Healthy Living explores how to cope with epileptic seizures

Epilepsy is a disorder that manifests itself through different type of seizures. It is treatable with prescribed medication and life style changes. Healthy Living this week talks to an expert about this neurological condition.

Marleni Cuellar, Reporting
Epilepsy is a common condition worldwide. Most commonly referred to in Belize as ‘fits’ due to the physical effects of the seizure experienced, epilepsy is not a widely discussed condition. Studies show that a third of persons with epilepsy worldwide often experience some form of discrimination in the workplace. This is merely one of the many misconceptions associated with the condition. Neurologist, Dr. John Sosa helps us to understand this neurological disorder.

Dr. John Sosa, Neurologist
“People in Belize call epilepsy basically fits but epilepsy is more than fits. We have epilepsy that is comprised of a thing called seizures. When we say the word seizures it means more than fits it can involve actual shaking or you can just have disturbances in your behaviour, for example. You can have disturbances in your awareness for a very short period of time and all those things are seizures. But epilepsy itself is a continuation of seizures; its having a more than one seizures on a recurrent basis.”

The normal brain functions with electrical signals. In the case of epilepsy the seizures are a result of abnormal electrical activity in the brain.

Dr. John Sosa
“With epilepsy what happens is that the signals gets altered they don’t work as well and your cells itself gets irritated that irritation spreads and you have a fit or a seizure.”

This irritation of the cells results in two different types of seizures.

Dr. John Sosa
“We have partial seizures and we have generalized seizures. Partial seizures are when they move, for example, one hand. This is a focal seizure a motor seizure. But you can have it with just feeling we call that sensory. You can have what we call psychic disturbances and that is just a part of your brain that goes bad and you can have hallucinations, you’re hearing or seeing and behave abnormally.”

Generalized seizures include the recognizable tonic-clonic seizures which include the loss of consciousness, stiffening of the body and jerking of the limbs.

Dr. John Sosa
“We have other types of generalize, for example, you get just stiff or we stare blankly for a few seconds we call those absence seizures. We can have just little jerks, we call those myoclonic.”

Epilepsy though is characterized by the repetitiveness of the seizures. This condition is diagnosed in accordance with its causes. The three main types of epilepsy are idiopathic, cryptogenic and symptomatic.

Dr. John Sosa
“Basically what that means is Idiopathic we don’t know the cause its probably genetic. Cryptogenic we assume that we have a cause but we can’t pinpoint it and symptomatic is if you had a head trauma, a brain tumour, a stroke, you had an infection somewhere along the line in your life and it cause seizures. Most commonly cryptogenic around half of the seizures we can’t find a cause maybe sometimes up to seventy-five percent we can’t find a cause for the seizure.”

Dr. Sosa, emphasized that not everyone who has a seizure is an epileptic but explains that multiple seizures may increase your risk.

Dr. John Sosa
“The majority of people have one seizure don’t have another one so the majority of people who have one seizure are not epileptic. But it can happen that you do become epileptic if you do have repeated seizures. We have a special type of seizure in Belize that we see quite commonly it is called a febrile convulsion. But not everyone with febrile convulsions will have epilepsy. A febrile convulsion is when a fever goes too high and for some genetic reason, that’s inherited, your brain cannot tolerate high temperatures and between the ages of six months and five years old you get a high fever you have a seizure. If you have one or two of those then no problem we don’t treat. If you have more than two we start to treat because the risk of having epilepsy with two or three of those seizure increases by two or three hundred percent.”

With the majority of cases of epilepsy being cryptogenic, it is a bit comforting to note that this very common condition is treatable. In addition to medication some lifestyle changes are required.

Dr. John Sosa
“You have to maybe sometimes maybe change your daily activities. The more stress free you are the better, the better sleep you get the less chance of getting a seizure. Not taking alcohol, not taking drugs, the less risk of having a seizure because those irritate your brain. And of course we use anti-epileptic drugs or A.E.D.’s to control the seizure depending on the type of seizure we try to pick a medication depending on the patient. The ideal thing is that the patient is seizure free is all the time. That ideal is kinda hard to maintain sometimes because people get ill or they get stressors because a family member dies, whatever. They get into problems with a bill or a loan and that could stress you out and possible give you a seizure.”

It is important to know the types of seizure and type of epilepsy to be prescribed the proper treatment. Unfortunately, the tests required for the neurological examination, can be very costly, somewhere around two thousand dollars.

Dr. John Sosa
“Sometimes some teachers would say this child is not paying attention in school, he losses concentration very quickly. That is an indicator that you may need to check it out because a child who for periods loosing concentration may be having seizures. Then you have very little babies who may just roll their eyes, or turn their heads or just cry a whole lot and funny little jerks and especially for a first time mom and they have their little kid having that kind of seizure and it happens and they don’t notice. And they come a month or two later and you say you know what this baby has been having seizures for some time and its not good because it does the brain damage especially when they’re very small. So we try to pick it up as soon as possible”

As for caring for a loved one during a seizure, Dr. Sosa offers some very valuable advice.

Dr. John Sosa
“Well the first thing you should not do is put something in the mouth, especially your finger or your hand or something wooden or metal because people with seizures will clamp down and bite and that thing can break or it can really do damage to your finger.”

Other tips include: staying calm: do not restrain or try to revive the person
Removing all hazardous objects around them, loosening any tight clothing and removing glasses, turning the person gently to the side to protect airways and calling an ambulance if the seizure lasts more than five minutes or is followed immediately by another seizure.