Lost Moments in Seizures
According to the World Health Organization (WHO), around 40 to 50 million people in the world have epilepsy. The annual occurrence in third world is twice that of the United States. In most countries, this remains a condition enclosed with spiritual beliefs and social taboos. As of to date, three fourths of people worldwide receive no treatment for their seizures.
Parents of Lia Lee, Hmong refugees from the hill country of Laos who now live at California, USA, calls this condition quab dap peg, (the spirit catches you and you fall down). But what really is this disease?
Epilepsy is a disorder of the nervous system that involves repeated seizures of any type (“fits”). These seizures cause an individual to lose consciousness during the time of the attack and oftentimes affect the behavior and attention of the afflicted person.
It is hard to trace exactly the beginning of this disease; however, there are three divisions created based on its causes and symptoms: Symptomatic, Idiopathic and Cryptogenic Epilepsy.  Symptomatic Epilepsy usually starts on age 5 to 20 but can occur at any age. It is the easiest to cure among the three types because the causes – head injuries, meningitis, brain stroke and any other brain infection – are known and therefore lead to proper treatment if given attention. The second division, Idiopathic Epilepsy, is when there is no clear cause behind the seizures. This is deemed to aside from low-seizure-threshold of the afflicted. The only good thing about this is that the afflicted individual responds well to treatment if given proper medication. The third and last is the Cryptogenic Epilepsy. This is so far the most challenging of all kinds of epilepsy. At present, there are still no known reasons behind it and medicines too are not much of help.
Generally, there is no known way to prevent epilepsy. However, proper diet and sleep, and abstinence from recreational drugs and alcohol, may decrease the likelihood of precipitating a seizure in people with epilepsy. In some severe cases of epilepsy, an individual is recommended to wear helmets during strenuous activities to lessen the risk of head injuries should sudden attack occurs.
Many illnesses and conditions can be confirmed by testing the blood for numerous substances and properties, epilepsy is one of those illnesses. Lumbar puncture, also known as Cerebral Spinal Fluid Collection (CSF), is also one test to determine the occurrence of epilepsy in an individual. This is done by testing a sample of the fluid that surrounds the brain and the spinal cord for abnormal pressure. CSF is often used to determine neurological disorders such as convulsions. Cranial CT Scan may also be used to verify presence of epilepsy. An electroencephalogram (EEG) is a test to detect abnormalities in the electrical activity of the brain. This is used to help diagnose the presence and type of seizure disorders, to look for causes of confusion, and to evaluate head injuries, tumors, infections, degenerative diseases, and metabolic disturbances that affect the brain. It may, in some cases, indicate the location of the lesion causing the seizure.
As of the moment, there is no specific medical test for Epilepsy. Diagnosis may require a long history or recurring seizures of any type. Physical examinations, CT scan, EEG and other neuromuscular examination may be included to diagnose properly the presence of the disease.
Prescription drugs that are usually used to treat epilepsy are Phenytoin, Primidone, Clonazepam, Carbamazepine and Sodium Valproate. All these drugs have anticonvulsant properties although they differ in some usage. Phenytoin is used in varied kinds of seizures. This is anti-arrhythmic and a muscle relaxant. The relaxant component works in such a way that it reduces muscle sensitivity. Its use however is limited because of its unpleasant side effects. Primidone, is also an anticonvulsant that is often used to manage certain types of seizures. It works as a regulator of brain impulses. It has no known adverse effects when used along with other drugs. Clonazepam also belongs in anticonvulsant drugs, its function is to prevent onset of sudden seizures and decrease the frequency and duration of the attack of minor motor seizures. Carbamazepine is an anticonvulsant that has an anti-manic substance. It is believed to be best used in case of psychomotor and partial epilepsies. Sodium valproate belongs to a group of drugs known as Anti-epileptics. It works by acting like a stopper of sending unnecessary messages in the brain.
In some other cases, brain surgery is also used in treating epilepsy. The two types of surgery are resection or resective surgery and the second and less common type of epilepsy surgery is often called disconnection. The goal of resection is to locate the cause and give the cure while the latter’s goal is only to provide relief but not a cure.
In managing drug-resistant epilepsy, Ketogenic Diet – a diet high in fats and low in all essential nutrients – is used. However, due to its complexity and unpleasant taste, it is rarely used in adults. Atkins diet is deemed to be more effective in reducing seizures in children.
In dealing with epilepsy, more often than not, the emotional and social aspects of the afflicted individuals are not properly addressed. In almost all types of illnesses, the social, psychological and emotional aspects associated with the illness can be more impairing than the illness itself. Epilepsy can affect an individual’s life in a lot of different ways. Oftentimes, people with epilepsy are being discriminated; hence, almost fifty percent of the epileptic are out of the workforce. This may have a great impact on the person, as they may feel worthless and useless in the society, even in the family.
Seizures are just symptoms of an underlying brain disorder. Medicines used in treatment often have unpleasant side effects that may affect the behavior of an individual too, hence, affect relationships. Many epileptic people are less likely to marry and have children. In male population, it is usual to have sexual dysfunction while in the case of women, getting pregnant is difficult because of drug side effects and birth defects. However, it is of utmost importance to have a positive outlook in life. Perceptions are often affected by emotions. If an afflicted individual manages to think of the disease as only one part of him, most likely, relationship and social problems may be lessened. A support group may also help an individual cope with stress and despair associated with the illness.
Legally, epilepsy has been considered in some US states as a disability for so many years now. The Epilepsy Foundation however, has given a lot of effort in passing the Americans with Disabilities Act (ADA). In recent view of the US Supreme Court, those people whose conditions are not severe and can be managed by medications are not considered disabled. Nevertheless, these people still need to prove that they are not substantially impaired since some medications may limit a person to perform daily life tasks like driving, reproduction, self-care and the likes.
The US Congress has given some indicators to know whether a person is substantially impaired, persons who belong in this category are under the care and protection of ADA. Those persons who take medicines, which have unpleasant side effects like drowsiness, memory problems and mood shifts, interfere with daily normal routine and are therefore considered substantially impaired. On the other hand, those people whose seizures cannot be controlled by medications are also considered impaired. I for one agree that disability depends on the severity of the disease in the individual.
There are numerous support groups of people with epilepsy worldwide, The Epilepsy Foundation, International League Against Epilepsy, Pediatric Epilepsy Support Group and Cleveland Clinic are some of those support systems that offer care and moral assistance for afflicted individuals.
“Efficacy of Modified Ketogenic Diet (Atkins) in Management of Epilepsy.” Sept. 2005. Oct. 11, 2006. <http://www.clinicaltrials.gov/ct/show/NCT00188500?order=2>.
This website discusses experiment with the ketogenic diet with children. It gives information as to why this diet is effective to epileptics. It also suggests to choose Atkins diet in place of the Ketogenic diet because of its more promising results to patients.
“Epilepsy as a disability.” Epilepsy Foundation. (c)1999-2005. Oct. 11, 2006. <http://www.epilepsyfoundation.org/answerplace/Legal/epasdisability.cfm>.
This website provides the legal aspects of disability of people with epilepsy. It contains statistics on employment of the epileptic population and also offers help and protection to epileptic people in the United States of America.
“Epilepsy.” Brain-tumour.net. (c)1999/2000. Oct. 8, 2006. <http://www.brain-tumour.net/epilepsy/fact1.htm>.
This website gave the statistics of the World Health Organization about the estimated number of people in the world who has epilepsy. It also gives basic facts about the disease
“Epilepsy.” Campellone, Joseph V., M.D. Oct. 4, 2006. Oct. 7, 2006. <http://medlineplus.gov/epilepsy>.
This website is complete with all necessary information about epilepsy. Joseph Campellone M.D. gives a thorough explanation of different kinds of this disease and the various treatments that may be used in people afflicted by epilepsy.
Arggawal, Mansi. What do you need to know about Epilepsy? January 11, 2006. Oct. 7, 2006. <http://ezinearticles.com/?What-do-You-Need-to-Know-About-Epilepsy&id=126533>.
The author has given valuable information on epilepsy. He included the divisions based on symptoms of the disease to properly identify treatments for seizures.
Fadiman, Anne. The Spirit Catches You and You Fall Down. USA : Farrar, Straus & Giroux. 1998.
The author tells a story about a girl, Lia Lee, who is affected by epilepsy. Lia belongs to a family who left Laos to settle in California. This book contains many superstitious beliefs in Laos about the disease, child bearing and death.
Martin, Jenna. Relationships & Epilepsy: Exploring the challenges. Oct. 7, 2006. <http://www.epilepsy.com>.
This website has provided ample examples on the effects of epilepsy in lives of the afflicted individuals. It discusses situations of real patients who undergo problems in relationships and acceptance in society.
Weiner, Howard L., MD. March 3, 2004. Oct. 8, 2006. <http://www.epilepsy.com/epilepsy/types_surgery.html>.
The page discusses the two types of surgeries for epileptics. It provided options for the patients to possibly eliminate or relieve the disease.
 “Epilepsy.” Brain-tumour.net. (c)1999/2000. Oct. 8, 2006.
 Fadiman, Anne. The Spirit Catches You and You Fall Down. USA : Farrar, Straus & Giroux. 1998.
 Arggawal, Mansi. What is Epilepsy? Oct. 7, 2006. <http://EzineArticles.com/?expert=Mansi Aggarwal>.
 “Epilepsy.” Campellone, Joseph V., M.D. Oct. 4, 2006. Oct. 7, 2006. <http://medlineplus.gov/epilepsy>.
 Weiner, Howard L., MD. March 3, 2004. Oct. 8, 2006. <http://www.epilepsy.com/epilepsy/types_surgery.html>.
 “Efficacy of Modified Ketogenic Diet (Atkins) in Management of Epilepsy.” Sept. 2005. Oct. 11, 2006. <http://www.clinicaltrials.gov/ct/show/NCT00188500?order=2>.
 Martin, Jenna. Relationships & Epilepsy: Exploring the challenges. Oct. 7, 2006. <http://www.epilepsy.com>.
 “Epilepsy as a disability.” Epilepsy Foundation. (c)1999-2005. Oct. 11, 2006. <http://www.epilepsyfoundation.org/answerplace/Legal/epasdisability.cfm>.