Epilepsy
 
Introduction
 
Around 2 per cent of the population suffers from epilepsy. Most people with epilepsy have had it since childhood. Epilepsy usually starts between the ages of three months and the teens. Around 60 per cent of children with epilepsy grow out of it. Most other people can control their seizures with medication and there is relatively little disruption to their lives.
 
What is epilepsy?
 
Epilepsy is characterised by seizures, sometimes called fits or convulsions. These occur when some of the nerve cells in the brain become overactive, and fire off uncontrolled random signals.

Some people have one seizure and then never have another ever again. People who experience repeated seizures - whether once a year, or several times a day - have epilepsy.

The cause of epilepsy is not known, but it's generally thought to be the result of a chemical imbalance in the brain. People can be more at risk if they have had a stroke, head injury, meningitis or if they have a history of drug or alcohol abuse.

Epilepsy sometimes runs families, and can be the result of a brain injury at birth or rarely due to a brain tumour. In most cases, though, it is not known why some people get epilepsy and others don't.
 
Seizures
 
The main symptom of epilepsy is repeated seizures. Most people have no other symptoms, and live perfectly normal lives.

Seizures normally come on without warning, although they can be triggered by flashing lights, or preceded by an 'aura' - people with epilepsy sometimes report a strange smell, taste or feeling.

There are different kinds of seizures. Some people experience just a fleeting loss of awareness. Others lose consciousness and suffer stiffening or jerking movements in their body and even incontinence.

Seizures can last just a few seconds, or may go on for some minutes, and can be barely noticeable or quite traumatic.
 
Types of epilepsy
 
There are several different types of epilepsy, each with different symptoms.

Primary generalised epilepsy
In this kind of epilepsy, also known as grand-mal epilepsy, nerve cells in both sides of the brain become overactive at the same time. Seizures usually last for about five minutes, and can be frightening.

In a grand mal, people are likely to experience some or all of the following:
  • falling to the ground
  • losing consciousness
  • experiencing stiffened muscles or jerking movements, known as involuntary movements
  • stopping breathing for a few seconds
  • the jaw going rigid, frothing at the mouth and biting the tongue
  • wetting or soiling themselves
  • feeling confused and drowsy when they come round


Absence seizures
Absence seizure, also called petit-mal epilepsy, is not as alarming as grand mal. There may be a loss of consciousness, or more often just a loss of awareness, but this kind of seizure doesn't involve falling down or experiencing involuntary movements. In fact, people may just look as if they are daydreaming.

This kind of seizure is most common in children aged between five and nine. Most grow out of them by the time they are 13.

Juvenile myoclonic epilepsy
During a juvenile myoclonic epileptic seizure, the hands, arms or whole body will start jerking, but the person doesn't lose consciousness or awareness. This type of epilepsy usually develops in late childhood, and it always runs in families.

Temporal lobe epilepsy
Temporal lobe epilepsy has quite different symptoms. They include:
  • making strange faces and noises
  • chewing, swallowing and smacking the lips
  • plucking at the clothes
People may seem to be awake, but they won't respond to what is going on around them
 
Diagnosis
 
To diagnose epilepsy, the doctor will need a detailed description of the seizures íV family members or friends can often help with this.

The doctor may then arrange for some tests. These can include:
  • an EEG (electroencephalogram )
  • a brain scan - either CT (computerised tomography) or MRI (magnetic resonance imaging)
  • blood and urine tests
 
Treatment
 
There is no cure for epilepsy, but drug treatment can control the seizures in around 70 per cent of people. These drugs sometimes have side effects, though, such as drowsiness or a rash.

If someone who has had epilepsy doesn't have a seizure for two years, their doctor may suggest they come off the medication (or reduce the dose).

Very occasionally, in very specific cases, brain surgery may be appropriate.
 
Managing epilepsy
 
People with epilepsy may need to avoid certain activities or jobs where it could be dangerous to have a seizure - most obviously, things like flying a plane, but also, for example, operating certain machinery, riding a bicycle in busy traffic, or swimming alone. People who are diagnosed with epilepsy cannot drive until their doctor confirms that their seizures are under control.

If a child has epilepsy, it is important to ensure he or she doesn't get too tired. Older children and adults may benefit from relaxation and anti-stress exercises.

It's also a good idea for someone with epilepsy to carry a card, necklace or bracelet which says that they have epilepsy. Family, friends, teachers and colleagues should be told what to do in the event of a seizure.
 
If someone has a seizure
 
If someone has an epileptic seizure while you are present - if they lose consciousness or suffer convulsions - protect them from injury by doing the following:
  • asking onlookers to keep back
  • loosening clothing around their neck
  • cushioning their head

When the convulsions stop, put them in the recovery position. After they regain consciousness, let them rest quietly in a safe place.

Do not try to move or restrain the person, or put anything in their mouth. Do not give them anything to drink until they are fully conscious again.

You should call an ambulance only if any of the following happen:
  • the seizure lasts more than five minutes
  • the convulsions happen again without the person regaining consciousness
  • the person injures themselves during the seizure
If someone has a seizure that does not involve loss of consciousness, do the following.
  • help them to sit down in a quiet safe place
  • talk to them calmly and reassuringly
  • stay with them until they feel well again
 
Further information
 
Enlighten Action for Epilepsy (Support Group)
1/F, Tang Chi Ngong Clinic,
Wanchai.
Hotline: (852) 2820 0111
Fax: (852) 2538 9873

The National Society for Epilepsy
http://www.epilepsynse.org.uk/

The British Epilepsy Association
http://www.epilepsy.org.uk/

The Epilepsy Foundation
http://www.epilepsyfoundation.org/

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/health_and_medical/disorders/
 
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
 
 
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