I recently read about the case of a young actor dying of epilepsy. Then I read about a young athlete collapsing after exercise and dying because of epilepsy. What is epilepsy?
Epilepsy is a neurological disorder characterised by fits or seizures, or even periods of unusual behaviour, sensations or loss of awareness. Fits happen when the nerve cells in your brain either misfire or repetitively fire.
Wait a minute, I thought epilepsy and fits meant the same thing.
Not at all. Fits or seizures are a symptom. They can be caused by many disorders and diseases of the brain and body, including brain tumours, brain infections, generalised infections, injury to the brain, and of course, epilepsy.
The confusion comes about because a seizure used to be known as an epileptic seizure. A seizure can happen once or multiple times. All of us have a 10% chance of getting a seizure.
But one seizure does not mean you have epilepsy. When you have chronic seizures (those that happen again and again), then only can it be defined as epilepsy.
What types of fits are there?
There are two main types of fits:
● Focal seizures
The word “focal” means a focus or a certain, specified part. In this case, it means that the seizure starts in a certain part of your brain. The name of the seizure is then based on which part of the brain they start in.
For example, temporal epilepsy means the seizure starts in the temporal lobe of your brain – the one associated with memory. These types of fits can cause both physical and emotional effects. They can make you feel, see or hear things that aren’t there, such as hallucinations or having deja vu.
You may even act strangely when you are in such a fit, but may not be aware of it, or even remember anything at all during the fit. You may walk around in circles, or make repetitive hand gestures and chewing, sucking noises.
This type of seizure, also called a partial seizure, is common with 60% of people with epilepsy having this type of seizure.
● Generalised seizures
These start on both sides of your brain. They can make your muscles spasm, and you may black out, or even fall down. The most famous of these are grand mal seizures, also called tonic clonic seizures. Here, your entire body stiffens (tonic phase), then jerks and shakes (clonic phase).
You lose consciousness and fall to the ground. You may even lose control of your bladder and bowels, and bite your tongue or cheek. These seizures last from one to three minutes. If they last longer, they are an emergency.
There are also dominantly tonic seizures, clonic seizures and atonic seizures (which causes you to drop suddenly due to a loss of muscle control). There is another type of milder seizure called petit mal. In this type of seizure, you appear disconnected from the world and you don’t respond to people around you.
You stare blankly into space and your eyes may even roll back in your head. These usually last a few seconds and you may not remember experiencing it. They are most common in children under the age of 14.
What causes epilepsy?
Many things are linked to epilepsy. Genetic influence plays a big role in focal seizures. Certain genes make a person more sensitive to certain triggers or stimuli in the environment, such as bright light or certain noises.
Diseases and conditions that can lead to a single seizure can also lead to epilepsy.
Head injury from a car accident, strokes, brain tumours, infections that affect the brain (e.g. meningitis and encephalitis), injuries or infections that happen to babies when they are born, and developmental disorders in the mother’s womb, are all culprits.
Autism can also be associated with epilepsy, while having dementia definitely increases the risk of epilepsy.
Is there a cure?
It’s a condition that can be treated with medication. Most people with epilepsy can be treated with just one medication for one or two years, and live relatively fit-free for life. Others may need a combination of anti-epileptic medications.
However, anti-epileptic drugs have a lot of problematic side effects like fatigue, dizziness, weight gain, rashes, loss of bone density, loss of coordination, loss of memory and loss of focus. There is also surgery to remove the focal part of your brain that is causing the seizures.