Epilepsy is a disorder marked by sudden, unprovoked recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain.
Epilepsy can also be known as seizure disorders. It is characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized). It is sometimes accompanied by loss of consciousness and control of bowel or bladder function. Epilepsy is a chronic disorder that requires prolonged care but can be appropriately managed. It is important to note that the occurrence of an episode of seizure does not signify epilepsy (up to 10% of people worldwide have had one seizure during their lifetime). Epilepsy is therefore defined as having 2 or more unprovoked seizures.
Epilepsy affects people of all ages. According to WHO, about 50 million people worldwide have epilepsy, making it one of the most common neurological diseases globally. It is more common in males than females. About 80% of people with epilepsy live in low- and middle-income countries.In a study conducted in Nigeria the prevalence of epilepsy is about 4.3/1000 people.
People with epilepsy respond to treatment approximately 70% of the time
Causes of Epilepsy
Most cases (60%) of epilepsy are idiopathic and is said to be secondary if there is an underlying cause such as brain tumors and brain infections. It is not contagious.
Some of the predisposing factors to epilepsy include;
- Genetic; people with a parent or sibling with epilepsy has an increased chance of having epilepsy
- Birth injury; low birth weight, the presence of birth injury especially the ones that affect the brain such as birth asphyxia, head trauma at birth, delay in spontaneous breathing at birth can predispose to epilepsy.
- Head injury; this can be secondary to road traffic accidents, domestic violence, child abuse
- Infections affecting the brain; neurocysticercosis, meningitis, encephalitis, AIDS
- Strokes;this occurs due to reduced blood supply to the brain which leads to the injury and death of some brain cells. This leads to abnormal functioning of the cells which can result in epilepsy.
- Congenital malformations affecting the brain
- Brain tumors
.Signs and symptoms
Epilepsy usually presents with different symptoms and manifestations. The symptoms include;
- Convulsion with no associated fever
- Short spells of blackout, or confused memory
- Intermittent fainting spells, during which bowel or bladder control is lost and is frequently followed by extreme tiredness
- Being unresponsive to instructions or questions for short periods.
- Sudden stiffness for no apparent reason
- The person suddenly falls for no clear reason
- Sudden bouts of blinking without apparent stimuli
- Abnormal jerking movements of the hands and legs with associated foaming of the mouth
- Sudden bouts of chewing, without any apparent reason
- Inability to communicate for a short time
- Repetitive movements that seem inappropriate
- The person becomes fearful for no apparent reason; they may even panic or become angry
- Peculiar changes in senses, such as smell, touch, and sound
- In babies these will appear as a cluster of rapid jerking movements of both the arms and the legs.
Epilepsy can be properly controlled. Different methods of treatment exists;
Medical; anticonvuslasnts can be uses to control seizures. Some examples of anticonvulsants include; carbamazepine, clonazepam and phenytoin.
It is important you take your medication daily and as prescribed by the doctor in other to achieve the desired seizure control. Anticonvulsants are more effective for seizures with no underlying cause. There might be a need to initially increase the dose of the medication in other to achieve seizure control and then gradually reduce the dose of the medication when seizure control is achieved over time.It is important to note that some of these medications have side effects however, they are not serious.
Usually, about 8 in 10 people with epilepsy that take their medications properly and as recommended by physicians usually have either no, or fewer seizures.
Surgery; this is required in some cases of epilepsy that are secondary to brain tumor and brain parasite infections. Surgery is required to remove the causative agent.
Vagal nerve stimulation; this is a form of treatment for epilepsy where a small generator is implanted under the skin below the left collarbone. The vagus nerve is stimulated to reduce the frequency and intensity of seizures. This can be suitable for some people with seizures that are difficult to control with medication.
Ketogenic diet; this is a diet very high in fat, low in protein and almost carbohydrate-free. This can be effective in the treatment of difficult-to-control seizures in some children.
Counselling; some people with epilepsy become anxious or depressed about their condition. Counselling should be arranged by the healthcare provider with the aim of overcoming such feelings. Genetic counselling may be appropriate if the type of epilepsy is thought to have a hereditary pattern.
When such abnormal movements are noticed it is important you visit your doctor for appropriate care. When you see a person with an epileptic fit you can help move the harmful objects away from the reach of such person especially if the person is unconscious.