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Epilepsy, what you need to know

Epilepsy, what you need to know - MediHub KZN

Epilepsy is a condition many are aware of. However, numerous people are uncertain about the causes of epilepsy and which steps need to be taken to address the ailment.

The National Office of Epilepsy South Africa explains, “Epilepsy is a tendency to have recurrent seizures (convulsions), which occur when there is an abnormal electrical discharge in the brain.”

These seizures may be prompted by either a chemical imbalance or structural abnormality. Moreover, Epilepsy SA elaborates that the term “epilepsy” covers a range of seizure types which may differ not only in cause and nature, but in severity, management, and long-term outcome as well.

“When looking at the causes of the disorder, Epilepsy SA highlights numerous possible causes, all of which one’s doctor will consider when making their diagnoses. “However, in most cases, the cause cannot be determined even after careful assessment (this is known as idiopathic epilepsy).”

Common Childhood Epilepsies

When diagnosing an individual with epilepsy, according to Epilepsy SA, the various variants of epilepsy can be divided into two categories, which are:

  • Generalised seizures involving the entire brain and usually characterised by some loss of consciousness (however brief).
  • Partial seizures. These originate in a particular part of the brain and may or may not involve a loss of consciousness.

Diagnosis

The Foundation stresses that diagnosing epilepsy can be difficult. Yet a correct diagnosis must be made. Epilepsy SA explains that diagnostic mistakes can happen, as doctors seldom witness seizures first-hand. Therefore, parents (or other observers) need to describe the episodes as accurately as possible and the circumstances in which they occurred.

In some cases, EEG monitoring over an extended period can help discover epileptic activity in the brain at the time of the seizure or to identify the nature of non-epileptic seizures.

Accurate descriptions can also help classify the type of seizure, establishing whether special investigations (such as CT scanning) are required and the best treatment options.

Treatment

According to the National Office of Epilepsy South Africa, the following forms of treatment are used for treating epilepsy:

  • Medication

In most cases, anti-epileptic drugs achieve reasonable seizure control without causing harmful side effects.

  • Surgery 

Some epileptic children will be suitable candidates for surgery, given improved investigations and the availability of new surgical techniques. Surgery is a delicate and complicated option that may remove the brain’s area producing seizures or splitting some connections in the brain.

  • Ketogenic diet

This is a high fat (75%), low carbohydrate (5%) diet, including 20% protein. It is most effective in children and not typically used in adults. The diet is also generally not a long-term option (1-2 years) and requires strict adherence. The process usually starts with hospitalisation and fasting and may enable the reduction of medication.

  • VNS therapy

VNS therapy is delivered by a small device similar to a pacemaker that sends mild electrical pulses to the neck’s vagus nerve, which sends these electrical pulses to the brain. These periodic pulses are delivered all day, every day to potentially reduce or eliminate seizures.

When looking at diets and possible supplements to minimise seizures, Epilepsy Society (the UK’s leading ‘provider of epilepsy services) adds, “Although there is little evidence that a balanced diet has a direct effect on seizures, it provides essential nutrients and keeps our energy levels steady. A balanced diet may also help you to keep a regular sleep pattern and keep active, both of which are good for overall health.”

Furthermore, the society claims, “Getting enough sleep may help to reduce the risk of seizures for some people. A diet that suits you may help you to feel positive, more able to focus and more in control of your life and decisions about managing your epilepsy.”

As with the National Office of Epilepsy South Africa, the Epilepsy Society also refers to the ketogenic diet.

The society stresses that while this diet is mostly used with children, it must not be done without the supervision of a dietitian and an epilepsy specialist. If you suspect a loved one has epilepsy or they are having seizures, be sure to visit your local doctor to take the necessary steps.

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