What you need to know about epilepsy

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Epilepsy affects about one in every 100 people in South Africa. It is not a disease, illness, psychiatric disorder or a mental illness. Nor is it infectious or contagious. 

It is however a symptom of a neurological disorder, and is characterised by unusual electrical activity in the brain, which manifests as seizures. 

Anyone can be affected by epilepsy regardless of gender, age and race. Even though gender differences occur in the epidemiology of epilepsy and specific epilepsy syndromes, generally slightly more males than females have epilepsy, and females have a lower incidence of unprovoked seizures than males. 

An article in the Journal of the Malta College of Pharmacy Practice attributes this to the influence of sex hormones on seizures and epilepsy, as well as changes in the endocrine system and levels of sex hormones. “Males also have a higher incidence of status epilepticus, sudden unexpected death in epilepsy, prognosis, and mortality,” says Professor Janet Mifsud from the University of Malta. 

Triggers 
Stress, sleep deprivation, poor diet, alcohol or drug abuse, not taking epilepsy medication, flashing lights or bright patterns, and menstruation and pregnancy in women may all induce and aggravate seizures.   

Recognise the signs
Generalised seizures occur when the excessive electrical activity in the brain encompasses the entire organ. There are different kinds of generalised seizures:

Generalised tonic clonic seizures: the person may shout, stiffen their body and/or fall to the ground. Rhythmic tightening and relaxation of the muscles takes place and the person may turn blue around their mouth due to the lack of oxygen. They may make strange noises, salivate and be incontinent. They will lose consciousness during the seizure.

Absence seizures: often mistaken for daydreaming, this involves blank staring and failure to respond with possible twitching, chewing, and blinking of the eyelids. There’s brief loss of consciousness.
Myoclonic seizures: involves sudden, brief, involuntary muscle jerks. Single or multiple jerks can take place as well as jerking of different bodily parts.
Tonic seizures: general stiffening of the muscles without jerking occurs. The person may lose consciousness and fall heavily.
Atonic seizures: also known as “drop attacks”, there is a sudden loss of all muscle tone, causing the person to go limp, lose consciousness and fall to the ground.

Partial seizures occur when the excessive electrical activity in the brain is limited to one area. There are two main forms: 

Simple partial seizures: consciousness is not lost or affected. The person may experience an altered sense of perception, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. There may be numbness or jerking in one limb or down one side of the body. 
Complex partial seizures: involves a change or loss of consciousness or awareness. The person may stare into space and may display abnormal behaviour or movements, such as disorientation, lip smacking, or wander around aimlessly.

5 ways to help:

If you suspect someone may be having a seizure, it is important to understand what is happening and try to remain calm. Keep yourself out of harm’s way if the person is writhing around. Never try to restrain or restrict their movements. 
Prevent injury by clearing the space around the person. Ensure that there’s nothing nearby that could harm the person, and cushion their head to protect them. Loosen tight-fitting clothing or neckwear and remove their glasses. 
Wipe away excess saliva to help the person breathe. Do not put anything between the person’s teeth or in their mouth during the seizure. Take note of the time in which the seizure took place and how long it lasts. 
Once the seizure has stopped, place the person in the recovery position, i.e. on their side, top leg bent, bottom arm extended slightly. Turn the person’s head to open their airways and make sure they are breathing normally. Stay with the person until they have recovered. Do not give them food or medication until they are fully alert. Allow the person to rest. Sleep is necessary after a seizure.
If the person has been injured or the seizure lasts longer than six minutes, or if the person has repeated seizures without recovering, call a doctor or an ambulance immediately. 

Self-care

Try not to worry or stress about having a seizure. This anxiety may trigger seizures. 
Get to know your condition and educate others about it, especially your family and friends, and those you work and live with. Teach them the correct way to handle a seizure in case they are with you when you have one. 
Wear a medical alert bracelet at all times to let others know about your condition. 
Join an epilepsy support group and mingle with others who understand what you're going through. 
Always take your medication as prescribed.  Never adjust your dosage or change your medication before discussing it with your doctor.

References:
Mifsud J. Gender differences in epilepsy: perceived or real? Journal of the Malta College of Pharmacy Practice. 2014;20:28-30. [Online]: http://www.mcppnet.org/publications/ISSUE20-9.pdf - Accessed 1 February 2016.
Causes of epilepsy. Health24 website. [Online]: http://www.health24.com/Medical/Epilepsy/Overview/Causes-of-epilepsy-20120721 - Accessed 1 February 2016.
Treatment of epilepsy. Health24 website. [Online]: http://www.health24.com/Medical/Epilepsy/Overview/Treatment-of-epilepsy-20120721 - Accessed 1 February 2016.
Symptoms of epilepsy. Health24 website. [Online]: http://www.health24.com/Medical/Epilepsy/Overview/Symptoms-and-signs-of-epilepsy-20120721 - Accessed 1 February 2016.
Epilepsy affects over 500 000 South Africans. Health24 website. [Online]: http://www.health24.com/Medical/Epilepsy/About-epilepsy/Epilepsy-affects-over-500-000-South-Africans-20150615 - Accessed 1 February 2016.
Symptoms & causes. Mayo Clinic. [Online]: http://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/dxc-20117207 - Accessed 1 February 2016.

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