Demystifying epilepsy

Last month, a young lady had a seizure in a banking hall in at a local bank in town. To most she seemed fine when she walked in, she queued like everyone else. It was hot and stuffy. At some point she excused herself from the queue to take a seat. Suddenly, she fell over with a thud and lay prostrate with her back to the floor and her eyes tightly shut and moving in a way that seemed involuntary. Her heels were drumming the floor and her mouth was foaming. Tellers stopped serving to stare; a lady near her began praying, others crowded around her to watch. Somebody put his fingers in the young lady’s mouth and tried to hold her tongue out to prevent her from choking. The young lady is epileptic.Epilepsy is a neurological disorder with a prevalence rate of 4.9 per cent in Rwanda (nearly half a million people), according to a survey by the Ministry of Health, in partnership with other stake holders such as Handicap international.Elie Mugabowishema, former chief of project of the epilepsy project by Handicap International, says epilepsy mostly manifests itself through recurrent seizures. There is more than one seizure type. “A person having a seizure may fall unconscious, twitch, droll and move uncontrollably, in others it may be just a brief moment of lesser consciousness (about twenty seconds). Different seizures are characterized differently,” Mugabowishema says.Mugabowishema says seizures are triggered by various factors. “Some seizures are triggered by flashing lights, hot and stuffy environments, emotional stress or even sleep deprivation. The seizure occurs when neurons in the brain begin firing uncontrollably, disrupting the balance of brain activity. It is important to note that not all seizures are as a result of epilepsy,” he says. Mugabowishema adds that just as there are several types of seizures, there are also several types of epilepsy.“It depends on the section of brain affected; it could be general, meaning most parts of the brain is affected or it could be partial,” Mugabowishema says.The most common cause of epilepsy is severe head injuries which causes injury to the brain. Epilepsy could also stem from brain tumours, stroke or high fever diseases like cerebral malaria-if not well treated, according to online sources.But the definite cause of the disorder is unknown. Talk of the disease being genetic is not yet fully proven. At times it is as a result of a combination of factors, some from the last stages of pregnancy or early childhood. MisconceptionsOne of the most common misconceptions about the disorder is that it is a mental illness or that it is contagious. “Just because some people with mental illnesses experience seizures doesn’t mean that all seizure cases are mental. When we had an epilepsy programme in several districts in the country, we found out that most people had misinformation about the disorder. Most people have a notion that it is a mental illness or that the people with epilepsy are crazy, there are also people who believe it due to demon procession or witchcraft,” Mugabowishema says.He says the misinformation has fuelled stigma to people with epilepsy. Some people are afraid to go near them when they are experiencing seizures, some parents also refuse to admit that their children suffer from epilepsy for fear that they will be shunned by the community.”After diagnosis, epilepsy can be managed although not entirely cured. Mugabowishema advises that it is not necessary to got to a mental hospital as most people have done in the past. “Any district hospital is capable of diagnosing and treating epilepsy. Even at Ndera Hospital, a leading facility for mental cases, it is treated separately and not as a mental illness.”Mugabowishema says it is necessary to begin medication immediately after diagnosis. “Some patients especially the younger ones tend to experience less seizures and at times they cease completely. Visiting a hospital is also good in that epileptics learn how to avoid seizure or control them. At times the doctors will even discontinue the medication when patients can handle the seizures or experience them less.”