Epilepsy
I have been told by my consultant
that I may experience epilepsy. I don’t
believe this for now; I think this would have already occurred prior to the
removal of the tumour. However, I am not
going to let it go, and here is some information about epilepsy. At the end are tips on how to support someone
who is having a fit.
I have had to return my driving
licence and am not allowed to drive a car.
If I do not experience epilepsy for 1 year (I think), I will be allowed
to drive again.
What is epilepsy?
Epilepsy
is a brain
disorder characterised by recurrent seizures -episodes of abnormal electrical
activity in almost any part of the brain. The symptoms of a seizure can mimic
any form of human behaviour, depending on which part(s) of the brain are
affected. Generally, the term epilepsy (or seizure disorder) refers to
relatively stereotyped attacks of involuntary behaviour. The exact symptoms and
severity may vary, and the seizures may occur infrequently or in rapid
succession.
While every case of epilepsy is
distinct, a standardised classification scheme has been developed to describe
seizures. The attacks are divided into two main types:
·
Generalised (involving the entire brain)
·
Partial (originating in one area of the brain).
Within these categories, seizures are
further identified according to the pattern of the attack. The two most common
forms of seizure are both of the generalised type:
·
Absence (petit mal) seizures
·
Tonic/clonic (grand mal) seizures.
Among the partial types are
"simple" seizures (without impairment of consciousness), such as
motor or Jacksonian seizures, and "complex" seizures (with impairment
of consciousness), such as temporal lobe seizures.
Types of epilepsy
Epilepsy
is the occurrence of sporadic electrical storms in the brain.
These storms cause behavioural manifestations (such as staring) and/or
involuntary movements (such as grand mal seizures).
There are several types of epilepsy,
each with different causes, symptoms, and treatments.
When making a diagnosis of epilepsy,
your doctor may use one of the following terms: idiopathic, cryptogenic,
symptomatic, generalised, focal or partial.
·
Idiopathic: no apparent cause.
·
Cryptogenic: there is a likely cause, but it has not been identified.
·
Symptomatic: a cause has been identified.
·
Generalised: the seizures involve the whole brain at once.
·
Focal or partial: the electrical storm starts from one area of the brain. One type of
partial seizure is called Jacksonian epilepsy.
Major types of epilepsy
|
Types of
epilepsy
|
Generalised
epilepsy
|
Partial epilepsy
|
|
Idiopathic
(genetic
causes)
|
Childhood absence
epilepsy
Juvenile myoclonic epilepsy
Epilepsy with grand-mal
seizures on awakening
Others
|
Benign focal epilepsy
of childhood
|
|
Symptomatic
or
cryptogenic
|
West syndrome
Lennox-Gastaut syndrome
Others
|
Temporal lobe
epilepsy
Frontal lobe epilepsy
|
Type 3: Symptomatic generalised
epilepsy
Symptomatic generalised epilepsy is
caused by widespread brain damage. Injury during birth is the most common cause
of symptomatic generalised epilepsy. In addition to seizures, these patients
often have other neurological problems, such as developmental problems or cerebral
palsy. Specific inherited brain diseases, such as
adrenoleukodystrophy (ADL, which was featured in the film Lorenzo's Oil)
or brain infections (such as meningitis
and encephalitis) can also cause symptomatic generalised epilepsy. When the
cause of symptomatic general epilepsy cannot be identified, the disorder may be
referred to as cryptogenic epilepsy. These epilepsies include different
subtypes - the most commonly known type is the Lennox Gastaut syndrome.
Type 4: Symptomatic partial
epilepsy
Symptomatic partial (or focal) epilepsy
is the most common type of epilepsy that begins in adulthood, but it does occur
frequently in children.
This type of epilepsy is caused by a localised abnormality of the brain, which
can result from strokes, tumours, trauma, a congenital brain abnormality (one
present at birth), scarring (or "sclerosis" of brain tissue), cysts
or infections.
Sometimes these brain abnormalities can
be seen on MRI scans, but often they cannot be identified, despite repeated
attempts, because they are microscopic.
This type of epilepsy may be
successfully treated with surgery that removes the abnormal brain area without
compromising the function of the rest of the brain. Epilepsy surgery is very
successful in a large number of epilepsy patients who failed to respond to
multiple anticonvulsant medications (at least two or three medications) and who
have identifiable lesions. These patients undergo a pre-surgical comprehensive
epilepsy evaluation in dedicated and specialised epilepsy centres.
What to do if you see a person having a
fit
If you see someone having a seizure or fit,
there are some simple things you can do to help. Use this article to find out
what they are, and when to call an ambulance.
Call 999 for an ambulance if the seizure lasts
longer than five minutes
It might be scary to see someone having a
seizure, but don’t panic. “Try to comfort them and make sure they’re not
hurting themselves,” says Dr Chris Clough, consultant neurologist (brain
specialist) at King’s College Hospital, London.
“If they’re having a tonic-clonic seizure, they may be trapped behind
something or kicking against something.” If you are with someone who is having
a tonic-clonic seizure or fit:
- move them away from anything that could cause injury, such as a
busy road or hot cooker
- cushion their head if they're on the ground
- loosen any tight clothing around their neck, such as a collar or
tie, to aid breathing
- when their convulsions stop, turn them so that they're lying on
their side
- stay with them and talk to them calmly until they have recovered
- note the time the seizure starts and finishes
Don’t put anything in the person’s mouth,
including your fingers. They may bite their tongue, but this will heal. Putting
an object in their mouth could cause more damage.
As the person is coming round, they may be
confused, so try to comfort them.
Do you need to call an
ambulance?
You don’t necessarily have to call an ambulance
because people with epilepsy don’t need to go to hospital every time they
have a seizure. “I have patients who have ended up in all parts of town
because they’ve had a seizure and were taken to hospital,” says Dr Clough.
Some people with epilepsy wear a special
bracelet or carry a card to let medical professionals and anyone
witnessing a seizure know that they have epilepsy. “If they know they have
epilepsy, they might just prefer to get on with their day.”
However, dial 999 if:
- it’s the first time someone has had a seizure
- the seizure lasts for more than five minutes
- the person doesn’t regain full consciousness, or has a
series of seizures without regaining consciousness
Remember what happens
Make a note of what happens during the seizure as
this may be useful for the person or their doctor.
Be aware of what the person does during the
seizure. Make a note of what they're like afterwards (such as sleepy,
confused, or aggressive), and record how long the seizure lasts.
The following information may be helpful:
- Where was the person?
- What were they doing?
- Did the person mention any unusual sensations, such as an odd smell
or taste?
- Did you notice any mood change, such as excitement, anxiety or
anger?
- What brought your attention to the seizure? Was it a noise, such as
the person falling over, or body movements, such as their eyes rolling or
head turning?
- Did the seizure occur without warning?
- Was there any loss of consciousness or altered awareness?
- Did the person's colour change? For example, did it become pale,
flushed, or blue? If so, where – the face, lips or hands?
- Did any parts of the body stiffen, jerk or twitch? If so, which
parts were affected?
- Did the person's breathing change?
- Did they perform any actions, such as mumble, wander about or
fumble with clothing?
- How long did the seizure last?
- Was the person incontinent (could not control their bladder or
bowels)?
- Did they bite their tongue?
- How were they after the seizure?
- Did they need to sleep? If so, for how long?
If you have epilepsy, record the details of your
seizures in your diary. Seizure diaries are available free of charge from the
Epilepsy Society helpline (01494 601 400, Monday to Friday 9am-4pm,
Wednesdays 9am-8pm) and other sources.
Further Reading:
