Understanding Epilepsy

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by Dr. Hussain Imam Hj. Muhammad Ismail

Epilepsy is the name for occasional, sudden, excessive, rapid and local discharge of gray matter, according to John Hughlings Jackson, an English physician who is considered the father of the modern concept of epilepsy. This classical description and concept of epilepsy as provided by Jackson remains relevant even after the 150 years since it was first coined.

To put it simply, epilepsy is a disorder whereby the transmission of electrical signals inside the brain is disrupted. It is sometimes likened to an electrical storm taking place inside the brain.

These abnormal electrical surges manifest outwardly as seizures. Seizures are widely perceived as jerky, violent convulsions, shrieking or falling to the ground, or some combination of the three.

In reality, a seizure can be any abnormal, involuntary movement or behaviour.

Type of Seizures

There are many types of seizures, and these are classified into generalised and partial seizures. The difference lies in where the seizure originated and how much of the brain is affected.

In generalised seizures, abnormal electrical activity occurs throughout the whole brain, in both hemispheres. The person loses consciousness.

Partial seizures only involve one part of the brain. Partial seizures are divided into simple and complex. During simple partial seizures, the person does not lose consciousness. He might experience unusual emotions or sensations, for example having sudden unexplainable feelings of joy or anger, or altering the way things smell, look, sound, taste or feel.

During complex partial seizures, a person may not be aware of their surroundings, may appear confused or even experience a dream-like state. Chewing, blank staring, pulling at clothing and walking in circles are common signs of this form of seizure.

Tonic-clonic is the most intense of all types of seizure. It is characterised by 'stereotypical' signs such as loss of consciousness, stiffening of the entire body followed by repeated jerking of the limbs.

Sometimes, a person experiences a 'warning' and is aware that a seizure is about to begin. This warning is also called an aura.

Generalised seizures are divided into four major types : absence, myoclonic, atonic, and tonic-clonic.

* Absence seizures commonly occur in children of primary school age, and are usually brief – measured in seconds. Common signs are blank staring and subtle movements such as fluttering of the eyelids. These brief episodes may pass unnoticed, and sometimes people who have them do not even realise it themselves.

* Myoclonic seizures cause brief, shock-like jerks of the arms, legs or upper body. It is somewhat similar to the sudden kick or jerk of a foot experienced by most people when about to fall asleep.

* Atonic seizures produce a sudden loss of muscle tone, causing a person to suddenly collapse or fall down.

* Tonic-clonic is the most intense of all types of seizures, and is the type that most often comes to mind when people think of seizures. It is characterised by 'stereotypical' signs such as loss of consciousness, stiffening of the entire body followed by repeated jerking of the limbs. Loss of bladder control may occur.

Causes of Epilepsy

If left untreated, epileptic seizures can adversely affect everyday activities such as driving or even bathing or swimming. Falling during a seizure may also cause head injury.

Epilepsy is relatively common - it affects some 0.8% of children and 0.4% of adults. Incidences are particularly high in the first year of life and after 65 years of age. Epilepsy can affect people of any age, gender, race or social status. In half the cases, no known cause can be found.

However, some of the common causes are infections of the brain (encephalitis, meningitis and so on), conditions such as stroke or tumour in the brain, birth trauma, major head injuries, exposure to toxic substances or drug abuse, and genetic predisposition.

Misconception

Due to lack of understanding and awareness, people with epilepsy are still viewed with fear and suspicion, and sometimes treated as outcasts. Having epilepsy does not mean that a person is 'insane' or mentally retarded. Neither does it lead to mental problems. It is not contagious.

The most common misperception in our society is that epilepsy has supernatural causes. Some still believe that the body of a person with epilepsy has been 'taken control of', or been possessed by spirits. A simplistic way of clearing the confusion and correcting the negative attitudes towards epilepsy is by comparing it to asthma, heart palpitations or even diarrhoea.

The same imbalance or disturbance that occurs in the heart or bowels that cause palpitations or an upset stomach can cause seizures if it happens in the brain. Therefore, it should be made known that most of the time, the abnormal electrical discharges that cause seizures are eminently treatable.

Better yet, medication to treat epilepsy is readily available at all government hospitals and clinics.

As such, people with epilepsy need not live in seclusion or shame because of their condition. Their family members and caregivers should be made aware that there is a very good chance for a person with epilepsy to enjoy a normal lifestyle.



More info on EPILEPSY here.






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