Introduction
It is estimated that there are greater than 10 million people with epilepsy in India.Its prevalence is around 1 % in our society. According to various data it is estimated that the overall prevalence of epilepsy in India is is 5.59-10 per 1000.
Epilepsy (Modern Aspect)
Epilepsy is derived from a Greek word which means convulsions. It is a disorder of brain function characterized by cerebral dysrrhythmia.
Based on seizures epilepsy may be divided into,
Generalized seizures– It is further classified as,
a) Generalized tonic-clonic seizures- It consist of 6 things
- Aura
- Cry-loss of consciousness
- Person fall to the ground
- Tonic please
- Clonic phase
- Period of relaxation
- Post epileptic automatism with confused states
b) Absence seizures- It is characterized by sudden onset of staring, unresponsiveness, and loss of consciousness for a very less time
c) Myoclonic seizures– It consist of single or multiple sudden, brief, shock like contraction
Partial seizures – It is classified as,
a) Simple Partial seizures– The manifestation depend upon the area of cortex involved. There may be paraesthesia or convulsions. Loss of consciousness is generally not found
b) Complex partial seizures– It includes aura-amnesia-abnormal behaviour and automatism with impaired consciousness.
Clinical Classification of Drugs used in Epilepsy
For Generalized tonic-clonic seizures (grand mal epilepsy) –
- Sodium valproate
- Lamotrigine
- Carbamazepine
For Simple/complex partial seizures –
- Carbamazepine
- Lamotrigine
- Sodium valproate
For Absence seizures –
- Sodium valproate
- Ethosuximide
For Myoclonic seizures –
- Sodium valproate
For Status Epilepticus –
- Lorazepam
- Diazepam
- Fosphenytoin
- Phenobarbitone
Chemical Classification of Drugs
- Hydantoins- phenytoin, fosphenytoin
- Barbiturates- Phenobarbitone
- Dibenzazepine (Iminostilbenes)- carbamazepine, oxcarbazepine
- Carboxylic acid derivatives- sodium valproate, divalproex
- Succinimide- Ethosuximide
- BZDs- Lorazepam, diazepam, clonazepam, clobazam
- Others- lamotrigine, topiramate, Gabapentin, pregabalin etc
Drugs that can cause seizures,
- Antimalarial – chloroquine, mefloquine
- Antimicrobials/Antivirals- Beta lactam and related compounds, Quinolones, Acylovir, Isoniazid,Ganciclovir
- Anaesthetic and Analgesics- Meperidine, Fentanyl, Tramadol, Local anaesthetics
- Dietary Supplements- Ginkgo, Ephedra
- Antidepressants, Antipsychotics, Lithium
According to Ayurveda (We may correlate Apasmara To epilepsy)
In medical science we may define it as a disease caused due to derangement of mind and intellect which is further characterized by loss of consciousness and memory. In this, darkness appears in front of eyes, body starts shivering and foam come out from mouth.
Causes
Those person who indulge themselves in unhealthy eating habits their doshas increase in amount .In these persons satva decreases due to increase in raja and tama and the heart gets filled with vata dosha thus due to fright ,anger passion,grief, anxiety etc Apasmara makes its manifestation.
Samprapti and Poorvaroopa
The doshas in vessels and in manovahi strotas affects heart due to which the person become unconscious.Due to disturbances in brain he start seeing imaginary things (visual aura) and drops down suddenly and is afflicted with tremors,his eyes and eyebrows become distorted,foam starts coming from mouth and the hands and feet become convulsed.
Types
a) Vataj
b) Pittaj
c) Kaphaj
d) Sannipataj
Symptoms according to types of Apasmara
a) Vataj- Trembling, gnashing of teeth, dribbling of saliva in form of foam, increase in breath sounds,the patient sees the visual aura which is usually red or black in colour and then faints
c) Pittaj- Yellowish foam comes out from mouth,face,eyes and body of patient becomes yellow (icteric tinge), there is a visual aura which is usually of red or yellow colour.Body becomes hot,there is increase in thirst and the patient visualise the whole world as being in flames.
d) Kaphaj- white colour foam comes out from mouth.Body, mouth and eyes become white.Body becomes cold and heavy.There is a visual aura which is usually of white colour .The patient takes a long time to recover from fits.
e) Sannipataj- In this combination of symptoms of vataj,pittaj,kaphaj Apasmara is seen
Chikitsa Siddhant
In order to bring the restoration of the brain,nerves and mind first we should give Tikshna vaman,nasya etc.
In vataj apasmara vasti is given mainly,in pittaj apasmara we do virechan,in kaphaj apasmara vaman is done mainly.
Medicines that are used in treatment of Apasmara,
a) Panchgavya ghrita– It consist of equal quantity of cow dung juice,sour curd,cow urine,cow milk and cow ghee.
b) Brahmi Ghrita- Brahmi swaras, Vacha, Shankhpushpi are its main contents.
c) Vachadi Ghrita– Sweet Vacha, Amaltas, Brahmi, Heeng, Gugglu ,etc are its main contents.
d) Triphaladi oil- Amla, Harad, Baheda, Marich, Peepal, Daruhaldi, Vantulsi, Shyama, Karanj etc are its main content.
e) Apasmarahara lepa (source Bhaishajya Ratnawali)- bark of drumstick tree and cow urine should be mixed and then grind .Using this lepa helps in curing patient from apasmara.
f) Bhootbhairav Rasa ( source Bhaishajya Ratnawali) – It’s contents are mercury, arsenic, iron, sulphur etc
Dose – 625mg
g) Chandbhairava Rasa ( source Bhaishajya Ratnawali)- It’s contents are copper, Mercury, arsenic, sulphur etc
Dose – 625 mg
h) Apasmaraharam Yogtrayam (source Bhaishajya Ratnawali(B.R)
It’s contents are
6gm til oil+6gm garlic swaras
Or
Milk + Shatavari kand swasras
Or
12 gm Brahmi swaras should be mixed with honey and then drink it.
" None of the drug listed above should be taken without proper consultation of the doctor.This post is just for educational purpose and not for any clinical purpose."
Contributor- Medico Rohan Barnwal
Nice 👏