Purple Day is international grass roots efforts dedicated to increasing awareness about epilepsy worldwide, and it is celebrated on March 26 every year. Today, we are going to examine in-depth issues relating to epilepsy.
What is epilepsy?
Epilepsy is truly best regarded as a disorder of the brain and can be caused by many diseases. The medical definition of epilepsy is ‘repeated seizures or convulsions (or fits) due to a brain problem’. This means that the seizures originate from the brain.
Head injury can lead to damage to nerves and the person can then have a seizure. Brain tumours also damage the nerves and can cause epilepsy.
Epilepsy can be congenital (the baby is born with it) or acquired (the person develops it after birth). It can have a named cause, such as an obvious abnormality of the brain or brain tumour, head injury, stroke, bleeding in the brain and meningitis. Epilepsy can also have no clear cause for it (idiopathic, which means ‘unknown’).
There are different names for different types of epilepsy and some types are also named after the part of the brain affected. Epilepsy can be simple, partial or complex. Simple epilepsy means that it is not too disruptive and does not disturb the life of the sufferer too much. Partial means it affects maybe just a part of the body and may not lead to unconsciousness. Complex is bad and leads to loss of consciousness, with disruption of the life of the person.
Some seizures, known as generalised seizures, affect the whole brain and lead to loss of consciousness.
An isolated, single seizure does not constitute epilepsy. Also, there are other diseases such as diabetes, that can cause someone to have a seizure; but this is clearly not epilepsy, as it is not originating from the brain.
Epilepsy can happen to anybody and even people who feel perfectly healthy like you and I can still suffer from epilepsy. It is therefore something that we all should learn about and be clear as to the possible reasons why some people have epilepsy. It should allow us to be more sympathetic to sufferers.
Myths, misconceptions
Some people believe that epilepsy is due to a spiritual attack and that the demon must be cast out of the patient. Needless to say, this is irrespective of educational background or level in the society. Some patients have been to church, mosques, spiritual healers and herbalists and, of course, numerous hospitals, looking for an explanation and treatment. Demons have been thought responsible and therefore ‘beaten’ out of sufferers in many churches and herbalist homes by unskilled people. In this regard, many patients have been subjected to massive cruelty and even death.
Epilepsy is not contagious. You cannot contract epilepsy by touching the sufferer or coming in contact with their saliva. It is not an infection and is not caused by a virus or germ.
It is not a mental illness. Seizures are mainly a symptom that there is a physical problem, like a scar, on the brain. Some people with epilepsy are extremely clever, others are of average intelligence and some have learning difficulties. Just like normal people in the population, really. Epilepsy does not have to be a bar to success in life. Many people with epilepsy enjoy highly successful lives.
Epilepsy is not normally an inherited condition. It can be genetically inherited, but more often, there is no family history. It can be because of infection such as meningitis.
Treatment options
Epilepsy is not always a life-long condition. Many people who have been seizure-free for three or four years have their medications carefully withdrawn under close medical supervision and remain free for the rest of their lives. Surgery can also be successful in eliminating certain types of seizures.
Epilepsy can be prevented, treated, controlled and rarely, cured. The easiest and most important treatment is prevention. The most important way to prevent epilepsy is to offer early drug treatment to patients with head injury, meningitis and those undergoing brain surgery. The hardest treatment to achieve is cure. Epilepsy can be best controlled and managed, rather than talk about cure. Patients may have to be on the medications for the rest of their lives.
Many of the drugs are available in Nigeria and there are many reputable local manufacturers. There are certain types of epilepsy caused by irritation of the brain due to an abnormality in the brain, head injury or a brain tumour that can be cured by surgery. Treating the cause such as removing the abnormal area or a brain tumour can then lead to cure. Epilepsy surgery as a specialist treatment is currently not available in Nigeria.
Handling a seizure
Patients having a seizure or a fit can jerk around, lose consciousness and foam from the mouth. The fit can last seconds or up to about five minutes. In close to 90 per cent of cases, the fit stops by itself and the patient recovers as if nothing happened.
The best management for the patient at the time of a fit is to make sure they do not come to harm or injure themselves during the period of loss of consciousness. Move objects that can harm the person out of the way. If possible, place a pillow under the person’s head so that the head doesn’t bang against the floor, causing injury. Keep calm and do not panic.
Let the seizure run its course and do not hold them down. If possible, move them to a comfortable place and let them sleep or at least have a good rest once the seizure is over.
If the seizure does not stop or is repeated often without the person waking up in-between, please get medical help immediately. Take the person to the nearest hospital where they can be helped.
Things you must not do
People trying to help can cause untold suffering, pain, lifelong disability and death. We have heard of some communities where burning the feet of the sufferer is supposed to be helpful! Please do not do this. Also, the practice of putting a stick or spoon in their mouth is not necessary and can be damaging. Finally, in some communities, various concoctions (urine, drugs and alcohol) are poured down the throat of the sufferer. This can lead to choking, asphixiation, pneumonia and death.
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