What you need to know about epilepsy

Epilepsy is a disorder in which nerve cell activity in the brain is disturbed, causing seizures or periods of unusual behaviour, sensations and sometimes loss of consciousness.

People with epilepsy behave differently, some simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs.

Having a single seizure doesn’t mean you have epilepsy – you need to have two unprovoked seizures to be diagnosed with epilepsy.

Symptoms

Symptoms differ depending on the type of seizure. Seizures can affect any process your brain coordinates, therefore the signs and symptoms may include:

• Temporary confusion
• Staring into space
• Uncontrollable jerking movements of the arms and legs
• Loss of consciousness or awareness

Seizures are classified as focal or generalised based on how the abnormal brain activity begins.

Focal seizures

These result from abnormal activity in just one area of your brain. These seizures fall into two categories:

Simple partial seizures – These are focal seizures without loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound.

They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights.

Complex partial seizures – These seizures involve a change or loss of consciousness or awareness.

During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.

Generalised seizures

These seizures involve all areas of the brain. Six types of generalized seizures exist.

Absence seizures – These often occur in children and are characterised by staring into space or subtle body movements such as eye blinking or lip smacking.

Tonic seizures – Tonic seizures cause stiffening of your muscles.

Atonic seizures – Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down.

Clonic seizures – Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms.

Myoclonic seizures – Myoclonic seizures usually appear as sudden brief jerks or twitches of your
arms and legs.

Tonic-clonic seizures – Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking.

Causes

Epilepsy most of the time has no identifiable cause. The condition may however be traced to various factors.

Genetics – In these cases, it’s likely that there’s a genetic influence.

Head trauma – Brain conditions, such as tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35.

Infectious diseases – Infectious diseases, such as meningitis, Aids and viral encephalitis, can cause epilepsy.

Prenatal injury – This can result in epilepsy or cerebral palsy.

Developmental disorders – Epilepsy can be associated with developmental disorders, such as autism and neurofibromatosis.

Age –  The onset of epilepsy is most common during early childhood and after age 60 (Dementia or seizures in childhood).

Complications

Having a seizure at certain times can lead to circumstances that are dangerous to yourself or others.

Falling – If you fall during a seizure, you can injure your head or break a bone.

Drowning – If you have epilepsy, you’re likely to drown while swimming or bathing

Car accidents – A seizure that causes either loss of awareness or control can be dangerous if you’re driving a car or operating other equipment.

Pregnancy complications – Seizures during pregnancy pose dangers to both mother and baby, and certain anti-epileptic medications increase the risk of birth defects.

Emotional health issues – People with epilepsy are more likely to have psychological problems, especially depression, anxiety and, in extreme cases, suicide.

Status epilepticus – This condition occurs if you’re in a state of continuous seizure activity lasting more than five minutes.

Treatment

Treatment of choice for epilepsy is medication. If medications don’t treat the condition, doctors may propose surgery or another type of treatment.

Picture: iStock

Medication

Most people with epilepsy can become seizure-free by taking one anti-seizure medication, called anti-epileptic medication. Your doctor will advise you about the appropriate time to stop taking medications.

More than half the children with epilepsy who aren’t experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life.

Many adults also can discontinue medications after two or more years without seizures. Finding the right medication and dosage can be complex.

Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing your medication.

Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled.

Anti-seizure medications may have some side effects which include:

• Fatigue
• Dizziness
• Weight gain
• Loss of bone density
• Skin rashes
• Loss of coordination
• Speech problems
• Memory/ thinking problems
• Depression

Prevention of Seizures

Take medications exactly as prescribed. Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies.

Never stop taking your medication without talking to your doctor.

Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in
your mood or behaviours.

Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy.

At least half of all people newly diagnosed with epilepsy will become seizure-free with their first medication.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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