Understanding Epilepsy

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behaviour, sensations and sometimes loss of awareness.

In this article, Dr. Sim Bee Fung, our resident consultant Neurologist/Physician shares her insights on the topic of epilepsy.

Overview

Epilepsy is a common condition that affects the brain and causes frequent seizures. A seizure is a sudden, disorganized electrical discharge in the brain. It can cause muscle twitches and spasms, changes in sensation, behaviour or altered consciousness.  A seizure is a single occurrence, whereas epilepsy is a neurological condition characterized by two or more unprovoked seizures. 

Causes Of Epilepsy

Common causes of epilepsy are genetic factor, stroke, head injury, brain infection such as meningitis/encephalitis. Oftentimes, though, the cause of a seizure is unknown.

Symptoms Of Epilepsy

Seizure signs and symptoms may include:

• Temporary confusion

• A staring spell

• Uncontrollable jerking movements of the arms and legs

• Loss of consciousness or awareness

• Cognitive or emotional symptoms such as fear, anxiety, or déjà vu

Signs and symptoms can range from mild to severe.  Seizure types vary by where in the brain they begin and how far they spread. Most seizures last from 30 seconds to two minutes. A seizure that lasts longer than five minutes is a medical emergency. A small percentage of patients may have refractory epilepsy, i.e. no matter how much medication is given, they still have seizures. This may impact the patient’s quality of life.

Diagnosis Of Epilepsy

Epilepsy is more common in children. It is unclear why. Quite often, epilepsy occurs in children who are otherwise healthy. These cases have good prognosis and the children usually outgrow the epilepsy.

However, if the epilepsy is caused by structural brain problems such as birth trauma, cerebral palsy, childhood brain infection, the epilepsy will likely be lifelong.

Treatment Of Epilepsy

Mainstay is still medications. Majority of patients respond to medications and eventually medication can be weaned off after a few years. If medications aren’t effective, surgery may be an option. Surgery works best for patients who have seizures that always originate in the same place in the brain.

The treatment of epilepsy using natural remedies such as supplements and herbs are not proven to be effective.

Warning Signs And How You Can Help

Some patients have feelings of impending fits. Others have gastric pain preceding the seizure, but there may not be any warning signs. It is helpful to know what to do if you witness someone having a seizure. To help someone during a seizure, take these steps:

• Carefully roll the person onto one side

• Place something soft under his or her head

• Loosen tight neckwear

• Avoid putting your fingers or other objects in the person's mouth

• Don't try to restrain someone having a seizure

• Clear away dangerous objects if the person is moving

• Stay with the person until medical personnel arrive

• Observe the person closely so that you can provide details on what happened

• Stay calm

Managing The Condition

It is important to be compliant to anti- seizure medications and avoid conditions that can trigger a seizure.  

• Take medication correctly. Don't adjust the dosage yourself or skip any dose.

• Get enough sleep and manage your stress.  Lack of sleep and stress can trigger seizures.

• Remember, you don't have to face it alone. Reach out to family and friends. Join an online support community e.g., Malaysian Epilepsy Society. Connect with other epilepsy patients, share your experience, and support each other. Having a strong support system is important to live with any medical condition.

• Most patients that respond well to treatment can lead normal lives. (e.g. working, having family etc.)