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Understanding Epilepsy: How to Help

When it comes to misunderstood diseases, epilepsy is at the top of the list.

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When it comes to misunderstood diseases, epilepsy is at the top of the list. Erroneous beliefs abound when it comes to this physical condition, which occurs when there is a sudden, brief change in the brain's inner workings, leading to epileptic seizures. Popular myths include: that you can swallow your tongue during a seizure; that you should force a pencil into the mouth of a person having a seizure; that individuals with epilepsy are mentally disabled; and that epilepsy is rare.

But epilepsy is far from rare. In fact, more than 2.5 million Americans have epilepsy - worldwide, that number surges to 40 million. In the United States, an additional 181,000 people of all ages, races and ethnic backgrounds will develop seizures and be diagnosed with epilepsy for the first time every year.

"Epilepsy and epileptic seizures are far more common than people realize,"
said epilepsy expert Jerome Engel, Jr., M.D., Ph.D., Jonathan Sinay Professor of Neurology and Neurobiology at the David Geffen School of Medicine at UCLA, chief of epilepsy and clinical neurophysiology at the UCLA Center for the Health Sciences, and director of the UCLA Seizure Disorder Center, Reed Neurological Research Center, Los Angeles. "This is a disease that strikes the young, often children,"
Dr. Engel says. "This means years and years of disability, lost years of good quality of life and lost earnings. When these elements are factored in, the impact of epilepsy worldwide is equal to the impact of breast cancer in women and lung cancer in men."

Epileptic seizures, Dr. Engel says, are a sign of brain dysfunction. Simply put, a seizure can be viewed as an overactivity in the brain. "Epilepsy is the chronic condition that results when these brain disturbances persist."
Early diagnosis and treatment are vital, he says, in order to prevent irreversible damage.

Dr. Engel spoke at a recent American Medical Association (AMA) media briefing during which the Academy of Neurology and the American Epilepsy Society released the first comprehensive, unbiased guidelines to assess the safety and efficacy of the newest epilepsy drugs and compare them to older drugs. The AMA and its partners hope to raise awareness of epilepsy, a disease often misunderstood by the public and not openly discussed due to a social stigma.

"Uncontrolled epilepsy presents an enormous personal burden,"
said Dr. Engel. "Seizures happen without warning and are frightening and embarrassing; they can result in accidental injury or even death. Imagine the restrictions this places on an active life. A person with epilepsy can't drive a car, hold certain jobs or participate fully in recreational activities."

The most destructive misperception about epilepsy, Dr. Engel said, is that it cannot be effectively treated. "Even physicians often believe that seizures can't be stopped, leading to treatment delays that can result in preventable, irreversible disability,"
he said. "Our treatment objectives should be no seizures, no side effects and the earliest possible intervention."

In the last decade, there has been an upsurge in epilepsy research. New drugs have changed the way the disease is treated and the quality of life for people with epilepsy. The American Academy of Neurology and the American Epilepsy Society have assembled the top experts in the field to evaluate 1,462 research articles to create the first guidelines that help physicians choose among the new and old drugs to select the best drug for each patient based on that patient's age, gender, type of epilepsy and other factors. This new information will change the way epilepsy is treated in the United States.

Says AMA Board of Trustee member and Newark, N.J. pediatric neurosurgeon Peter W. Carmel, M.D., "Epilepsy certainly is treatable and after many years in which there were just a handful of effective medications, there has been an explosion in new medicines, many of which appear to be very effective in controlling many patients' seizures."

It is important to note that an individual may experience a single seizure without any real, underlying brain abnormality, Dr. Carmel says. Such seizures are not uncommon in children, particularly in those with high fevers, and, he said "there may be no implications for further seizures during the patient's life."

Increasing attention is also being paid to the use of surgery for the control of some types of seizures, Dr. Carmel said. "While this is an old concept, dating back to the last decade of the 19th century, the new forms of brain imaging and the more accurate recording of abnormal electrical activity in the brain have allowed surgeons the opportunity to remove abnormal portions of brain that "˜trigger' the epileptic seizure."

Dr. Carmel has performed such surgeries many times and said that, when successful, "it's the difference between night and day. People who have even rare seizures find them to be embarrassing, socially disabling and even dangerous. The idea of being truly seizure-free is extremely rewarding and liberating for these patients, whether the successful treatment is surgery or drug management."

Helping Someone during a Seizure

Most seizures end naturally without emergency treatment; if you are called on to provide first aid for someone having a seizure these are the key things to remember:

* Stay Calm

* Don't hold him or her down

* Loosen necktie

* Cushion the head with something flat and soft

* Turn the person on his or her side

* Put nothing into his or her mouth

* Look for ID

As seizure ends naturally, offer help.

Courtesy of ARA Content

EDITOR'S NOTE: Information courtesy of the Epilepsy Foundation.

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