DailySun
Johannesburg – This week is recognized as “National Epilepsy Week,” a dedicated period aimed at raising awareness about epilepsy, a condition that affects around 50 million people worldwide.
This year, National Epilepsy Week runs from 10-16 February, focusing on the following goals:
Improve awareness of epilepsy and advocate for the rights and welfare of individuals living with this condition.
Dr. Themba Hadebe, Clinical Managed Care Executive at Bonitas Medical Aid, provides insights into the causes, classifications, treatments, and the unfounded social stigma related to epilepsy.
“Epilepsy represents the most widespread chronic brain disorder,” states Dr. Hadebe,
“impacting an estimated 50 million individuals globally, irrespective of age, culture, or background.”
“In South Africa, approximately one in every 100 people has epilepsy.”
“While acknowledging the international relevance of epilepsy, understanding this brain disorder is essential, particularly in tackling the societal challenges and stigma associated with it.”
He underscores, “Despite its prevalence, many individuals with epilepsy – especially in low and middle-income countries – still lack access to adequate treatment and awareness.”
What is epilepsy?
Epilepsy is characterized by recurrent seizures, resulting from excessive electrical activity in specific neurons in the brain.
Dr. Hadebe explains, “Seizures can range from minor lapses in awareness to intense convulsions with loss of consciousness, exhibiting significant variance in frequency and intensity.”
“It’s crucial to understand that experiencing a single seizure does not signify epilepsy; a diagnosis is made after two or more unprovoked seizures.”
In higher-income countries, while treatment access is generally more prevalent, challenges like misdiagnosis and persistent stigma continue to complicate the lives of those affected.
Moreover, it’s noteworthy that up to 70% of individuals with epilepsy can achieve seizure freedom with accurate diagnosis and intervention.
However, estimates suggest that in some low-income regions, close to 90% of individuals remain untreated.
This gap in access is further worsened by a shortage of trained healthcare professionals in these areas.
Causes of epilepsy
Various factors can contribute to the onset of epilepsy, including:
- Structural: Brain damage from birth complications, severe head injuries, or strokes
- Genetic: Certain genetic disorders may increase the possibility of developing epilepsy
- Infections: Diseases like meningitis, encephalitis, and neurocysticercosis (pork tapeworm), prevalent in tropical areas, can induce epilepsy
- Metabolic and immune disorders: Rare conditions affecting brain functionality
- Unknown: Around 50% of epilepsy cases have no identifiable origin
Types of seizures
Seizures fall into two main categories: focal seizures, which start in one localized area of the brain, and generalized seizures, which affect both sides.
Focal seizures
Simple focal seizures: The person remains aware but may experience unusual sensations, like atypical tastes or visual distortions.
Complex focal seizures: These can affect consciousness or awareness, possibly resulting in repetitive behaviors like hand-wringing or lip-smacking.
Generalized seizures
Tonic-clonic seizures: Marked by muscle rigidity followed by rhythmic jerking motions, often associated with a loss of consciousness.
Absence seizures: Cause brief lapses in awareness, often mistaken for daydreaming.
Myoclonic seizures: Involve sudden jerky movements, which may affect the limbs or body as a whole.
Atonic seizures: Result in a sudden loss of muscle tone, causing falls or head drops.
The impact of seizures
The consequences of epilepsy may extend beyond physical symptoms.
Individuals with epilepsy frequently contend with elevated rates of mental health issues, notably increased anxiety and depression.
In fact, the risk of premature death for those with epilepsy is up to three times greater than that of the general public, with the highest risks found in low-income areas.
Treatment and care
While epilepsy is a chronic condition, seizures can often be effectively managed through medication.
“The main treatment for epilepsy consists of antiseizure medications, which enable up to 70% of individuals to live seizure-free,” Dr. Hadebe states.
“In certain cases, when medications do not suffice, alternative treatment options such as surgery, vagus nerve stimulation, or responsive neurostimulation can aid in managing seizures.”
Many regions struggle with a lack of affordable antiseizure medications, and healthcare providers often lack the training necessary for accurate diagnosis and treatment of epilepsy.
The World Health Organization (WHO) seeks to address this gap by training primary healthcare professionals to diagnose and manage epilepsy, a method proven effective in pilot programs in nations like Ghana and Myanmar.
Prevention
Research indicates that up to 25% of epilepsy cases could be preventable.
Preventative measures such as reducing injuries, improving prenatal care, decreasing rates of stroke and infections, and managing conditions like hypertension and diabetes can help lower the incidence of epilepsy.
In tropical areas, combating parasitic diseases such as neurocysticercosis is crucial in diminishing the prevalence of epilepsy.
The impact of diet on epilepsy management
Diet can play a significant role in managing epilepsy.
The ketogenic diet, which is high in fats and low in carbohydrates, has been shown to greatly reduce seizure frequency in both children and adults.
This diet encourages a metabolic state called ketosis, where the body uses fat for energy instead of carbohydrates, helping to stabilize brain functioning.
For those who do not respond well to the ketogenic diet, alternatives like the Modified Atkins Diet or Low Glycaemic Index Treatment (LGIT) can also be effective.
Additionally, ensuring adequate consumption of omega-3 fatty acids, vitamin D, and magnesium may support brain health and lower the risk of seizures.
Further research is necessary to fully comprehend the effects of diet on epilepsy, yet these dietary strategies serve as a vital complementary approach alongside medical treatments.
Social stigma and Human Rights
Dr. Hadebe highlights that societal stigma surrounding epilepsy poses a significant barrier to care.
“Many individuals with epilepsy face discrimination, illustrated through myths about the disorder, biases in the workplace, or limitations on their legal rights,” notes Dr. Hadebe.
“The issue is so pressing that the hashtag #StampOutStigma has been adopted by Epilepsy South Africa.”
“In some regions, individuals with epilepsy face hurdles in obtaining marriage licenses, finding employment, or even driving.”
“Tackling these issues requires enhanced public awareness and legislation to protect the rights of those with epilepsy, ensuring they receive fair treatment in all aspects of life.”
Epilepsy remains a global health challenge that affects millions, especially in low and middle-income countries.
The global community, led by organizations like WHO, persists in its efforts to reduce the worldwide burden of epilepsy.
By understanding the causes, types, and available treatments, along with addressing social stigma, we can cultivate a more inclusive environment for those living with epilepsy.
It is time to bring the obstacles of epilepsy into the light of understanding, compassion, and support.
What to do if someone has a seizure
- Stay calm and avoid panic.
- Keep bystanders calm and maintain a clear space around the individual.
- Remove any hard or sharp objects nearby.
- Position the individual on their side to help keep their airway open.
- Do not attempt to restrain them or interfere with their movements.
- Avoid putting anything in their mouth.
- Check if they have a medical bracelet with pertinent health information.
- Time the seizure duration using your watch.
- Call for emergency assistance if the seizure lasts longer than five minutes, if the person remains unresponsive for more than five minutes afterward, or if another seizure occurs immediately after the first.
