Epilepsy: treating misconceptions
June 8, 2011
Epilepsy is one of the most misunderstood conditions and has often been confused with magical or religious events while epileptics have been labelled as ‘possessed’ said Dr Mughis Sheerani, Consultant Neurologist, Aga Khan University Hospital, speaking at a seminar held on June 8, 2011 at Aga Khan University Auditorium.
Unfortunately a lack of awareness about this disease has led to many misconceptions, often linking epilepsy with mental disability or magic and there are horrifying stories of people tying up and beating epileptics he added. What is little known is that the likes of Socrates, Lenin, Alexander the Great, Napoleon Bonaparte and Alfred Nobel, all were epileptics.
Worldwide nearly 50 million people suffer from epilepsy of which an overwhelming majority are from the developing world. In Pakistan, about 1.7 million people suffer from this condition and are vulnerable to recurring seizures caused by sudden changes in the electrical activity of the brain. In three-quarters of these cases the epilepsy can be managed, but unfortunately most people are unable to get proper treatment or medication.
Pinpointing the actual cause of epilepsy has proven to be difficult for doctors and in most cases it is thought the patient’s genes predispose them to the disease. An epileptic seizure itself, is thought to be caused by environmental or personal triggers. The most common include lack of sleep, stress, strong emotions, intense exercise, flashing lights (like video games), fever and the menstrual cycle. At times, however, seizures can also occur without any identifiable reason.
Epileptics are not only at risk from seizures but are also 20-50 per cent more susceptible to developing mood disorders, explained Dr Farah Khan, Consultant Psychiatrist, AKUH. According to Dr Khan, the most common disorders are major depression and dysthymia, a low or irritable mood for extended periods of time. Seizures and mood disorders often occur at the same time making it extremely important for epileptic patients to consult a psychiatrist if they feel that they are suffering from constant mood disorders; in such cases, a neurologist-psychiatrist partnership to treat the patient is extremely important, stressed Dr Khan.
Although medication is the preferred form of treatment, patients suffering from intractable seizures (not controlled by three medications over a period of one to two years) can be treated surgically, emphasised Dr Ehsan Bari, Consultant Neurosurgeon, AKUH.
Haroon Daniel, Senior Neurology Coordinator Nurse II, AKUH spoke about how family members may need counselling to help them not only understand and work with the person suffering from epilepsy, but also to assist the person in activities such as climbing ladders or swimming. Highlighting the importance of handling epileptic episodes in a calm manner, Mr Daniel stressed that during a seizure, the person should not be restrained and nothing should be forced between the teeth. Instead, the person should be turned to one side to prevent choking and sharp objects in the vicinity should be removed. Epilepsy is a condition that needs to be managed.
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