What is epilepsy?
For easy understanding it is generally understood as a “falling sickness”, the level of consciousness lasts a short time, after which a person recovers and behaves normally or gets into a state of confusion with strange behaviors.
What Causes Epilepsy?
There is a wide range of cause. These include:
- Unknown causes or hereditary factors
- Birth injury
- Febrile convulsions during childhood.
- Infections (syphilis, HIV, AIDS); tape worm, onchocerciasis.
- Head injury
- brain tumours
- Alcohol abuse
- Witchcraft or curses do not cause epilepsy.
Types of epilepsy
There are many types of epilepsy with different and varying presentations. These include:
- Grand mal fit (most common, generalized tonicclonic seizure).
- Petit mal (absence seizure).
- Simple partial seizure (Jacksonian fit).
- Complex partial seizure (temporal lobe epilepsy).
The above types of epilepsy may affect a child, an adult or an elderly person.
Generalized seizure (Grand mal fit):
It strikes like a lightning Patient loses consciousness, falls down if standing or seated, his arms and legs make jerking movements. He / She salivates, may suffer incontinence of urine or feaces. The saliva is mixed with traces of blood incase the tongue is bitten.
After a short period he / she will recover consciousness, feels tired and remembers nothing of what has happened. He / She behaves normally again.
Absence seizure (Petit mal):
There is a transient loss of consciousness. The person stops what he / she is doing, drops what he has in the hands and stares vacantly, only to resume what he was doing immediately- it may pass unnoticed by people around.
It is common in children though adults rarely get it.
Simple partial seizure (Jacksonian fit):
It may be motor or sensory or both, if motor, movement starts form an extreme end of the limb and spreads to cover the whole of one side of the body. This is termed Jacksonian march. The person remains conscious.
If the other side gets involved a person loses consciousness and gets a generalized seizure. After recovering from a fit usually there is temporary paralysis of the side where the movement started. This is called Todd’s Paralysis.
If sensory, a certain type of sensation starts from an extreme end of the limb and spreads to cover the whole of one side of the body. A person remains conscious. If the other side gets involved, a person loses consciousness and gets s a generalized seizure.
After recovering, there is temporary anaesthesia (loss of sensation) of the side where the sensation started.
Complex partial seizure - (Temporal lobe epilepsy):
It starts with an AURA. The patient gets any of the following:
Churning sensation in Theo abdomen which spreads to the chest or neck (Epigastric Aura).
Visual hallucination (sees particular things which are not there).
Auditory hallucination (hears voices or sounds)
Olfactory hallucination (gets a bad smell).
In case any of the above experiences is present, it will happen in a similar way during every attach. It occurs in clear consciousness and the patient will always recall this. After the aura, there is impairment of consciousness; some patients appear confused, turn their head to one side with their eyes fixed, smack their lips and then return to full consciousness immediately. However others could behave strangely, being violet and aggressive excited, shouting and running around in an abnormal way. Others after the aura they get a grandma fit.
Temporal lobe may present in the following forms:
Psychiatric manifestation (abnormal behavior).
A combination of partial or convulsive seizure and psychiatric manifestation.
A partial seizure with a secondarily generalized seizure.
The attack is always similar and recurrent. The person has amnesia (loss of memory) for the attack.
First aid management, especially for grand mal fit (major fit):
- Protection of the person (patient). Remove a patient from danger or danger from a patient, e.g in case a person fell into fire, immediately remove him / her from fire.
- Loosen tight clothings.
- Do not give anything by mouth.
- Do not put anything between the teeth (in the process of attempting you may injure the gum).
After the jerking has ceased, turn the patient in a recovery position for easy ventilation, and to allow the saliva and mucus to flow out of the mouth easily or avoid tongue from falling back and blocking the air passage.* Remain with the patient until he regains full consciousness.
Orientate the person before leaving him.
Encourage him to seek medical attention.
People believe epilepsy is infectious. The truth is that epilepsy is not infectious e.g. mothers with children suffering from epilepsy have not contracted epilepsy despite the closeness with their children. School going age children should go to school.
Can epilepsy be treated with modern drugs?
There are drugs used in the treatment of epilepsy.
These drugs effectively control fits if properly used.
They should be used for a lot time. They have to be taken daily as instructed by the health worker.
Information concerning these drugs can be obtained from qualified health workers.
Patients with epilepsy should never take alcohol, because it increases the occurrence of fits.
Common false beliefs about epilepsy are:
Epilepsy is infectious, thus
Children with epilepsy are taken from school;
Many children and adults get serious bums or drown because other people fear to touch them when they suffer from an epileptic seizure,
Epilepsy is caused by witchcraft, thus A lot of money is spent on traditional treatment.
Person with epilepsy should not marry.
Experiences of persons with epilepsy:
“I got terribly worried, disturbed, unsettled in the mind after I learned of it! I had heard of the same as an incurable one; I felt myself an abnormal person, less of a being useless and lost the anxiety, ability and courage of participating in various social activities!......It made me loose a job..I ended up failing to put up a personal residence up to now where I had piled bricks on the site, the Kumamu lady rejected to come to me as a wife and bring my child fearing the illness!...At times breakages of radio, lantern screen, plastic jugs, cups, a brief case, dirtying clothes Also due to thought eating up my mind as it continued on me and knowing that it could never cease, I had personally planned to commit suicide...Lastly since it stopped re-attacking me January 19995 up to now (after receiving treatment) I feel firm relieved, not so much worried, can go out or participate in the expected day -to -day activities.”
Deo, Chaiwan of The Epilepsy Support Group
“ At one time he had a fit, whereby he lost his tooth. He had fits almost daily, until he lost one of his toes. I am very grateful to Robina, who assisted me to get medical treatment for Abdu. We had all lost hope in Abdu, but now we can speak to him, he can feed himself, can go to toilet by himself, he even knows my name.. I am very grateful to the health workers for having treated Abdu&rdquo.
The grandmother of the 6 years old Abdul.
The epilepsy support group meets every first Tuesday, of the month during the epilepsy clinic at the Psychiatry Department.
During the meeting information on causes and treatment of epilepsy are discussed and experiences are shared.