Understanding Epilepsy

Encountering epilepsy for the first time can be a frightening experience, especially for a parent whose child has a seizure. Mickey McCamish, executive director of the Epilepsy Foundation of Southeast Tennessee, knows this all too well. His son, a popular student and star athlete, had his first seizure at the age of 14.

“I even asked the principal if he was certain he was calling the right parent,” McCamish says. “It just didn’t fit with what we knew about our son who was the picture of health. That is how my family and I met epilepsy.”

According to the Epilepsy Foundation, epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. Also called a seizure disorder, a person is considered to have epilepsy after having two or more unprovoked seizures. Epilepsy affects about 2.5 million Americans.

While epilepsy can occur at any age, it is more likely to begin in early childhood or after age 65; men are slightly more at risk than women. While epilepsy is a neurological disorder, it is not a psychological one, and epilepsy is not contagious.

By Pamela Boaz

Seizures and Epilepsy

Say the word epilepsy, and most people visualize a grand mal seizure in which a person loses consciousness, becomes stiff, shakes violently and loses control of bodily functions. Actually, there are many types of seizures, and their symptoms can vary from a momentary disruption of the senses to short periods of unconsciousness or staring spells to convulsions.

Seizures happen when the electrical system of the brain malfunctions, according to the Epilepsy Foundation. Instead of discharging electrical energy in a controlled manner, the brain cells keep firing. The result may be a surge of energy through the brain, causing unconsciousness and contractions of the muscles.

Researchers classify seizures into two broad groups, partial and generalized seizures.

Partial seizures result from abnormal activity in one part of the brain and are classified as simple partial or complex partial. While simple partial seizures do not result in loss of consciousness, they may cause involuntary jerking of an arm or leg, a change in emotion or sensory input, or a tingling sensation or vertigo. Complex partial seizures alter one’s consciousness, resulting in staring or non-purposeful movements, such as hand rubbing.

Primary generalized seizures seem to involve all of the brain and include grand mal or tonic-clonic seizures. Petit mal or absence seizures fall into this category. These seizures result in staring and can cause a brief loss of consciousness. Myoclonic seizures usually cause sudden jerks or twitches of arms and legs. The fourth type of generalized seizure, commonly called a “drop attack,” causes a person to lose muscle control and suddenly fall down.

With the exception of very young children and the elderly, the cause of the abnormal brain function is usually not identifiable. In about seven out of 10 people with epilepsy, no cause can be found. Among the rest, the cause may be any one of a number of things that can make a difference in the way the brain works. Head injuries or lack of oxygen during birth may damage the electrical system in the brain. Other causes include brain tumors, genetic conditions, lead poisoning, problems in development of the brain before birth, and infections like meningitis or encephalitis.

Genetics seem to play a part in some forms of epilepsy. Evidence indicates that people who have generalized epilepsy are somewhat more likely to have other family members who have seizures than those with partial epilepsy. Parents with a history of generalized absence seizures are more likely to have children with the same condition.

When a first-time seizure occurs and the person is taken to an emergency room, he or she will likely have a computerized tomography (CT) scan. CT scans determine if emergency steps should be taken because of a tumor or bleeding in the brain. If emergency treatment is not indicated, a referral will likely be made to a neurologist who may order blood tests and neurological exams. Tests may include an electroencephalogram (EEG), which detects brain patterns and helps determine appropriate medication, or magnetic resonance imaging (MRI), which offers a more sensitive view of the brain. It is only after a second episode that medication is indicated.

Living with Epilepsy

While there is no cure for epilepsy, 60 percent of those diagnosed have their seizures controlled with a single antiepileptic drug. For others, the frequency and severity of seizures can be reduced.

Many children ultimately outgrow their seizures, and some adults who have had no episodes for two to three years can discontinue medication.

Understanding epilepsy and knowing how to react helps everyone.

“The bravest person I know is a local high school student (who suffers from epilepsy) who invited me to talk to her youth group at church and then to the students at her high school,” says Aubree Sullivan, education services director for the Epilepsy Foundation of Southeast Tennessee. “Students look to the teacher to know how to react to a seizure. If the teacher doesn’t know what to do, the students definitely won’t.”

Training is available for law enforcement personnel to help them interpret behavior associated with epilepsy. A complex partial seizure can look like intoxication. Attempting to restrain a person having this type of seizure or expecting verbal communication can make the situation worse for the person and the police officer.

People with epilepsy almost always carry their medication with them. Knowing which medications are prescribed for the treatment of epilepsy can help officers determine if a person is in legal possession of the drugs.

The Epilepsy Foundation organizes support groups for people with epilepsy, as well as for parents of children who have been diagnosed. The foundation can also assist those who have financial difficulties in paying for treatment and medications.

Dr. Paul Knowles, a neurologist at T.C. Thompson Children’s Hospital, says that awareness is critical for parents of children who have a seizure or who have been diagnosed with epilepsy. “First, don’t panic,” Knowles says. “The vast majority of seizures are self-limiting, which means they will stop on their own.”

Knowles advises that if a child is having a seizure, turn the child on her side or, in the case of infants, onto her tummy. The child should be protected by moving furniture or objects that might be in the way. Finally, he emphasizes the importance of timing the seizure. “It is difficult to think to check a clock at a time like this, but the emergency room doctor will ask how long the seizure lasted – usually a 1 to 2 minute seizure is benign,” Knowles explains.

Knowles stresses that, for many people living with epilepsy, lifestyle changes are minimal. Young children should never be left alone in the bath tub, and showers are recommended for older children and adults, instead of baths. Activities such as swimming should not be done alone. While contact sports and activities that require helmets are not totally off-limits, participation soon after a diagnosis is not recommended and caution should always be taken.

In Tennessee and Georgia, drivers must abstain from driving for six months following their last seizure before operating a vehicle again; however, many people choose to give up driving because they fear hurting themselves or others.

McCamish emphasizes the importance of taking responsibility for one’s own health. He recommends wearing a medical alert bracelet and knowing what triggers seizure episodes.

“Sleep deprivation is the most common trigger,” says Sullivan. “Flashing lights can be triggers, as can alcohol use. It’s not the alcohol itself. It’s the effect of alcohol on the medication.”

The slogan of the Epilepsy Foundation is: Not another moment lost to seizures. “There is hope,” says Sullivan, reminding anyone living with epilepsy that they don’t have to settle for a life that’s less than what they want.

Pamela Boaz, a writer and editor, earned a B.S. degree from the University of North Florida and an M. Ed. from UTC. During her more than 30-year career in education, she has served as faculty advisor for student publications and written curricula for a variety of courses. Pam also works as Professor-in-Residence for UTC, supervising student teachers.