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Shakes, A Fall and More Shakes

               Taiwo was delighted, he hadn’t been this happy in a long while. His new girlfriend, Bisola would be visiting him today for the first time. He met Bisola a week ago in an inaugural lecture organized on campus. He was of the school of thought that only geeks and nerds attended such events, as pretty girls preferred to attend beauty pageants, fashion shows and musical concerts. But this was something new, she was tall and dark skinned with high cheekbones and she sauntered with the grace of a supermodel to occupy the seat next to him. The rest was history. Now, hundreds of hours of voice calls and thousands of text messages later, she would be paying him a visit. He had cleaned his room and fixed his disco light bulb, with love songs blasting from the surround speakers setting the right mood. A soft knock on the door brought him out of his doldrums, and he opened the door to let her in. She looked prettier than ever, her fragrance filling the entire room. But as soon as she stepped in, she started shaking, fell and continued shaking, foaming at the lips and peeing on herself. Taiwo was shocked and scared to touch her as he had heard from his grandparents that epilepsy was contagious, so he ran out screaming for his neighbours. What really was wrong with Bisola? What could have triggered her fall and seizures? Was it really contagious?

                Epilepsy is the fourth most common brain related condition in the world. It affects 1 in 26 people and at any given time, between 2.2 and 3 million people are being treated for epilepsy. One is diagnosed to have epilepsy when he/she has had 2 or more unprovoked seizures at least 24 hours apart. A seizure is a sudden surge of electrical activity in the brain that usually affects how a person acts for a period of time. Normally, there is a balance between two types of chemicals in the brain, the inhibitory chemicals and excitatory chemicals. A seizure usually happens when there is an imbalance between these chemicals. Not all seizures are easily noticeable while others are vivid.

                The cause of epilepsy varies largely by age, many without a clear cause usually have a genetic basis. However, half of patients diagnosed with epilepsy have no unknown cause. A patient experiencing recurrent episodes of seizures would benefit from neurological consultation and investigations such as CT Scans/MRI and Electroencephalography. This would help determine what kind of epilepsy the person has and tailor treatments. Common causes of seizures based on age are listed below.

  • New-borns:  Brain malformations, lack of oxygen, low sugar levels, problems with electrolytes such as calcium and magnesium, drug abuse by mothers during pregnancy.
  • Infants/Children: Infections, fever (febrile seizures), brain tumours.
  • Teenagers/Adults: Genetic causes, Head Injuries, Congenital conditions such as Down’s syndrome, Drug Abuse (cocaine).
  • Elderly: Head injury, Stroke, Alzheimer’s disease.

                In those already diagnosed with epilepsy, seizures are usually triggered by missing medication, poor sleep, illness, psychological stress, abuse of alcohol or recreational drugs such as cocaine and ecstasy, nutritional deficiencies, poor eating habits, menstrual cycle and hormonal changes, flashing lights or patterns and loud noises. Individuals diagnosed with this condition would do well to avoid these triggers to reduce the occurrence of seizures. The risk of developing epilepsy is higher in individuals who have relatives with this condition, however the risk for passing the condition to one’s children is extremely low. This risk is higher for epilepsy with genetic causes and generalized epilepsy which affects both parts of the brain involves more genetic factors than partial or localized epilepsy.

                When someone has had a seizure, it is important to know what to do and what not to do. It is important to time the length of seizure and stay with the person throughout the seizure, also turn the person to their side and remove objects which could harm the person. The person should seek for medical help after the episode. If the seizure lasted for greater than five minutes, if there is difficulty breathing or an injury occurred during the seizure, they require urgent medical attention. Do not put anything in the person’s mouth (spoons, liquids), do not burn the person with fire or pour oils. It is also important to keep onlookers away as this might have a negative psychological effect on the individual when they recover from the seizure. Reassurance of the person after recovering from the seizure is also important. It is worthy to note that epilepsy is not contagious and so we should not avoid contact with those having seizures.

                Drugs are the primary way in which epilepsy is treated. These drugs are called anti-epileptic drugs (AEDs) and different drugs are used for different types of seizures/epilepsy. These medicines help to control epilepsy to a large extent in a majority of patients. Other ways of treating epilepsy include the use of special diets called ketogenic diets and stimulation of certain areas within the brain. Also, surgeries such as removal of portions of the brain severely affected have helped sufferers of epilepsy resistant to drugs to become seizure free.

                It is important to note that people living with epilepsy have issues beyond just the seizures. They have psychological problems, learning problems and stigma based issues. These should be taken into consideration when dealing with them, they deserve our empathy, compassion and love. Epilepsy should not be an albatross, as in all chronic conditions, learning to live with the condition is key. People diagnosed with epilepsy should ensure they observe regular clinic visits, compliance with prescribed medication is important and avoiding known triggers is a major key. One does not have to take AEDs for the rest of their life, adherence to medication can lead to being seizure free for years. Gradual discontinuation of drug therapy can be discussed when a patient has been seizure free for at least 5 years. Also associating with individuals having epilepsy to discuss how they are coping with the disease is of importance. We hope that in the future science would have a quick fix for epilepsy, but till then we should live with it.

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