Let’s color the world purple and erase the stigma of epilepsy. Epilepsy is an indiscriminate disease. It has many variations in presentation. It impacts the lives of everyone around. Epilepsy kills.
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It is also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy. Epilepsy may briefly alter a person’s consciousness, movements or actions.
Most people are familiar with the sudden jerking motions. The seizures are known as Tonic-Clonic, formerly referred to as Grand Mal seizures.
Staring spells, lip smacking, and ticks are signs of Absence seizures. These were formerly referred to as Petit Mal seizures. There are no convulsive movements. The person is unaware of their surroundings. And when the seizure is complete; they are back in time to where ever the conversation or activity left off prior to seizing.
Drop seizures are just that. A child suddenly collapses and falls. It can be from the body stiffening or the opposite — a complete loss of muscle tone. These seizures can cause injuries, including head injuries, because of the force of the fall. Therefore, doctors often recommend that children who get these kinds of seizures wear helmets while playing, especially outdoors. After an atonic or tonic seizure is over, usually in less than a minute, the child regains consciousness and awareness.
Infantile Spasms (West Syndrome) is a rare form of epilepsy primarily afflicting baby boys. These seizures present with the baby’s arms and legs thrusting away from the body and becoming stiff. The baby screams in bursts. This has a distinctive EEG pattern.
Gelastic Seizures are extremely rare. They are otherwise referred as “Laughing seizures”. These spells may last up to thirty minutes. The child starts laughing uncontrollably and for no apparent reason.
Lennox-Gastaut Syndrome is a severe form of epilepsy. Seizures usually begin before 4 years of age. Seizure types, which vary among patients, include tonic (stiffening of the body, upward deviation of the eyes, dilation of the pupils, and altered respiratory patterns), atonic (brief loss of muscle tone and consciousness, causing abrupt falls), atypical absence (staring spells), and myoclonic (sudden muscle jerks). There may be periods of frequent seizures mixed with brief, relatively seizure-free periods. LGS can be caused by brain malformations, asphyxia, head injury, or infection. In 30-35 percent of cases, no cause can be found.
Pyridoxine-dependent epilepsy (PDE) is a rare cause of stubborn, difficult to control, (intractable) seizures appearing in newborns, infants and occasionally older children. PDE presents in a variety of forms with variable signs and symptoms. The one clinical feature characteristic of all patients with PDE is intractable seizures that are not controlled with anticonvulsants but which do respond both clinically and usually on EEG (electroencephalographically) to large daily supplements of pyridoxine. These patients are not pyridoxine-deficient. They are metabolically dependent on the vitamin. In other words, even though they get the recommended daily allowance (RDA) of pyridoxine from their normal diet, they require substantially more of the vitamin than an otherwise normal individual. Patients with PDE require pyridoxine therapy for life.
Dravet syndrome is a severe form of epilepsy. It appears during the first year of life with frequent febrile seizures – fever-related seizures that, by definition, are rare beyond age 5.
Sudden Unexplained Death- People with epilepsy have an increased risk of dying suddenly for no discernible reason. Sudden Unexplained Death can occur at any age. Researchers are still unsure why sudden unexplained death occurs; it may not be a direct result of a seizure. Recent research points to abnormal heart and respiratory function due to gene abnormalities. Not taking the prescribed dose of medication on a regular basis may increase the risk of SUDEP in individuals with epilepsy, especially those who are taking more than one medication for their epilepsy. One study suggested that use of more than two anticonvulsant drugs may be a risk factor. However, it is not clear whether the use of multiple drugs causes the sudden death, or whether people who use multiple anticonvulsants have a greater risk of death because they have more severe types of epilepsy.
Epilepsy is diagnosed using EEG monitoring, lab tests, brain scans, medical history, and Developmental, Neurological, and Behavioral Tests.
EEG Monitoring
An EEG records brain waves detected by electrodes placed on the scalp. This is the most common diagnostic test for epilepsy and can detect abnormalities in the brain’s electrical activity. People with epilepsy frequently have changes in their normal pattern of brain waves, even when they are not experiencing a seizure.
Brain Scans
The most commonly used brain scans include CT and MRI. These scans reveal the structure of the brain, which can be useful for identifying brain tumors, cysts, and other structural abnormalities.
Medical History
Taking a detailed medical history, including symptoms and duration of the seizures, is still one of the best methods available to determine if a person has epilepsy and what kind of seizures he or she has.
Blood Tests
Doctors often take blood samples for testing, particularly when they are examining a child. These blood samples are often screened for metabolic or genetic disorders that may be associated with the seizures. They also may be used to check for underlying problems such as infections, lead poisoning, anemia, and diabetes that may be causing or triggering the seizures.
Developmental, Neurological, and Behavioral Tests
Doctors often use tests devised to measure motor abilities, behavior, and intellectual capacity as a way to determine how the epilepsy is affecting that person. These tests also can provide clues about what kind of epilepsy the person has.
It is most important to remember that despite the seizure or syndrome there is a child needing to be loved and cared for. Allow them to live. Allow them to be seen and heard. Cherish them; as they are still God’s perfect gift to you and to their families.
Resources
Epilepsy Foundation LGS FOUNDATION
8301 Professional Place 129 Lexington Avenue Suite 216
Landover MD 20785 New York, NY 10016
Tel.: 1 800 323 1000 Tel: 1 718 374 3800
Fax: 1-301-577-2684 E-mail: info@lgsfoundation.org
Español: 1-866-748-8008
Hospitals
Johns Hopkins, Vanderbilt University, Texas Childrens Hospital
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