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September 02 2020

What Does It Mean to Have Epilepsy?

Epilepsy is one of the most common central nervous system disorders affecting 50 million people globally, with 23 million of them living in Asia. Truthfully, many people are still misinformed about it, like what causes epilepsy and how it is different from a seizure.

A seizure occurs when electrical activity in the brain spikes up and spreads to neighboring areas. This causes uncontrollable impulses and short periods of unusual behavior. Causes may differ from one person to another, but it can be attributed to certain factors:
  • Genetic influence
  • Head trauma
  • Infectious diseases
  • Prenatal impairments
  • Underlying brain illnesses
Epilepsy, on the other hand, is a term used to diagnose a person that has experienced an unprovoked seizure more than once. Most cases are controlled by medication or surgery, but recovery varies. Some people (mostly children) are lucky enough to outgrow their condition as they age, while others may require lifelong treatment.

What happens during an epileptic seizure?

Due to irregular brain activity, seizures impair the function of the central nervous system and affect the processes of the brain. Common signs include:
  • Confusion and disorientation
  • Fearfulness or anxiety
  • Loss of consciousness
  • Staring blankly into the distance
  • Uncontrollable jerking movements
Signs and symptoms may vary depending on the type of seizure. A person with epilepsy will experience the same kind of seizure at any given episode, so the signs are expected to be similar. Here are the two main types of seizures:

1. Focal (Partial) Seizures

When abnormal brain activity occurs in one area, this seizure can be classified as focal.
Simple Partial – This type of focal seizure does not involve loss of consciousness, but may alter one’s senses. A person may see, feel, smell, or taste things differently or experience heightened emotions and muscle jerking.
Complex Partial – This type can result in a loss or change in awareness. Unlike Simple Partial that causes alterations to the senses, people with this condition stare blankly into space, become unresponsive, and perform repetitive movements.

2. Generalized Seizure

Seizures that involve all areas of the brain are labeled as generalized. There are six (6) types, each with their own set of symptoms.

Absence – Also known as Petit Mal Seizures, this condition commonly occurs in children. It may cause repetitive movements, such as rapid blinking and lip-smacking, and may eventually result in a loss of awareness.
Tonic – This type of seizure stiffens out one’s muscles. An episode may include a tightness in the back, arms, and legs, while a sudden attack may cause a person to fall to the ground.
Atonic – Also known as drop seizures, this is a more severe version of a Tonic seizure. Instead of tightness, a person completely loses muscle control and collapses.
Clonic – This is associated with people who experience repeat jerking muscle movements around the neck, face, and arms.
Myoclonic – Similar to the Clonic Seizure, Myoclonic causes a sudden twitching of the arms and legs.
Tonic-clonic – This is known as the most severe type of seizure. People with this condition experience loss of awareness, body stiffening, shaking, loss of bladder control, and tongue biting.

What triggers an epileptic seizure?

According to medical research, the commonly reported triggers or factors of an epileptic seizure are the following:
  • Alcohol or substance abuse
  • Exposure to bright lights
  • Fever
  • Lack of sleep
  • Missing medication
  • Psychological stress
  • Skipping meals or overeating
Identifying the primary cause of a seizure can be very challenging. While skipping medication, lacking sleep, and experiencing high levels of stress are some common triggers, these alone are not enough to cause a seizure. It is important to know that seizures can occur due to the combination of different factors.

When looking after a loved one who is having some trouble identifying triggers, it is best to record each episode. Keep a journal to help document the activities and potential triggers that the person may have been exposed to before an episode. The information gathered will be crucial in optimizing treatment.

Risk Factors

Just like any other ailment, certain factors may increase the risk of acquiring the disease.  
  • Brain infections – Meningitis and other similar diseases that cause inflammation in the brain can result in epilepsy.
  • Dementia – Cognitive decline is linked to various brain diseases and can increase the risk of epilepsy for older adults.
  • Family history – Having family members who have a history of the disease increases one’s chances of developing it, too.
  • Head injuries – People who were involved in an accident or experienced concussions may experience seizures.
  • Stroke and vascular diseases – Damage to the blood vessels can impair the brain and trigger epilepsy.

Treatment Options

Most cases of epilepsy can be managed with the help of a neurologist. The treatment plan will be based on the manifested symptoms and how well the patient is responding to medication. More treatment methods are currently being developed, but for now, here are the options available:
  • Anti-epileptic drugs (AEDs) – Medication can effectively reduce the number of seizures, and in most cases, eliminate its occurrence, as long as they are taken as prescribed.
  • Brain Surgery – In severe cases, the doctor may require brain surgery to address the condition. Altering the affected area of the brain will effectively minimize the chances of an episode.
  • Ketogenic Diet – Diet can significantly affect the condition of the brain, blood vessels, and other parts of the body. People with epilepsy who do not easily respond to medication are said to react well to this diet.
  • Vagus nerve stimulator – This wearable device is surgically placed beneath the chest to electrically stimulate the nerve in the neck, thus preventing seizures.
  • Deep Brain Stimulation – This is a new form of therapy that is still under development, but showing promise. The process involves implanting a small generator in a patient’s chest and sending off electrodes to the brain.
Witnessing someone having a seizure can be overwhelming, especially if it happens to a loved one. Panic may set in the moment the person falls flat on the ground and starts twitching. Here are some general first aid treatment tips when helping someone who is experiencing an attack.
  • Stay calm, attend to the person, and reassure bystanders that everything is going to be alright.
  • Clear the area of anything sharp, ease the person on the floor, and place something flat or soft beneath the head.
  • Remove the person’s glasses and loosen any part of their clothing that may impede breathing.
  • Do not restrain the person.
  • Avoid giving cardiopulmonary resuscitation (CPR) and water until they are fully conscious.  People undergoing a seizure cannot swallow.
  • If the person is anxious or fearful, comfort the person, and speak calmly.
  • Keep track of time. Most seizures happen for a minute, but if it lasts longer than five, call an ambulance.
  • Make sure the patient doesn’t bite his/her own tongue.
  • Turn the person to the left side after the seizure.
Once the seizure has passed, do not leave the person immediately. Wait until a friend or help arrives to manage any disorientation.

Stay Safe and Healthy

Despite the millions affected by epilepsy around the world, innovations in the medical field have paved the way for various treatment methods, and managing one’s condition is easier than ever before. In case you are exhibiting symptoms, or if you have any other health concerns, don’t hesitate to reach out to Makati Medical Center for consultation, management, and treatment.