Epilepsy—Today’s Outlook

IT WAS the noon hour at an African high school. An attractive tenth-grade girl was coming down the steps, along with many of her classmates. Suddenly she fell to the ground. The muscles of her body tightened. She briefly ceased to breathe, and her muscles went into contractions, jerking her body around violently. Many fellow students watched anxiously, completely surprised by what they saw happening to the girl. It was an epileptic seizure.

How would you have reacted if the girl had been your classmate or acquaintance? Would you have continued to treat her as a friend? Or would you now think she was somehow undesirable? Would you be afraid of her, and try to avoid her?

Earlier Views and Present Attitudes
Here in Africa, it is a common believe that there was something magical or demonic about epilepsy. Epileptics were accused of witchcraft and ostracized. Holes were bored in their heads and they were branded with hot irons to drive out evil spirits. Their disorder was considered a hereditary “family taint,” and mentally retarding.

Such views persisted because no voice had been given to this. The media know little or nothing about it. They considered no news, yet these ones are friends and family members. It is common to see many friends and relatives restricting the marriage of epileptics.

Epileptics are prohibited from driving an automobile and to represent any group of people for the fear of creating an embarrassing scenario.

And few firms would employ them.
This obviously led to the conclusion made by the former director of the National Institute for Neurological Diseases and Blindness, Dr.

Pearce Bailey, who observed that: “Epilepsy is the only disorder where the sufferer is more handicapped by the attitude of society than by his disability.”

Happily while the stigmatism continues, the outlook has improved in some part of West Africa. Yet there are no-go-areas. Sterilization laws applicable to epileptics have not been enforced at obtained in many developed world like Denmark and United states, as well as the laws forbidding them to marry non-sufferers. It has still become impossible for epileptics to receive driver's licenses. And employers are still not inclined to hire them.

In keeping with the improved outlook is the change in attitude of the general public. They can be admitted in some schools and be allowed to enjoy every privilege available. The problem is with the government and the local people. The problem is with everybody. No voice has been given to this problem and if in this century such is allowed to continue, it will be explained as brazenly and deliberately violating the right we have to live as humans no matter our health and social status.

What Epilepsy Is
Epilepsy is a term that covers a variety of basic conditions. All of these conditions, however, have a dominant symptom in common:

recurrent seizures. And it has been found that the various forms of epilepsy also have in common a malfunctioning of some brain cells.

By probing into the brain we learn that its cells emit electrical impulses. The electrical firing of brain cells is normally rhythmic, forming wavelike patterns. A machine has been invented that can pick up these wave patterns and record them on a moving strip of paper. But in some persons the electrical activity of the brain becomes disrupted temporarily, and faulty messages are flashed to the body's action centers. This results in an epileptic seizure. But the disturbance in the brain, sometimes called a “storm,” soon passes, and the seizure ends.

Thus it can be seen why Dr. Louis D. Boshes explained: “Epilepsy is not a disease. It is a symptom that something is wrong with the brain—just as a fever is not a disease or an ailment in itself but a symptom that there is an infection somewhere in the body.”

Far from being a rare condition, epilepsy is quite common. About one person in a hundred is believed to be affected, most of them children.

In Nigeria, millions are affected by this. In addition, millions more at one time or another have had isolated seizures, but this is not classed as epilepsy, for the seizures are not recurrent.

Although seizures vary greatly in their manifestations, there are three main forms that authorities frequently list. Each is associated with characteristic brain-wave patterns, reflecting the type of electrical “storm” in the brain. The most severe form is that experienced by the girl described in the introduction of the article.

She had grand mal, which is what most people regard as a true epileptic seizure.

Although a grand mal attack can be frightening to an onlooker, since the victim is unconscious it is not painful and it rarely causes injury. The jerking and thrashing of the body lasts only about a minute, although it may seem longer to someone watching. The person then relaxes, and after a few minutes he may be up and able to resume normal activities as though nothing had happened.

A second main form is petit mal, common in the five-to-twelve-year age range. However, this form rarely continues into adult life. It is characterized by brief interruptions of consciousness that usually last only five to ten seconds. They can occur frequently, up to a hundred times or more a day. The eyes may roll back and there may be slight jerking movements of the head or arms, but the person does not fall. Immediately following the spell the individual is mentally alert and is able to carry on with his activities.

Psychomotor seizures are the third main form of epilepsy. They are characterized by automatic stereotyped movements or odd behavior. The victim may seem all at once to “switch off,” and engage in irrelevant activity. He may pick or tug at his clothes, examine objects about him or walk around. A patient in a waiting room once was observed to pick up an ashtray and go from person to person offering gifts of cigarette butts to each one.

A psychomotor attack usually lasts but two to three minutes. Afterward there is generally little or no recollection of what happened. Only if the person is physically restrained may he appear angry or become obstreperous.

Although malfunction of brain cells is the source of the trouble, intelligence is not affected. Most epileptics are average in intelligence, some are brilliant and, as in any segment of the general population, some are below average.

Physical Causes
What causes persons to have recurrent electrical “storms” in the brain, bringing on seizures? The fact is that in most cases of epilepsy the cause is not known. However, it is said that anything that damages nerve cells in the brain can be responsible.

Thus a blow to the brain can be the cause, or a brain tumor.

Infections also can be responsible. Viruses that cause measles, meningitis and other diseases can travel up the spinal cord and affect the brain. Or an imbalance in body chemistry may be the source of the disorder. For example, a person's body may lack a certain enzyme that can lead to an irritation of the brain cells. Or a deficiency of pyridoxine, vitamin B6, can be responsible.

Although emotional upsets are not known to cause epilepsy, they frequently provoke the seizures of persons already subject to them.

Financial or domestic worries, fear of seizures or other upsetting factors can precipitate attacks. In girls, seizures sometimes occur only in association with the menstrual cycle, generally premenstrually.

Some persons seem to have a predisposition to epilepsy. It is this tendency that seems to pass on from generation to generation, even as susceptibility to other disorders such as cancer and heart troubles also seems to run in families. But epilepsy itself is not inherited.

Thus laws prohibiting epileptics from marrying have been widely repealed. A generally accepted view is that an epileptic has one chance in fifty of having an epileptic child, and a non-epileptic has one chance in two hundred.

Encouraging Outlook
It is encouraging that epileptic children frequently recover from epilepsy with increasing age. Also, at least half of all epileptics can now be kept seizure free. In another 35 percent, seizures can be drastically reduced. And even the remaining 15 percent of epileptics can be helped. How is this done?

Principally it is by means of anticonvulsant drugs. Now twenty or more are available, phenobarbital and diphenylhydantoin sodium being the most widely used. Therapy involves finding the dosage of a drug, or combination of drugs, required to eliminate seizures, while endeavoring to avoid adverse side effects to the extent possible. The drugs act to supplement the body's natural chemical balances and thus suppress the abnormal electrical activity of the brain. But the drugs are not cures. They are regularly taken to avoid seizures, just as diabetics regularly take insulin to maintain health.

But to obtain the maximum benefit of the drug therapy, a healthful mental outlook and style of living is vital. The fears, frustrations and anxieties that can provoke seizures need to be alleviated. And the best medicine for this is LOVE. An epileptic needs to feel wanted and that others truly care for him. He needs care and assurance. He needs smile and cuddle. He needs you.

Important, too, is proper nutrition, rest, exercise and moderation in every aspect of his life. The seizures of some epileptics have been controlled by taking dietary supplements of vitamin B6 and magnesium.

When seizures are controlled, an epileptic acts as normal as anyone else. It is only proper that they should also be permitted to enjoy suitable employment.

Being of Help
If you are the relative, friend or just an acquaintance of an epileptic, you certainly want to be of help. And perhaps the best way you can be is by treating an epileptic as normally as possible. By all means do not try to avoid him or treat him as being somehow undesirable. Remember, epilepsy is due simply to a physical malfunction, even as heart trouble and other such disorders are.

As far as epileptic children are concerned, do not be overly protective. Let them engage in the activities of other children.

Actually seizures rarely occur during physical activity, so the danger while at play is minimal. Of course, for children subject to frequent attacks activities such as horseback riding and tree climbing are wisely prohibited.

What if you should witness a seizure? Keep calm. There is nothing you can do to stop it. Clear the area around the person so that he does not injure himself, but do not try to interfere with his movements. If his mouth is open, you can place a soft object such as a folded clean handkerchief between the side teeth, to prevent him from biting his tongue. But be careful in doing this so that your fingers are not bitten. And when the seizure ends, you can be there at his side and talk quietly and encouragingly.


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Articles by Emmanuel Ugokwe