‘Epilepsy’ means a tendency to have recurrent seizures. A seizure is any abnormal involuntary movement. Normally there are multiple neuronal circuits in the brain which work together for synchronous activity, but because of various reasons, this circuit is sometimes disturbed. This is manifested in the form of abnormal movements of parts of body depending on the part of brain affected.

Seizures may be generalised as involving the whole body. These are the best known by lay people. The affected person may suddenly fall down while standing or doing some work followed by involuntary outward movement of limbs. The tongue may be put out and bitten, accompanied by frothing from mouth. There may also be respiratory arrest in severe cases and the epileptic may become unconscious. When they regain consciousness, they may have no memory of the preceding event. They usually get exhausted and may sleep for hours following the attack. And it tends to comes instantly, making it hard to avoid it.

Partial seizures involve only a part of the body — may be a limb or face. The person may suddenly start staring blankly or making rhythmic smacking or grimacing movements of the lips.

All this happens in few minutes. Sometimes an attack of epilepsy may be followed by paralysis for few moments or hours.

There are many types of epileptic seizures depending on the part of brain affected. Overall it is a very scary situation for the sufferer as well as the observer. Due to ignorance about the disease, it is often thought that the concerned person is possessed by evil spirits. Observing a man having a seizure, one would think him to be mad or intoxicated. If not attended to urgently, one may sustain injury, develop permanent paralysis or even die due to aspiration of secretions.

There are many causes of epilepsy. It may be genetic and run in families. In children it may be due to head injury or high fever.

Metabolic disturbances such as diminished sugar or salt in blood may cause seizures. Any trauma, infection or tumor of the brain can cause epilepsy. In addicts, withdrawal of alcohol can result in seizures.

Strokes are the commonest cause of epilepsy in elderly, followed by degenerative diseases of the brain like Parkinsonism and Alzheimer’s disease.

Diagnosis of epilepsy is based on a history of recurrent seizures and electroencephalogram (E.E.G which shows the electric activity of the brain). In between seizures, these people are mostly normal.

Certain factors trigger the attacks in susceptible people. These are bright flickering lights, loud music or sounds, high fever especially in children and looking down from heights.

Unaccustomed exertion in any form, excess consumption of alcohol can also precipitate a seizure. Pregnancy aggravates epilepsy.

Once epilepsy is diagnosed treatment is by antiepileptic medication and treatment of cause if possible. Antiepileptic drugs, invariably produce side-effects on long term use. A person suffering from epilepsy should always be very careful. Bright lights, loud sounds, alcohol or exertion should be avoided. Careful driving is needed with permission from the doctor. The person’s family and friends also have to be vigilant. In case of youngsters, their epileptic status should be disclosed to the school authorities and friends so that in case of emergency they can help.

If one sees a person having an attack of epilepsy he / she should be immediately put in a lateral position with head flexed so as to avoid aspiration of fluid in lungs in case of frothing. A gag should be placed in the mouth so that no injury occurs because of tongue bite. The person should be sent to the hospital immediately.

Women on anti-epileptic medication should be careful while taking contraceptive pills. Anti-epilepsy pills reduce the effectiveness of contraceptive pills. If pregnant, they should be very careful as the attacks may be aggravated. Also the medications are harmful to the fetus.

With certain precautions and medicines, an epileptic can lead a normal life.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital

rachna212002@yahoo.co.uk