Epilepsy


The brain is a complex organ. It is made up of billions of nerve cells, each with a precise role to play in the functioning of the brain. Some of those functions include: controlling movements (voluntary and involuntary), sensations, emotions, memory and thought. The nerve cells communicate with one another through electrical signals. A change in regular brain electrical activity can result in a seizure. Epilepsy is not a mental illness, but rather a neurological disorder. Epilepsy affects 1 in every 100 Canadians.

Causes

In most cases, there is no identifiable cause for the onset of seizures. We do know however, that certain factors can trigger epileptic seizures, including:

  • Head trauma
  • Severe brain infection (e.g. meningitis)
  • Stroke
  • Substance abuse
  • Brain tumour
  • Problems with foetal brain development during pregnancy

Symptoms

There are several types of epileptic seizures. The kind of seizure depends on which part of the brain is affected. If the entire brain is involved, it is a generalized seizure. If only part of the brain is affected, it is known as a partial seizure. The characteristics of seizures vary greatly from one person to another. It is possible for a person with epilepsy to experience more than one type of seizure. The table below presents different types of seizures and some of the related symptoms. There are many more.

Partial (focal) Seizures Generalized Seizures

Simple

  • No alteration of awareness
  • Unusual sensations (visual, olfactory, auditory, gastric, fear, etc.)
  • Sudden movements

Absence (petit mal)

  • Unresponsiveness
  • Blank stare, dazed appearance
  • Can be mistaken for inattentiveness (daydreaming)

Complex

  • Unresponsiveness
  • Automatisms or repeated motions

Tonic-clonic (grand mal)

  • Loss of consciousness
  • Generalized convulsion (muscle spasms)

Some persons with epilepsy experience auras or warnings that alert them to an impending seizure. This warning is, in itself, a simple partial seizure.

Status epilepticus is defined as a potentially life-threatening event whereby epileptics experience a series of recurring seizures from which they do not regain consciousness or a seizure that lasts long enough. If left untreated, status epilepticus can lead to severe brain damage.

Diagnosis

When diagnosing epilepsy, the physician will want to gather as much information about the seizure as possible. An exact description of the symptoms will help identify the affected area of the brain. He/she will also want to know whether it was an isolated occurrence or if there have been additional seizures. Another important point will be whether there were trigger factors (fever, infection) or if a medical condition is to blame. The physician will most likely order blood tests, medical imaging and an EEG (electroencephalograph) to rule out certain possibilities.

Treatment

To date, there is no curative drug on the market. There are however, certain medications known as anticonvulsants that allow persons with epilepsy to lead active lives by controlling and preventing seizures. Treatment generally involves taking only one type of anticonvulsant. Some people nevertheless, require a combination of drugs to keep their seizures under control. Finding the right medication or combination of medications and the ideal dose may take some time. Also, finding the dose that will prevent seizures and cause the least amount of side effects is also vital. It is important to note the frequency of seizures, accompanying symptoms and circumstances surrounding the event. Do not suddenly stop taking your medication.

Anticonvulsants can have an effect on the efficacy of many drugs. Always consult your physician or pharmacist before taking any other medication (prescription or over-the-counter). Avoid alcohol.

Certain measures can be taken to help limit seizures. These include avoiding triggers such as lack of sleep, the use of recreational drugs and drinking too much alcohol.

First Aid

Onlookers cannot do much more than wait for the seizure to stop and try to prevent the person from injuring themselves.

There is no need for special precautions or care when dealing with a person having a partial simple or generalized absence seizure.

As for partial complex seizures, stay close to the person and calmly reassure them.

Here are a few recommendations to follow when witnessing a tonic-clonic seizure:

  • Stay calm and reassure onlookers
  • Remove any objects that could harm the person
  • Do not put anything in the person's mouth
  • Do not move (except if there is imminent danger) or hold the person down
  • Gently turn unconscious persons onto their side to clear the airway
  • Place something soft under their head to protect it

Once the individual regains consciousness, gently reassure them. Most people with epilepsy can, after a seizure, resume their normal activities once they have rested.

If a seizure lasts (generally more than five minutes) or if seizures are recurrent and the person does not regain consciousness, immediately call for help to prevent status epilepticus, which could cause irreparable damage. Also, if the person is diabetic, pregnant or if the seizure occurs in water, it is recommended that you call an ambulance.

For more information or for support :

Epilepsy Canada

www.epilepsy.ca

Canadian Epilepsy Alliance

www.epilepsymatters.com

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