There are many forms of epilepsy and each is characterized by specific symptoms. Regardless of the form, the disease is the result of a functional disorder in brain communication system. Nerve cells in the brain communicate with each other usually by sending tiny electrical signals. In epileptic person, signals from one group of nerve cells occasionally become too strong – so strong that they “overpower” neighboring parts of the brain. This excessive electrical discharge can occur suddenly in the whole brain, but it may also start locally and expand or remain limited to the initial area. This sudden, excessive electrical discharge causes the behavior that we call a seizure. The onset can be expressed in different ways, depending on the location and extent of the affected area of the brain tissue.
It is not known why the communication system of the brain fail in this manner and why it frequently occurs in some people. Extensive research by the testing of a large number of patients have shown that in approximately two thirds of epilepsy can not detect any structural defects in the brain. As for the remaining third, their condition can generally be associated with some fundamental problems, such as brain damage at birth, serious head injury or infection of brain tissue.
In some cases (especially if the epilepsy develops in adulthood), the cause is a brain tumor.
The main symptom of epilepsy is short, abnormal phase of behavior which is generally called a seizure or convulsion. It should be noted that a single episode of this kind is not a sign of epilepsy. Epileptic seizures are repeated. Among the many forms of the disease two major are worth mentioning: petit mal and grand mal.
Petit mal epilepsy is a disease of childhood, which usually disappears in late adolescence.
If the child, from time to time, suddenly starts staring blankly around him/her for a few seconds (sometimes up to half a minute), interrupting the activity he/she was dealing with, it’s probably this form of epilepsy. In this period, children are not aware of events around them and will not answer you if you talk to them. There may be weak twitches of head or hands, although children with petit mal seizures usually do not fall on the floor during a seizure. When the seizure finally stops the child behave as if nothing had happened, and often doesn’t know about this “blank period”.
The most characteristic symptom of grand mal epilepsy is a seizure in which the unconscious patient falls to the floor, his whole body stiffens at first, and then begins to twitch uncontrollably. It may take several minutes, usually followed by a period of deep sleep or mental confusion. During the attack, some patients even lose control of bladder and discharge urine.
In many cases, unusual sensations, before losing consciousness, warn epileptics about the upcoming attack. Any warning of this type just before the attack is called the aura; abnormal sensations in the hours preceding the attack are called prodrome. These sensations may be just a feeling of tension or some other kind of vague feeling; some epileptics, however, have a very specific sense e.g. smell odors, hear unusual noises, see a distorted image, or have a funny feeling in the body, especially in the stomach. Some epileptics eventually meet “their” warning signs which, sometimes, give them enough time to avoid accidents.
Some types of epilepsy are not as frequent as petit mal and grand mal; one of them is so-called “focal” epilepsy. A person suffering from focal epilepsy may not lose consciousness when a seizure occurs; instead, it can lead to an uncontrolled twitching of a part of the body or to abnormal sensations, such as flashing before the eyes, depending on the localization of brain processes. Twitching can spread; if, for example, a thumb of one hand starts to twitch, a twitching of the whole arm may follow, and after that spread on other parts on that side of the body.
There is another kind of epilepsy, “temporal epilepsy”, named after the part of the brain – temporal lobe – in which the abnormal electrical activity occurs. In people with this type of epilepsy aura usually lasts for only a few seconds. After that, unknowingly, a person does something unusual, interrupting the normal activity with unusual behavior. During such episode, epileptic often strangely moves his mouth like he’s chewing.
A poll conducted in the UK shows that about every 200 people suffer from epilepsy. Both sexes are equally susceptible to epilepsy, and it seems that the disease is hereditary. Petit mal epilepsy occurs only in children; epilepsy is generally more common in children than in adults, partly because in some children epilepsy slowly disappear in adolescence. It should be noted that in children a high fever, caused by infection, can often lead to the appearance of so-called febrile (feverish) cramps. When the body temperature goes back to normal, these cramps do not occur, unlike epileptic who are repeated yearly. From the mentioned rule on the higher incidence of epilepsy among children deviates only focal epilepsy, which is more common in middle aged and elderly people.
Fortunately, the modern drugs can control most forms of epilepsy, so today epileptics can practically lead a normal life. However, if it comes to occasional seizures – usually because the disorder is not treated properly – there is an obvious danger that the attacks will come at the wrong place, at the wrong time. If epilepsy is not controlled, epileptic may endanger his life – and perhaps the lives of others – if he climbs the ladder, operates dangerous machinery or if he drives. Such patient gets the car license for only for two years, and after that he must take another commission medical examination.
Epileptic may have an accident during a seizure even when he is safe, on the ground, for example he may accidentally bite the tongue during the uncontrolled jaw clamping. Also, during the twitching, epileptic can be hurt by coming in contact with sharp objects. Frequent, uncontrolled epilepsy can lead to extensive damage to the brain, but thanks to modern preventive tools such cases are rare.
What to do?
If you think that someone in your family might have epilepsy, consult a doctor. He will ask you to describe in detail convulsions (seizures), and will ask both you and the potential patient any details on their frequencies. If there were no recent illnesses or injuries that could cause seizures, the doctor will, based on stated facts, most likely diagnose the condition as epilepsy. In some cases, the electroencephalogram (EEG) is recorded to confirm the diagnosis.
If there is a possibility that a cause of epilepsy could be brain damage or infection, examination will include X-rays of the skull, blood type and computerized axial tomography. Most of these examinations are performed in a hospital under the supervision of a neurologist.
Self-help: if anyone in the family has epilepsy and takes medication, make sure they take them right in time and in the amount specified by the doctor.
Tell your colleagues at school or at work that you have epilepsy. If you have not previously advised them, they could be scared when they first attend to attack. If they know about your situation and what measures they need to take, they won’t be intimidated and will probably be able to help you more.
Professional help: epilepsy cannot be cured. The only exceptions are the relatively rare cases which are the result of curable brain damage, tumors or infections. However, regular and reasonable taking anticonvulsant agents can prevent seizures in most cases; since approximately one third of epileptics no longer gets seizures at a later age, drug therapy is reviewed periodically and can be stopped in such cases.
Today, there is a number of anticonvulsant agents, and the doctor will prescribe medication (sometimes more than one) that best suits your case. Medication for epilepsy should be taken regularly as long as those attacks last, which means it could be for a lifetime.
Sometime, taking anticonvulsant agents is accompanied by adverse side effects, especially in the case of overdose. Your doctor will have to check on you from time to time, perhaps with a blood test, to see if you are taking the correct dose of prescribed medication. If the drug does not appear effective, the doctor may increase the dose or decide to try a different anticonvulsant agent. If your status is obviously a result of a primary disorder of the nervous system, that disorder also needs to be healed.
How to help a person who has a seizure? As already mentioned, some epileptic seizures are immediate unconsciousness that practically does not affect the position of the body. If someone (it could easily be a child who is suffering from petit mal epilepsy) experienced such an attack in your presence, it is generally best to ignore it. Take the person to a safe place only if the seizure of petit mal epilepsy occurs in a potentially dangerous situation – for example, when crossing the street. This advice also applies to cases of temporal epilepsy where the affected person – instead of falling to the ground – can behave strangely; do not forget that the patient, no matter how active he looks, is not really aware of what is going on with him, so he should be gently removed from a dangerous place, not scold or be with him quaff.