epilepsy: seizures and stigma
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men have a slightly higher risk of being diagnosed with epilepsy than women. getty
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epilepsy is a neurological disorder that is characterized by abnormal surges of electrical activity in the brain. these surges can cause debilitating symptoms in patients, including recurring seizures or periods of unusual behaviour.
to be diagnosed with the disorder, according to the canadian epilepsy alliance, patients must have experienced at least one unprovoked seizure, which is a sudden burst of electrical activity in the brain that temporarily disrupts the way brain cells communicate with one another. seizures can take different forms in patients depending on which part of the brain — and how much of it — is involved. this can manifest in symptoms that range from a blank stare to full body convulsions. a single seizure does not mean a person has epilepsy, however, as some people can have one and never experience another.
although seizures can be difficult, the impending fear of recurrence may be just as distressing, if not more so, for patients. according to a national study, the top three challenges identified by patients with epilepsy were: a loss of independence, including not being able to drive (56 per cent); the impact on their social lives (38 per cent); and dealing with stigma, discrimination and lack of awareness of the condition (38 per cent).
fortunately, epilepsy is highly treatable and 70 per cent of patients are able to gain seizure freedom — the main goal of therapy — through the use of medication alone. for the 30 per cent of patients with medication-resistant epilepsy, however, there are other treatments available that can slow or stop the rate of seizures and allow a return to a more normal life.
symptoms of epilepsy
unprovoked seizures are the hallmark of epilepsy and any signs of the disorder typically revolve around processes coordinated by the brain. according to epilepsy canada, these seizures can be grouped into two broad categories: generalized and focal. generalized seizures are disruptions that involve both sides of the brain and often lead to loss of consciousness, falls or massive muscle contractions. focal seizures, on the other hand, occur in just one area of the brain. these types of seizures, which affect 60 per cent of people with epilepsy, can become generalized seizures.
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regardless of the type, seizures can cause temporary changes in a wide range of function and produce symptoms that include:
- convulsions in the arms and legs
- stiff muscles
- staring blankly
- brief bouts of confusion
- loss of awareness or consciousness
- fear or anxiety
causes of epilepsy
although about half of people diagnosed with epilepsy with an unknown cause, according to epilepsy canada, underlying reasons can include genetics, brain structure abnormalities, trauma, stroke and tumours.
diagnosing epilepsy
as there is no single test that can confirm the presence of epilepsy, doctors typically rely on the investigation of a first seizure, combined with a physical examination, patient history and supportive tests when making a diagnosis. these tests, all of which yield valuable information on brain function, can include: computerized tomography (ct scan), magnetic resonance imaging (mri), functional mri (fmri), magnetic resonance spectroscopy (mrs), positive emission tomography (pet) and single-photon emission computerized tomography (spect).
treating epilepsy
treatment for epilepsy depends on a few things, according to healthline, including the severity of symptoms, a patient’s health and how well they respond to therapy. the first line of defence is typically antiseizure medication, which works for around 70 per cent of patients. this medication, usually taken orally, acts on neurotransmitters in the brain in a manner that reduces the electrical activity that leads to seizures. there are more than 20 different types of antiseizure medication available, however, and finding the right one(s) and dosage for a particular patient can take time and patience.
if medication does not work for a patient, there are a few others options available, including:
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- surgery — used to remove the area of the brain causing seizures if it is small, well-defined and does not interfere with vital functions
- vagus nerve stimulator — an implanted device is used to electrically stimulate the nerves heading to the neck to prevent seizures
- ketogenic diet — research has shown that more than half of children who do not respond to antiseizure medication benefit from a high fat, low carbohydrate diet
- deep brain stimulation — electrodes are surgically implanted in the brain and connected to a generator in the chest that sends timed pulses to reduce seizures
preventing epilepsy
there is no sure way to prevent an epilepsy diagnosis but you can reduce your risk by taking a few precautions. according to the cdc, this entails:
- preventing brain injury by using seatbelts in cars and helmets when engaged in dangerous activities. it’s also crucial to seek help for brain trauma as soon as it occurs
- take steps to lower your chances of stroke or heart disease
- stay up to date on vaccinations to lower the chances of an infection that may lead to epilepsy
- wash your hands and prepare food safely to avoid parasites that may cause epilepsy
- stay healthy during pregnancy
prevalence of epilepsy
it is estimated that around 260,000 canadians have epilepsy, based on a research-derived prevalence of 7.46 cases per 1,000 people. the condition is most common in children and older adults but can be diagnosed at any age. men have a slightly higher risk of diagnosis than women, a difference usually attributed to greater exposure to risk factors — such as head trauma — by men.
support for epilepsy
for more news, information and support with regards to an epilepsy diagnosis, visit epilepsy canada or the canadian epilepsy alliance.
dave yasvinski is a writer with healthing.ca
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