What is epilepsy?
What is epilepsy?
According to the Epilepsy Society (www.epilepsysociety.org.uk), epilepsy is a neurological condition where there is a tendency to have seizures. A seizure is caused by a burst of abnormal electrical activity in the brain. This means that having one seizure does not necessary indicate epilepsy. In fact, many times people will have a single seizure and never have another one again.
How many people have epilepsy
Epilepsy is a common neurological disorder affecting 1% of the population. In Malta there are over 4,000 people with epilepsy. Anyone can develop epilepsy, but it often begins in children or in seniors over the age of 65.
What are the types of seizures?
There are over forty types of seizures depending on the part of the brain affected by the extra discharge of electrical activity and what that area of your brain controls. The most widely recognized seizure is called a generalized tonic-clonic seizure and this affects the entire brain from the start. The person will lose consciousness, fall and their arms and legs will begin to shake. Other types of seizures known as absence seizures may involve staring blankly for a few seconds. In focal seizures the person involved may become confused and behave in an unusual way.
How is it diagnosed?
Epilepsy is a clinical diagnosis. Descriptions of the event by an eyewitness can be very helpful if the person has lost awareness or consciousness. Investigations such as an EEG (electroencephalogram) may be performed. An EEG tracks and records brain wave patterns. It is a painless procedure and can last anywhere from 20 minutes to a full week. An MRI (Magnetic Resonance Imaging) or a Computerized Topography Scan (CT) might also be recommended by the clinician.
What causes epilepsy?
There are several conditions that may lead to the development of epilepsy including a genetic tendency, stroke, head injury or infections. In certain cases no cause is found. About 70% of people with epilepsy will be controlled with Anti-Epileptic Drugs (AEDs). Others are candidates for surgery depending on the assessment of neurologists and neurosurgeons.
What triggers seizures?
Sometimes there are no known causes, but certain situations such as stress, sleep deprivation and alcohol abuse or withdrawal can increase the likelihood of a seizure.
What first aid procedures are recommended during a seizure?
If a person is having a focal seizure, stay with them and guide them away from danger whilst reassuring them. In some situations where seizures are prolonged, the doctor may also suggest “rescue medications”. However, this depends on the case and the advice given by the caring physician.
If the person is unresponsive:
1. It is important to keep calm.
2. Time the seizure.
3. Put a cushion or something soft under the person’s head.
4. Put the person into the recovery position (on their side) after the shaking stops.
5. Stay with them until breathing returns to normal.
When is urgent assessment by a doctor recommended?
If the person:
– Is having a seizure for the first time.
– Is injured.
– Is diabetic.
– Is pregnant.
– Has a seizure in water.
– Has a seizure a short while after the first.
– Is not breathing properly.
– Has a seizure that lasts longer than 5 minutes.
If in doubt, seek medical advice.
Is there anything that one should not do during a seizure?
– Do not hold them down. Let the seizure happen.
– Do not put anything in their mouth.
– Do not move them unless they are in danger.
Can a person with epilepsy live a normal life?
Yes, a person with epilepsy can live a normal life with some small adjustments. Almost 80% of people with epilepsy are able to have long periods in life where their seizures are controlled by medications. Some even go into remission. Unfortunately there are still some whose epilepsy is resistant to anti-epileptic drug treatments. However, this is improving thanks to continuous research and breakthroughs in technology.
13 COMMON EPILEPSY MYTHS, DEBUNKED
The truth about an often misunderstood condition
Some myths about epilepsy are centuries old, but they still persist. Epilepsy Center Director Imad Najm, MD, dispels 13 of the most common myths about epilepsy:
Myth 1: If you’ve had a seizure, you have epilepsy.
Fact: A person is diagnosed with epilepsy when he or she has two or more unprovoked (“out of the blue”) seizures that occur more than 24 hours apart. But when something provokes a seizure, such as binge drinking, sleep deprivation or a new medication, these are not related to epilepsy.
Myth 2: People with epilepsy are mentally ill or emotionally unstable.
Fact: Epilepsy is an umbrella term covering many types of seizure and epileptic disorders. It is a functional, physical problem, not a mental one, and it has many unidentifiable causes.
Myth 3: People with epilepsy aren’t as smart as other people.
Fact: Epilepsy has little to no effect on a person’s ability to think, except during some seizures, during a short period following some seizures and sometimes as a side effect of certain anti-epileptic medications.
Myth 4: People who have seizures can’t handle high-pressure, demanding jobs.
Fact: They often can, and they do. Most professions — including those in the highest tiers of business, government, justice system, sports and medicine — can accommodate a person with epilepsy.
Myth 5: It’s easy to tell when a seizure is about to happen.
Fact: We can’t yet predict when seizures are beginning, although some patients say they can feel a brief sensation within seconds of a seizure — which we call an “aura.” Research is ongoing and include training dogs to detect the onset of seizures.
Myth 6: Seizures hurt.
Fact: A person is unconscious and not in any pain during most seizures. Afterward, the patient could feel discomfort if he or she falls down, has muscle aches or if he or she bit their tongue (during a grand mal seizure).
Myth 7: Epilepsy is most common in children.
Fact: Epilepsy is most common in both the very young and the elderly. However, it can develop at any age.
Myth 8: During a seizure, a person could swallow or choke on his or her tongue.
Fact: Impossible. The worst thing that can happen during a seizure is that a person could bite his or her tongue.
Myth 9: You should force something into the mouth of someone having a seizure.
Fact: Never put anything into a person’s mouth if they are having a seizure. This could actually injure them. Roll the person on one side, keep him or her a safe distance from any nearby objects, and let the seizure run its course. If you see any signs of distress or if the seizure persists for more than a couple of minutes, call 9-1-1 (in Malta for emergency call 112).
Myth 10: Epilepsy can’t be controlled effectively.
Fact: There are many ways to treat, minimize, control and even — under the right conditions — eliminate epilepsy. With anti-epileptic medications, it’s possible to control epileptic seizures adequately in almost 70% of patients. The remaining 30% are possible candidates for surgery, but it depends on where the epilepsy originates in the brain.
Myth 11: Women with epilepsy can’t or shouldn’t get pregnant.
Fact: Epilepsy does not generally affect a woman’s ability to conceive and has a minimal effect on a child’s development. However, if women are taking anti-epileptic drugs, the risk of birth defects ranges from 2% to 10%. “This is a bigger concern,” Dr. Najm says. People can minimize the risk by working closely with a neurologist and Ob/Gyn.
Myth 12: People with epilepsy will pass it on to their kids.
Fact: “Kids of parents with some forms of epilepsy are at higher risk of developing it, but the risk is very low,” Dr. Najm says. This is because a single gene problem rarely causes epilepsy; it usually involves a combination of multiple gene defects.
Myth 13: You can’t live a full, normal life with epilepsy.
Fact: Epilepsy can affect a person’s lifestyle, but you can live a full life, Dr. Najm says. “Live your life, but live with moderation. Avoid extremes in lifestyle.” Before you start doing something new, Dr. Najm advises: “Ask yourself: ‘Could I hurt myself or someone else if I had a seizure?’ If the answer is ‘yes,’ and seizures are not well-controlled, people should avoid the activity or be very cautious.”