Coping with epilepsy

Mar 15, 2005

HIS classmates always described 12-year-old Paul as “the boy who gets fits.” Whenever he got the seizures in class, it would cause commotion and so his classmates always thought he was mad.<br>

By Elvina Nawaguna

HIS classmates always described 12-year-old Paul as “the boy who gets fits.” Whenever he got the seizures in class, it would cause commotion and so his classmates always thought he was mad.

Paul was actually suffering from a condition called epilepsy, which manifests itself in seizures (also called fits and convulsions).

This makes the patient go through motions like temporary confusion, staring spells, muscle spasms, speech disturbance, uncontrollable jerking and stiffening movements of arms and legs, and even loss of consciousness.
Dr. Catherine Abbo, a psychiatrist at Butabika Mental Hospital, says epilepsy is not a mental illness. It is a neurological disorder, although some epileptic patients may go through psychological complications like depression because of the stigma attached to the disease.

Even though it mostly occurs in young children and of adults over 60 years old, epilepsy is likely to occur to anyone at any age. Epilepsy is a chronic disorder of the brain that causes the patient to have seizures or convulsions. The convulsions are caused when certain cells in the brain release abnormal electrical impulses, causing other cells to fail to work properly.

According to a World Health Organisation report, about 50 million people in the world are likely to have epilepsy at any one time.

Augustine Mugarura, the director of The Epilepsy Support Association in Bukoto says the patient has to have suffered at least two similar seizures, before he/she can be declared epileptic.

In most cases the real cause of epilepsy is unknown. Mugarura says in Uganda, the biggest cause has been poorly treated malaria or cerebral malaria. Malaria causes high body temperature, which may damage the brain.

Mugarura also says prolonged labour and delivery causes an interruption in the supply of oxygen to the brain and may cause the child to develop epilepsy.
Tapeworms can also cause epilepsy when the cysts invade the brain.

Sometimes epilepsy may be inherited. People with a family history of the disease have an increased risk of getting it.

However, information from the American Epilepsy Project indicates that children may be born with a defect in their brain, or may suffer an infection or injury to the head that may trigger the epilepsy. Such head injuries may be due to accidents that have impact on the head.

In young adults, the main cause is severe head injury and in middle age, the most common causes are tumours, strokes and injuries. The project says in people over 65, strokes are the most common causes.

Degenerative conditions like Alzheimer’s disease, brain infections and poisoning from exposure to lead, carbon monoxide and other toxins also may predispose people to epilepsy.

How to you manage epilepsy
Most adults who have epilepsy can live a normal and productive life.
Dr. Abbo says management of epilepsy is multi-disciplinary.

The disease can be treated by modern drugs which are available locally.
Mugarura says epilepsy is a chronic condition and needs long-term, regular medication. In 70% of the cases, the seizures will actually stop. In other cases, their frequency may just be reduced.

“A patient can only be put off medication if they have been on medication daily for at least two years without getting a seizure,” Mugarura emphasises.

  • You can, however, reduce the risk of getting injuries by wearing a seat belt when in a car or wearing a helmet when riding a motorcycle, bicycle or engaging in any activity that can expose you to head damage.

  • Having a healthy diet, regular exercise, limiting alcohol and cigarette intake and treating fevers properly also reduces the chances of getting epilepsy.

  • It is also important to see a doctor or take your child to a doctor if they show any signs or symptoms of epilepsy. Doctors mainly use seizure-preventing medicine to treat epilepsy. These medications are not a cure of epilepsy, but help to reduce the occurrence of seizures.

  • How to deal with children suffering from epilepsy

  • People living or working with someone suffering from epilepsy should know that it is not contagious and not caused by evil spirits.

  • Dr. Abbo recommends that integrating the patients into the community and educating the community about epilepsy will help to deal with the stigma. She also recommends counselling the patients to deal with the effects of social stigma through counselling.

  • Mugarura advises that people with epilepsy should live an equal life like the rest of the family members.

  • Parents should, however, explain to teachers the condition of their child so that the teacher knows how to protect the child and what to do in case a seizure occurs.

  • People with epilepsy should be safeguarded from harm in case of a seizure. For instance, they should not sleep on bunk beds, they should not be sent to the well alone and if they have to cook, it is best that the stove be at least two-and-a-half feet high so that in case of a seizure, he or she does not get burnt.

  • Parents with children suffering from epilepsy must also ensure the child’s medication is always available and that the child is consistent in taking it if it us to be effective.

  • Mugarura says in case a patient gets a seizure anybody around should protect the patient’s head from injury, by placing a pillow or the palm under the head. Loosen any tight clothes like a tie or belt and give the person fresh air.

  • Stay with the person until the seizure ends and explain to him what happened and where he or she is and take them to a nearby clinic.

  • However, if the seizure lasts more than 10 minutes, call an ambulance or rush the patient to the nearest health unit.
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