Thursday, November 29, 2007

 

People with epilepsy can live normal lives

Epilepsy is among the most serious, life threatening illnesses neurologists must treat. Epileptic seizures are even described in the early writings of Hippocrates in 480 BC. He was the first to use the term aura (the Greek word for breeze) to describe the feeling that often precedes an epileptic seizure.
Epilepsy is a disorder of the central nervous system in which seizures are the main symptom. Seizures can be epileptic or non-epileptic in origin. Some epileptic seizures are provoked by fever, sleep deprivation, or alcohol withdrawal. Others are the result of a physiological abnormality in the brain which causes an electrical “short-circuit” that can last from seconds to minutes. Partial seizures begin in a specific area of the brain before spreading. Generalized seizures begin diffusely without a focal origin.
Neurologists take a detailed history and perform a neurological examination when they suspect a patient has epilepsy. The examination is supplemented with an MRI or other imaging study of the brain and an electroencephalogram (EEG). An EEG evaluates normal and abnormal electrical discharges in the brain circuitry.
The most effective way of controlling epileptic seizures is with anticonvulsant medications. They work by suppressing abnormal electrical discharges. The earliest anticonvulsants were used in the late 19th century with side effects of sedation and slowed mentation giving the impression that people with epilepsy were mentally deficient. The advent of newer anticonvulsant drugs that did not produce sedation showed the world that those with epilepsy could lead normal, successful lives.
Violent movements, along with loud vocalizations, led many to believe these people were possessed by the devil. When someone does suffer a generalized seizure, it is frightening for the patient as well as for those who witness the event. Preventing harmful injury rather than uselessly attempting to abort the seizure is the principal rule. Some helpful first-aid tips to assist someone having a generalized tonic-clonic (grand mal) seizure are:
1. Help the person into a prone position, cushioning the head and face
2. Remove eyeglasses
3. Clear area of harmful objects
4. Loosen tight clothing around the neck
5. Do not restrain the person
6. Do not force any object into the person’s mouth, especially a finger

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org.

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