produce abnormal emotions, sensory phenomena, or jerking movement of a limb.

With impaired awareness (Complex partial):

Produce loss of awareness or responsiveness, staring spells, or repetition.

Examples of focal seizures:

Temporal Lobe Seizures: Related to emotion, memory alteration, or automatic behaviors such as lip-smacking.
Frontal Lobe Seizures: Produce unusual movements, laughter, or bicycle-pedaling movements.
Occipital Lobe Seizures: Impact vision, leading to hallucinations or temporary loss of vision.

2. Generalized Seizures

Absence seizures (Petit mal): Staring spells, a common pattern in children.
Tonic seizures: Sudden stiffening of back, arms, and legs.
Atonic seizures (Drop attacks): Sudden loss of muscle tone leading to falls.
Clonic seizures: Rhythmic jerking of face, arms, or legs.
Myoclonic seizures: Sudden brief jerks of upper body or limbs.
Tonic-clonic seizures (Grand mal): Stiffening of the body, twitching and shaking, loss of consciousness, and bladder loss at times.

When to See a Doctor

Contact a doctor immediately if:

A seizure continues for over 5 minutes.
Resolves neither breathing nor consciousness after the seizure.
Suddenly another seizure follows.
You are pregnant, diabetic, or hurt while seizing.
Experience a first-time seizure.

Causes of Epilepsy

In approximately 50% of instances, there is no known cause of epilepsy. In the remaining instances, potential causes are:

Genetic: Certain forms run in families or are associated with certain genes.
Head trauma: Trauma from accidents.
Abnormalities of the brain: Tumors, malformations of blood vessels, or scarring.
Stroke: A major cause in people aged more than 35 years.
Infections: Viral encephalitis, meningitis, HIV, or parasitic infections.
Birth injury: Deprivation of oxygen or maternal infection during pregnancy.
Developmental conditions: Autism, ADHD, and other neurodevelopmental disorders.

Seizure Triggers

Triggers don't cause epilepsy but can bring on seizures:

Alcohol or drug use
Flashing lights
Missing anti-seizure medications
Lack of sleep
Stress or hormonal fluctuations (e.g., during menstrual cycles)
Dehydration or missed meals

Risk Factors

You might have a greater chance of having epilepsy if you:

Are a child or older adult (age-related risk peaks)
Have a family history of epilepsy
Have had a head injury
Have vascular disease or a stroke
Had dementia or brain infections (e.g., meningitis)
Had seizures caused by fevers in childhood

Epilepsy Complications

Injury: Seizures may lead to falls or accidents that result in fractures or head trauma.
Risk of drowning: 13–19 times greater than the general population because seizures occur in water.
Car accidents: Because of seizure-related loss of control.
Pregnancy complications: Anti-seizure medicines can be harmful to the baby.
Memory loss: Recurring seizures cause chronic cognitive effects.
Mental illness: Depression, anxiety, or suicidal ideation.

Life-threatening complications:

Status Epilepticus: Continuous seizures lasting >5 minutes or back-to-back seizures without regaining consciousness.
Sudden Unexpected Death in Epilepsy (SUDEP): A rare but serious risk, especially in people with uncontrolled tonic-clonic seizures.

Diagnosis of Epilepsy in Delhi

IBS Hospital, Delhi’s top hospital, provide state-of-the-art diagnostics, including:

Neurological exam (behavior, motor skills, reflexes)
Blood & genetic testing
EEG & High-density EEG
CT & MRI scans (including fMRI)
PET & SPECT (SISCOM mapping)
Magnetoencephalography (MEG)
Neuropsychological assessments

Treatment Plans for Epilepsy in Delhi

The majority of patients with epilepsy control medications, while some need surgery or newer treatments.

1. Medications (Anti-seizure medicines)

Initial treatment in 50–60% of patients.
Neurologists in Delhi tailor treatment according to the seizure type, age, and medical history.

2. Surgery for Epilepsy

In case of treatment failure (drug-resistant epilepsy), surgery can be indicated:

Temporal Lobectomy
Lesionectomy
Corpus Callosotomy
MRI-Guided Laser Ablation

Success Rate in India:

70–80% seizure-free results in temporal lobe epilepsy.

3. Advanced Therapies in Delhi

Vagus Nerve Stimulation (VNS): Decreases frequency of seizures by 20–40%.
Deep Brain Stimulation (DBS): Medanta, AIIMS.
Responsive Neurostimulation (RNS): Soon available in India.

4. Ketogenic & Modified Atkins Diet

Effective in children and adults with resistant epilepsy.
Dietitian-based ketogenic programs are available in Delhi hospitals such as Sir Ganga Ram and Apollo.

5. Emerging Treatments in Delhi

MRI-guided focused ultrasound (non-surgical option)
Transcranial Magnetic Stimulation (TMS)
Transcranial Direct Current Stimulation (tDCS)

Why Choose Delhi for Epilepsy Care?

Expert epileptologists & neurosurgeons
Advanced imaging and diagnostic tools
Affordable treatment compared to global costs
Comprehensive rehabilitation and counseling services

Conclusion

Epilepsy is a manageable condition with the right diagnosis and treatment. Delhi’s neurology centers combine modern technology, experienced specialists, and holistic care to help patients lead a seizure-free life.

By -Dr Aaksha Shukla | July 30, 2025 | 9 Min Read