Epilepsy


~ What is Epilepsy? ~

Epilepsy is a brain disorder in which the normal pattern of neuron activity (groups of nerve cells) in the brain becomes disturbed. This can cause strange sensations, emotions, behaviour or sometimes convulsions, muscle spasms and loss of consciousness. Epilepsy has any different causes. These are anything that disturbs the normal patterns of neuron activity which can be from illness to brain damage to abnormal brain development. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signalling chemicals (neurotransmitters) or a combination of factors. A person is diagnosed with Epilepsy when there are patterns of spontaneous, recurrent seizures.
Once epilepsy is diagnosed, it s important to begin treatment. For about 80% of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Epilepsy cannot currently be cured, however for some people it does eventually go away. Most seizures do not cause brain damage, but it is common for those with epilepsy to develop behavioural and emotional problems. These can sometimes be embarrassment, frustration or bullying, teasing or avoiding social settings and school.
According to the World Heath Organisation (WHO), epilepsy is the world’s most common serious brain disorder. Around the world as estimated 50 million people have epilepsy at any given time and 100 million will develop the condition during their lives.
Epilepsy Action Australia (2001) suggests that approximately one in 120 people have epilepsy. Given access to medication, information and practical support, most people with epilepsy can maintain a healthy and balanced lifestyle.
Who has epilepsy?
° At least 50% of cases begin in childhood or adolescence.
° Epilepsy is the 3rd most common neurological disorder in the elderly.
° The incidence of epilepsy and seizure disorders is highest in children and the elderly.
Evidence suggests that people with epilepsy in Australia, despite good health and education systems, experience stigma and discrimination. (Christine Walker, 2007) Epilepsy is more than three times as common as multiple sclerosis, Parkinson’s disease and cerebral palsy. Epilepsy is a condition of the brain, not a mental illness.
It is commonly thought that epilepsy always involves convulsions or “grand mal” seizures. In fact there are around 40 different types of seizures. (Epilepsy Action Australia, 2001) All seizures are caused by a disruption to the normal electrochemical activity of the brain and can last from a few seconds to many minutes. Seizures can range from altered awareness, perception, sensation, behaviour or body movements, to full loss of consciousness with convulsions and may be mistaken for anything from intoxication to daydreaming. The emotional impact can be just as intense as the physical experience. Anxiety can result from a sense of loss of control, not knowing if or when a seizure may occur. (Epilepsy Action Australia, 2001) 30 - 40% of people with epilepsy won’t gain full control of their seizures. For these people, and those who care for them, they need a range of support measures to help them manage their uncertainties and the health and lifestyle compromises that unpredictable and recurring seizures will bring.

~ What triggers epilepsy? ~


Seizures are unpredictable but there are some triggers that can start an epileptic seizure. The most common trigger is missing medication. Sleep cycles and hormonal fluctuations also influence seizure frequency. Other causes include excessive use or withdrawal from alcohol or drugs, fever and illness, and changing medications. If adding or removing a medication, it should be done gradually. Other studies have indicated that emotions such as worry, anxiety or anger may trigger seizures, especially if combined with fatigue. Reflex epilepsy is a condition where seizure can be provoked by an external stimulus (flashing lights) or occasionally by an internal mental process (math calculation). (Epilepsy Foundation America)

~ What to do if someone is having an epileptic seizure? ~

When encountering someone having an epileptic seizure many people feel inadequate to handle the situation. Steven C. Schachter (2004) has the following tips for responding to a person having a seizure.
° Stay calm
° Prevent injury
° During the seizure, you can exercise your common sense by insuring there is nothing within reach that could harm the person if she struck it.
° Pay attention to the length of the seizure
° Make the person as comfortable as possible
° Keep onlookers away
° Do not hold the person down (If the person thrashes around there is no need for you to restrain them. Remember to consider your safety as well.)
° Do not put anything in the person's mouth
° Contrary to popular belief, a person having a seizure is incapable of swallowing their tongue so you can breathe easy
° Do not give the person water, pills, or food until fully alert
° If the seizure continues for longer than five minutes, call an ambulance
° Be sensitive and supportive, and ask others to do the same
After the seizure, the person should be placed on her left side. Keep in mind there is a small risk of post-seizure vomiting, before the person is fully alert. Therefore, the person’s head should be turned so that any vomit will drain out of the mouth without being inhaled. Stay with the person until she recovers (5 to 20 minutes).

~ The impact on the person ~

Epilepsy can have multiple effects on the mind and body. A person’s body plays a part in their identity and self-esteem. Finding that their brain doesn’t function as others do, can cause the person to change how they feel about themselves. Anxiety is one of the emotions that can arise from the unpredictability of seizures and feeling of lack of control and helplessness. Lowered energy and vitality may result from disrupted sleep patterns. For many people the risk of seizures can restrict their independence and recreational activities. Some states refuse drivers licenses for people who have epilepsy however they can obtain a driver’s licence if their seizures are controlled by medication or if they fulfil the guidelines set out by the driving authorities. (Epilepsy Action Australia, 2001)
Dealing with epilepsy can cause emotional effects. The reactions of others when they find out about epilepsy can be stressful. Others may avoid the person with epilepsy which can cause embarrassment. As seizures can be unpredictable, the people with epilepsy become embarrassed causing them to be reluctant engaging in social interaction. Management of emotional problems requires a positive outlook and support from family and friends.
A person who has multiple seizures may disrupt communications between different parts of the brain such as portions of the temporal lobe that manage the formation and retrieval of memories. This can affect a person’s memory. Seizures can occur in the area of the brain that is associated with language so naming items may be a problem also. Brain damage is not common in most people with epilepsy; however there is a condition which increases the risk of permanent brain damage. This is called epilepticus, where a person has continuous seizures last for more than five minutes or frequent seizures without regaining consciousness. (Brooks, 2010)
Another possible effect of epilepsy is death. People who have generalized tonic clonic seizures (also know as grand mal seizures) or have poorly controlled or uncontrolled epilepsy are at a higher risk of unexplained death.
People with epilepsy continually face social stigma and exclusion. A fundamental part of reducing this stigma is to raise public and professional awareness.
“It is doubtful if there is any other medical condition so universally neglected, due to a combination of social stigma, low profile and lack of resources.” (Epilepsy Action Australia, 2001)

~ The impact on the family and peers ~

Having a child diagnosed with Epilepsy can lead to stress in parent, which can put a strain on relationships in the family. Many of the negative events experienced by children with epilepsy are likely to extend to all family members. (Epilepsy Ontario, 2010) Parents and family members may become overprotective of their child as they try to gain control over the feeling of helplessness. Communication between family members may stop as they may withdraw emotionally in order to protect themselves for their emotions.
Epilepsy Ontario (2010) suggests that the environment of the family is very important in the course of epilepsy and may influence the severity and the impact if the condition. If their attitudes towards epilepsy are negative, the child with epilepsy will be affected negatively which in turn will have a negative affect on the family.
‘Poor social adaption can result from perceived stigma or over-dependency caused by parental overprotection.’ (Michael D Hills, 2007)
The reactions from peers that the person with epilepsy receives can be stressful. Some may avoid the person with epilepsy which can cause embarrassment and lead to poor social skills. If a child witnesses a friend with epilepsy having a seizure it can cause stress and scare the witness. This can be avoided by creating awareness in the school and community. What epilepsy is and how they can help when a person with epilepsy is having a seizure?
Positive emotions and support for the families that are struggling are available from their community.

~ Impact on teachers and schools ~


Having Epilepsy can affect how a child learns at school. Learning difficulties and memory problems are often shown in school. Anti-epileptic drugs can have side-effects such as drowsiness, shot attention span and affect the person’s memory. These can affect a child’s educational achievement. Teachers also have to be aware of seizures, as they can range from altered awareness, perception, behaviour or body movements to losing conscious. Some seizures can look like the child is daydreaming. ‘Transient cognitive impairments can occur during interictal discharges, which may affect cognitive function. In addition, depending on seizure severity, longer-term transient impairment may occur.’ (Colby Strong, 2010)
Students who has epilepsy are the same as other students in regards to activities, discipline and performance expectation, unless a learning difficulty is established. Overprotection or allowing the student to use their epilepsy as an excuse is something teachers need to be aware of. Teachers must also be aware of student’s seizures, any medication they are taking and any lifestyle restriction they may have. For students who have ongoing seizures there are areas such as climbing and water sports that should be cautioned.
To help people cope with epilepsy, information, psychological and social support needs to be given to those who are affected by it, including students and teachers in the school. The informed teacher’s attitude to epilepsy and to the student with seizures can positively influence the rest of the class, encouraging positive responses from both students and adults. (Epilepsy Action Australia, 2001)

~ Websites for more information ~

http://www.epilepsy.org.au/
http://www.epilepsy.com/info/family_guide
http://www.lumosity.com/ (brain training and memory games)

~ Reference ~

Hills, Michael D. (2007) Neurology Asia. The Psychological and Social Impact of Epilepsy. http://www.neurology-asia.org/articles/20073_010.pdf
Walker, Christine. (2007) Chronic Illness Alliance. Researching the Personal Impact of Epilepsy. http://www.chronicillness.org.au/downloads/ImpactofEpilepsyMay07_000.pdf
Epilepsy Action Australia (2001-2008) Understanding the Impact of Epilepsy. http://www.epilepsy.org.au/pdfs/EA_Brochure_02.pdf
Epilepsy Action Australia, (2001-2008) Epilepsy Explained: Facts and Figures, http://www.epilepsy.org.au/epilepsy_explained5.asp
Brooks, Dominique (2010) What are the Effects of Epilepsy http://www.livestrong.com/article/244469-what-are-the-effects-of-epilepsy/
Epilepsy Ontario (2010) Epilepsy and the Family http://www.epilepsyontario.org/client/EO/EOWeb.nsf/web/Epilepsy+and+the+Family
Strong, Colby (2010) Neurology Reviews, The Cognitive, Behavioural and Psychiatric Impact of Epilepsy http://www.neurologyreviews.com/10%202Feb/A1%20Epilepsy.html
Schachter, Steven C. (2004) Seizure First Aid. http://www.epilepsy.com/epilepsy/firstaid

Epilepsy Foundation America, http://www.epilepsyfoundation.org/about/types/triggers/livingtrigger.cfm