EPILEPSY

WHAT IS EPILEPSY?

Epilepsy is a medical condition characterized by recurrent, disorganized, abnormal electrical firing (impulses) in brain cells, known as seizures, which can disrupt the normal functioning of the brain.

There are many types of seizures, depending primarily on what part of the brain is involved: The specific area of the brain affected may result in a particular type of seizure.

Tonic clonic seizures are characterized by muscle contractions and loss of consciousness which usually comes on quite suddenly. The tonic phase is when muscles become stiff. The clonic phase is characterized by repetitive contraction and relaxation of muscles. Grand mal seizures are generalized tonic clonic seizures
Absence seizures (also called petit mal seizures) - These seizures may not always be recognized as seizures at first. They may begin gradually, with a person staring off into space. Since a person with this type of seizure may just appear inattentive or distracted, it can be difficult to distinguish these seizures from behavioural disorders.

**Seizures caused by high fevers in children are not considered epilepsy.

EPILEPSY CAUSES:

Healthy people may have seizures under certain circumstances. Common causes include:

Tumour
Chemical imbalance such as low blood sugar or sodium
Head injuries
Certain toxic chemicals or drugs of abuse
Alcohol withdrawal
Stroke, including haemorrhage
Birth injuries
Genetic

EPILEPSY TRIGGERS:

lack of sleep
illness or fever
stress
bright lights, flashing lights, or patterns
caffeine, alcohol, medicines, or drugs
skipping meals, overeating, or specific food ingredients
Missed medication
Menstrual cycle

SYMPTOMS OF EPILEPSY

The symptoms which you experience will depend on the type of seizures you are having. Some common symptoms of seizures in people with epilepsy include:

Nausea
Blurry vision
Headache
Dizziness
Contraction, or Jerking, of Body Muscles
Loss of Consciousness - Some seizures may cause a loss of consciousness which may last for a few seconds to hours.
Fainting is also important as it is one of the more common reasons behind a misdiagnosis of epilepsy.
Weakness can occur in any seizure type and in any area of the body e.g. either an arm, a leg or both. **Weakness in one part of the body may look very much like a stroke, but resolves when the seizure is over. This can be even more confusing, because strokes can sometimes cause seizures.
Anxiety, fear, or a sense of impending doom. There are many different types of auras which people may experience
Staring out into space is a symptom experienced by individuals who have absence seizures (also called petit mal seizures.) Often, these individuals appear to be briefly daydreaming or lost in thought when, in fact, they are actually experiencing a seizure. Staring behaviour usually lasts for only a few seconds and may be accompanied by blinking or repetitive movements, such as movement of the mouth or fingers.
Purposeless or Repetitive Movements such as picking lint off of a shirt, repetitive shifting, repetitive tapping of the fingers, repetitive chewing or repeating words. These movements, called automatisms
Behavioural Disorders - Unusual thoughts, hearing and seeing things not present
Repeated flatulence and vomiting.

LIFESTYLE CHANGES:

See your doctor regularly and stick to your treatment plan – drink medication strictly as prescribed.
Keep a seizure diary to help identify possible triggers so you can avoid them.
Wear a medical alert bracelet so people know what to do if you have a seizure and can’t speak.
Teach the people closest to you about seizures and what to do in an emergency.
Seek professional help for symptoms of depression or anxiety.
Join a support group for people with seizure disorders.
Get a seizure alert dog that can sense some symptoms even before you are aware of them yourself.
Follow a ketogenic diet - this diet is low in carbohydrates and high in fats. The diet forces the body to use fat for energy instead of glucose, a process called ketosis.

HOW TO MANAGE YOUR EPILEPSY MORE EFFICIENTLY

Educate yourself on the type of epilepsy you have, the medications you are taking and the dosages, warning signs, triggers and how to avoid them, etc.[4]
Keep a record of the seizures, triggers of the seizures, duration of the seizures to help you learn to avoid them and to share with your doctor for better management. [4]
Avoid alcohol, stop smoking or using other illicit drugs as they can exacerbate your epilepsy. [1]
Support from family and friends will help you to cope better with the disease. Support groups will also help as you can share experiences, frustrations and coping mechanisms. [2]
Counselling may be needed to help with emotional support. [2]
Make sure you talk to your doctor before taking supplements or other medications as they can react with your epileptic medication.[1]
Improving your overall wellbeing can be done with a healthy balanced diet, keeping physical active, managing stress through meditation, yoga or deep breathing exercises and having enough sleep. This can help reduce the number of seizures you have with the addition of your epileptic medication. [4]
Speak to your doctor about home safety techniques, especially if your seizures are not controlled. Heights, water, heat and electricity are the ones we are mostly concerned with. Your doctor can refer you to an occupational therapist or a visiting nurse who can give specific recommendations. [3]

REFERENCES

Epilepsy Action [Internet]. Managing Epilepsy. Australia: Epilepsy Action Australia; [updated 2017; cited 2019 Aug 12]. Available from: https://www.epilepsy.org.au/about-epilepsy/managing-epilepsy/.
Centers for Disease Control and Prevention. Managing Epilepsy. America: CDC; [updated 2018 Dec 17; cited 2019 Aug 12]. Available from: https://www.cdc.gov/epilepsy/managing-epilepsy/index.htm.
WebMD [Internet]. Management & Support. America: WebMD; [updated 2017 Apr Jul 26; cited 2019 Aug 12]. Available from: https://www.webmd.com/epilepsy/guide/epilepsy-living-managing.
Epilepsy Society [Internet]. Managing your epilepsy. London: Epilepsy Society; [updated 2016 Dec; cited 2019 Aug 12]. Available from: https://www.epilepsysociety.org.uk/managing-your-epilepsy#.XVGwDugzbIU