Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures can also vary in frequency, from less than 1 per year to several per day.
One seizure does not signify epilepsy (up to 10% of people worldwide have one seizure during their lifetime). Epilepsy is defined as having two or more unprovoked seizures. Epilepsy is one of the world’s oldest recognized conditions, with written records dating back to 4000 BC. Fear, misunderstanding, discrimination and social stigma have surrounded epilepsy for centuries. This stigma continues in many countries today and can impact on the quality of life for people with the disease and their families.
Facts about Epilepsy
- Epilepsy is a tendency to have recurring seizures.
- Epilepsy can affect anyone. Any age, any background, any level of intelligence.
- Epilepsy in not contagious.
- There are many different seizure types and seizure syndromes. Epilepsy is not just one condition; there are many forms of epilepsy.
- Most people with epilepsy can live a perfectly normal life and do most things everyone else can do, with the help of simple safety measures where appropriate.
Terminology and labels to be avoided that may help reduce stigma:
- Disorder- epilepsy is a disease, not a disorder.
- Illness- epilepsy is a neurological condition, not an illness.
- Fit- the term seizure is preferred. There are many different types of seizures. A convulsion is a term for a seizure involving stiffening and jerking of the body. ‘Fit’ implies willful outbursts, like a ‘tantrum’, or loss of emotional control.
- Victim or sufferer – this implies someone who is helpless. Most people with epilepsy want your understanding, but not your pity.
- Epileptic – the person is a human being first, a person with epilepsy second. A person with epilepsy is a more appropriate term to use. Like most of us, people with epilepsy dislike labels. These feelings can be explained by the phrase ‘epilepsy is what I have, not who I am
Signs that a tonic-clonic seizure has stopped are:
Jerking stops
Breathing returns to normal
Color returns
What to do if someone has a tonic-clonic seizure
Once a seizure starts it will usually stop on its own.
- Keep calm
- Check the time to see how long the seizure lasts
- Move any objects that could cause injury
- Put something soft like a rolled-up jacket or cushion under the persons head to prevent injury
- Maintain the person’s airway by wiping away any vomit or saliva, and/or tilting the head slightly backwards (this can usually only be done after convulsions have stopped)
- Loosen tight clothing around the neck
- Remove glasses
- Stop other people crowding around
- Check for medical identification as this may have more information on the persons epilepsy
- Turn the person onto their side into the recovery position as soon as the jerking stops
- Protect the persons privacy, particularly if they have emptied their bladder and/or bowels
- Speak softly and gently when you tell the person what has happened
- Remember they may be confused after a seizure
Some people with epilepsy will have a care plan or epilepsy profile. This will have detailed information about their seizures and information on how best to support the person. You can refer to this during a seizure
Do not move the person unless they are in danger, eg on a busy road or at the top of stairs
Do not try to stop the jerking or restrain the person
Do not put anything in the person’s mouth or between their teeth
Do not offer the person anything to eat or drink until they are fully conscious
When to call an ambulance or rush the person to the nearest hospital
- This is the persons first seizure as far as you are aware
- The person has injured themselves beyond first aid
- You suspect they may have inhaled food or liquid
- The jerking lasts for five minutes or a longer time than is usual for that person
- One seizure follows another with no recovery time in between
- The person is having problems breathing after the seizure
Treatment
There is no known cure for epilepsy, developments in treatment have made it possible for most people to achieve seizure control. The first treatment step is usually to find the right medicine or Anti-Seizure Medication (ASM).
There are different Anti-seizure medication that can stop or prevent seizures. Anti-seizure medications successfully control seizures for about 70% of people with epilepsy.