VC, a 26-year old fashion designer, is full of life. Everything is apparently fine with her but for the occasional convulsions she experiences. She gets confused after most episodes of seizures. This is in addition to the bruises she sustains. She convulsed while she was being proposed to. She had been avoiding medications to prevent seizures.
What is a seizure? Seizures are involuntary abnormal changes in behaviour of the affected individual due to erratic electrical discharges in the brain. It can occur in any age group, and affects both sexes. The stigma it causes makes persons who have recurrent seizures to be withdrawn. Some even deny its existence. The denial is more of a problem than the disease itself because the affected person will only seek attention if the condition had been acknowledged.
Any individual who experiences seizures needs to be evaluated closely to identify the cause. If the exact cause is found, appropriate treatment makes the person better. He or she may not have another seizure especially if only one episode had been observed. Individuals who have recurrent episodes of seizure are regarded to have seizure disorder.
What are the common causes of seizure? Some cases of seizures are temporary, meaning that once the cause is identified and managed appropriately, the individual may not have another episode of seizure. Some cases are recurrent.
- Infections: Severe malarial infection as found in cerebral malaria may cause seizure. Bacterial, fungal, and also viral infections affecting the brain can cause seizure as a manifestation of the disease. In small children between 6 months and 5 years of age, elevated body temperature may also cause seizure. With appropriate treatment, the individual may not have another episode of seizure in his/her lifetime.
- Brain injury. Some individuals experience seizures later in life as a result of injury sustained during birth leading to poor oxygen supply to the brain. Brain damage from severe jaundice in the first four weeks of life may also cause some irreversible changes in the brain that result in seizures later in life. Physical injury to the brain sustained during accidents may cause seizure in the future.
- Brain tumours: Some cancers involving the brain may have seizure as one of the symptoms the individual experiences.
- Metabolic diseases: Some rare medical conditions are characterized by poor metabolism of nutrients, especially carbohydrates and lipids. Seizure may be one of the symptoms of these rare diseases.
- Withdrawal state of drug abuse: The brain of persons who abuse illicit drug is most times in a state of apparent quiet depending on the particular drug that is abused. Inability to use the drugs over a period of time results in what is called withdrawal symptoms. These symptoms may include seizures.
- Stroke: Having suffered shortage of blood supply, parts of the brain may later in life give abnormal electrical discharges manifesting as seizures.
What are the perceptions and attitudes regarding seizures?
1. Most individuals do not understand the facts explaining the seizures. Some persons in developing countries think it is a ”spiritual attack.” This belief prevents orthodox treatment until it is late.
2. Some feel it is contagious. This belief makes unaffected persons avoid those who experience seizure. Seizure is not contagious.
3. Individuals who clench their teeth during seizures have had several objects stuck into their mouth to keep the teeth apart. It is believed that teeth clenching causes death. This opinion is false.
4. Some persons would prevent individuals who experience seizures from getting involved in physical and pleasurable activities. This is wrong. This act will easily make seizure patients get depressed. They can live their lives to the maximum fulfillment so long they understand that they would need rescue care if seizure occurs.
What ways do seizures manifest? The following are suggestive that an individual might be having seizures.
– Involuntary convulsions.
– Fainting attacks.
– Brief confusion.
– Abnormal staring of the eyes, especially in children.
– Bizarre behaviour, thought to be caused by mental health disease.
How are seizures managed? First aid care when seizures occur include keeping the environment safe around the seizing individual. With support of other witnesses, the patient should be rolled on their side with a chin lift to help keep the airway open.
The patient should be taken to the hospital as soon as possible for proper attention. Treatment includes use of medications for a long time. Some individuals discontinue their medications because they have been well only to experience seizure. In a few cases, brain surgery may be required. Some individuals know what triggers their seizures. These triggers, like bright light, or watching very fast moving objects, should be avoided.
Take-home message. Seizure raises alarm that the individual requires comprehensive evaluation to identify what problem he or she has. People should beware of myths and seek orthodox treatment in time.
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the Medical Director/Chief Executive Officer of Nathaniel Health Consulting (a family hospital), Matogun, Ogun State. He is the editor-in-chief of The Family Doctors. He can be contacted via firstname.lastname@example.org