Epilepsy is a neurological condition which affects the brain. Its most dominant and well-known feature is the seizure (convulsions, or fit).
Epilepsy is relatively common, affecting approximately 2% of the population, with more than 75% of individuals being diagnosed in childhood or adolescence. Whilst between 10 and 30% of people may suffer a seizure at some point in their life, this does not result in a diagnosis of epilepsy. Diagnosis relies on the occurrence of two or more seizures, as well as the results of an Electro-Encephalogram (EEG). An MRI scan may also be used to provide images of the brain and blood tests taken to rule out other medical conditions.
What Causes Epilepsy?
Epilepsy seizures occur due to an abnormal electrical discharge within the brain. Whilst this is clear, often the cause of an individuals epilepsy is not known. In some cases, it may be due to genetic or anatomical abnormalities, or even following surgery, a stroke or a head injury.
What Happens during a Seizure?
Most epileptic seizures are known as Tonic-Clonic seizures. These involve a period of muscle stiffness (tonic phase), followed by muscle twitching and involuntary movements (clonic phase). The individual may or may not lose consciousness during the seizure. Most seizures last no more than 30 seconds.
Afterward, it is common for the individual to be confused, dreary and to have a headache.
What should I do if I see someone having a Seizure?
Observing a seizure can be unnerving, or even frightening, especially for children. But it is important to remember that seizures are rarely life-threatening and that the individual does not feel pain or even really remember it.
The most important things to do if you observe a seizure are to protect the individual from injury and to observe the patient so that you are able to give a good description of what happened if required by the patient's Doctor.
During a seizure, involuntary muscular contractions and twitching/shaking are common. In some cases, this can be quite extreme. It is important that the individual is protected from injuring themselves during the seizure. This can be done by placing something soft such as a pillow or blanket under the head and moving/padding any hard objects in the immediate vicinity.
Once the seizure has ended, the patient will start to breathe normally again and consciousness will slowly return, although they may feel very sleepy.
It is not usually necessary to call an ambulance, especially if seizures are frequent. Diagnosed epileptics usually carry an identity card or wear an i.d. bracelet. An ambulance may be required if:
- It is their first seizure.
- The seizure continues for 5 minutes or more.
- They are injured during the seizure.
- A second seizure occurs without them gaining consciousness in between.
How is Epilepsy Treated?
Epilepsy treatment usually involves a combination of medication and lifestyle adaptations.
Certain factors are known to increase the likelihood of seizures in epileptics, although what affects one person may not affect another. Common triggers include:
- Sleep deprivation
- Skipping meals
- Hormones (especially in women)
- Flashing lights
Anti-Epileptic Drugs (AED's) are used in the majority of cases of epilepsy. AED's aim to prevent seizures by reducing the excitability of the brain. AED's are generally very effective with around 50% of epileptics on AED's being free of seizures. Around 30% may suffer occasional seizures. There are several different types of AED and if one does not control an individual's seizures, another one may.
Side-effects of AED's may include tiredness, lack of concentration and reduced coordination.
Epilepsy and Exercise
In general, exercise is recommended for those with epilepsy as in the majority of cases regular exercise helps to control seizures. Occasionally exercise may lead to an increase in seizures and so this should be monitored and each case treated accordingly.
There are some considerations when exercising with epilepsy, especially when seizures are frequent. Sports, where any impairment in split-second neuromuscular timing could be dangerous (such as rock climbing, motor racing or skydiving), should not be undertaken. Other sports which could present a dangerous situation, were a seizure to occur, should be considered on an individual basis.