National Epilepsy Week, 18-24 June 2012

Epilepsy is a condition affecting the brain and nervous system that has been estimated to be prevalent in as many as 60 million people around the world. Approximately 5% of all people may have an epileptic seizure at one time of their life or another. Epilepsy is therefore a relatively common condition. The good news is that epilepsy can be controlled with appropriate medication in as much as 70% of all cases. 

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members and future members on a range of healthcare topics, we would like to explore certain important healthcare issues. This article looks at the subject of epilepsy this National Epilepsy Week, 18-24 June 2012.

What is epilepsy?
An epileptic seizure is a sudden surge of electrical activity in the brain that may affect how a person feels or acts for a period of time. Such an electrical surge may cause a person to blackout very briefly for a second - sometimes they may not even notice that it has happened. However, in other more severe cases it may cause an individual to have a major seizure during which they collapse and writhe around on the ground.

Many of us will at some point in our lives come across a person who is having a major seizure. Perhaps epilepsy will even affect someone in our family. While a major seizure, or grand mal seizure as it is sometimes known, may catch us by surprise it is important to remain calm and to do the correct thing. National Epilepsy Week seeks to raise awareness of this very common medical condition about which there are many misconceptions.

Seizures are a symptom
Seizures are not a disease, but are a symptom of one of a number of possible different disorders of the brain. Seizures can take on many different forms and can affect different people in different ways. As noted previously, some seizures may not even be noticed, while others may cause the individual to have major convulsions. Uncontrolled epilepsy can be devastating to the lives of sufferers.

If we or someone in our family is affected by the condition we should keep in mind that it can usually be successfully treated with medication. An individual who suffers a seizure or suspects that they may have had one should therefore visit their doctor. Epileptics usually lead completely normal lives, but should make sure they take especially good care of their health.

What causes epilepsy?
Epilepsy is not confined to any specific group, and many people will come to suffer from it. In as many as 65% of cases it is not known what causes the condition. Sometimes it runs in families while at other times an illness or disease affecting the brain or some sort of damage caused to the brain, by for example a knock to the head, may result in epilepsy.

The following conditions may cause an individual to suffer epileptic seizures:

• Head injury
• Tumour
• Low blood sugar levels
• Brain infection such as encephalitis or meningitis
• Medical conditions affecting the nervous system such as multiple sclerosis
• Exposure to certain street drugs
• Exposure to certain toxins such lead or carbon monoxide
• AIDS

Possible triggers of seizures
Many epileptics have certain ‘triggers' that may result in them having a seizure, sometimes for the first time in their lives. Epileptics may learn what their triggers are and learn to avoid or treat these. Any individual who suffers from epilepsy should seek to live as healthy a life as possible as this can help to control the condition. The following may help to trigger epileptic seizures in certain individuals:

• Stress
• Lack of sleep
• Street drugs
• Alcohol
• Excessive tobacco consumption
• Flashing lights (i.e. caused by strobe lights)

Treatment
Epilepsy is treated through the use of a class of medications known as anticonvulsants, which usually controls the condition. In some cases treating the underlying medical condition that is causing the seizures may help to control the epilepsy. For example the successful removal of a brain tumour or control of diabetes may stop an individual from suffering convulsions.

What should you do?
Many people feel ill equipped to handle an epileptic seizure but in fact the most important things to remember to do is to remove anything that may be in the way and harm the individual who is suffering the convulsion. You should never try to hold the person down or put anything in their mouth while they are having the seizure. The following are some tips on how to handle a person suffering an epileptic seizure:

• Stay calm and composed
• Prevent injury - ensure that there is nothing within reach that could harm the person
• Do not hold the person down or attempt to restrain them
• It is not possible for a person having a seizure to swallow their tongue as many people think, so there is no need to put your fingers or foreign objects in their mouth to stop them from doing this
• Try and place something soft such as a pillow under the person's head to help protect it from injury
• Keep bystanders away
• Do not give the person anything to eat or drink until they are fully alert
• If the seizure occurs in water keep the person's head above the surface of the water
• If the seizure shows no signs of stopping and keeps reoccurring contact the emergency services

Once the seizure is over the person should be placed on their left side and their airway kept free of vomit or other obstructions so they can breathe normally.

Stay with the person until he or she recovers, which should be within five to 20 minutes. Everyone who suffers a seizure should be checked by a medical professional or his or her caregiver and he or she should decide if further medical care is necessary.

Most epileptics respond well to treatment
Epilepsy is fairly commonplace and anyone could potentially develop the condition. Sufferers should therefore be treated with the respect and dignity they deserve. Most epileptics respond well to treatment, so sufferers should be sure to get to their doctor.
 
For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

Sources:
1. PuMed Health, www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001714/
2. Epilepsy South Africa, www.epilepsy.org.za/facts/index.php
3. Epilepsy Therapy Project, http://www.epilepsy.com/101/101_EPILEPSY