Tuesday, November 11, 2008

Epilepsy can look scary

We're talking about a little-known and even less-understood disability known as epilepsy. This week, we want to spend some time describing the more well-known manifestations of epilepsy, the epileptic seizure. Seizures may look frightening, but they're usually not painful. They affect different people in different ways. Epileptic seizures also fall into two main categories: partial and generalized.

Partial seizures start in one part of the brain. The electrical disturbances may then move to other parts of the brain or they may stay in one area until the seizure is over. A person having a partial seizure may lose consciousness. There may be twitching of a finger or several fingers, a hand or arm, a leg or foot. Certain facial muscles might twitch. Speech might become slurred, unclear or unusual during the seizure. The person's vision might be affected temporarily. He or she might feel tingling through-out one side of the body. It all depends on where in the brain the abnormal electrical activity is taking place.

Genera-lized seizures involve electrical disturbances that occur all over the brain at the same time. The person may appear to be daydreaming, may stare off into space or may pass out. The muscles may stiffen and the person might make sudden jerking motions, such as flinging the arms outward, for example. He or she also may suddenly go limp and slump down or fall over.

Most seizures last only a few seconds or minutes. After a seizure is over, the person might feel sleepy or confused for a few minutes, even an hour or more. People who've had seizures may not remember the seizure or what happened immediately before the event. They may also be alert and ready to resume whatever they were doing before the seizure happened. As one can see, epileptic seizures also vary from person to person.

Certain things can sometimes trigger seizures in people with epilepsy. They include:
Flashing or bright lights.

A lack of sleep.

Various levels of stress.

Overstimulation (like staring at a computer screen or playing video games for too long).

High fevers.

Certain medications.

Hyperventilation (breathing too fast or too deeply).

Doctors who specialize in the brain and nervous system are called neurologists. If you think you might have had a seizure, it's important to tell your doctor about it. He or she will likely refer you to a neurologist who will check for epilepsy or other conditions.

In addition to doing a physical examination, the neurologist will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues, as well. This is your medical history, and it's important to give the most accurate description possible of the seizure (or seizures) you may have experienced. Because people who've had seizures may not remember anything about them, it's a good idea to get a detailed description from someone who actually witnessed the seizure and, better yet, to write down what they saw after the seizure is over.

The neurologist will most likely perform other medical tests, such as an electroencephalogram, or EEG, to measure the electrical activity in the person's brain. Scans of the brain, such as a computerized tomography, or CT scan, and a magnetic resonance imaging, or MRI, may also be done. All these tests are painless.

If the neurologist determines that a person has epilepsy, he or she will recommend an appropriate type of treatment. Treatment for epilepsy usually involves medication, but sometimes other treatments may be recommended, too. The goal of treatment is to control seizures so a person can live as normally as possible. In some cases, doctors can even implant a device called a vagus nerve stimulator. This device sends signals through the vagus nerve in the neck to control seizures.
The doctor also may recommend a cacogenic diet, which is a special diet that might help people with epilepsy who don't respond well to medication alone. Sometimes doctors can help by performing surgery directly on the brain tissue when the condition can't be controlled using other treatments.

Next week, we'll discuss how people with epilepsy can best cope awith this disabling neurological condition.

Paul Rendine is chairman of the Disabled Advocates of Delmarva Inc. group. Call him at 410-860-1137 or send e-mail to paulrendine@ comcast.net.


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