Pediatrics in Brevard: Here's what to know about epilepsy, what to do if someone has seizure
More than 3.4 million people in the United States have epilepsy, so it is a relatively common diagnosis.
In fact, it is the fourth-most common neurologic condition in the world.
November is National Epilepsy Awareness Month, and a fitting time for us to seek to better understand this condition.
In this article, we will explore what epilepsy is, how it affects the lives of those who have it, and what we can all do to help.
Epilepsy is defined as the tendency to have recurrent seizures. It is also known as “seizure disorder.”
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A seizure happens when the brain cells, or neurons, malfunction and send electrical signals uncontrollably, kind of like a short in the wiring.
These uncontrollable signals then cause effects on the body and upon behavior, depending on the part of the brain affected by the seizure.
It is no surprise, then, that there are different types of seizures, which occur depending on the part of the brain affected.
Seizure types are divided into 3 major groups:
1. Generalized onset seizures
With these seizures, both sides of the brain have abnormal electrical firing at the same time. Generalized onset seizures include:
Tonic-clonic (aka grand-mal) seizures. The person tends to be unconscious or unaware of things around them, and may have stiffening then jerking of their arms and legs.
Absence seizure, or staring spell. When the person stares into space; these seizures tend to be very brief, less than 10 seconds. The person may look like they are daydreaming, though the eyelids may flutter and the eyes turn upward. This is the most common type of seizure and also an easy one to miss, as the person mayappear to be daydreaming.
Atonic seizures or “drop attacks.” This is another form of generalized onset seizure. With these seizures, all or part of the body becomes limp. The person may drop things or fall to the ground suddenly. These seizuresare usually brief, 15 seconds or less.
2. Focal onset seizures
These seizures start in a group of cells in one area of the brain and the effect of the seizure depends on where in the brain the abnormal firing occurs.
The person may be awake and alert during the seizure, though their awareness may be affected in some way.
Focal seizures are also known as partial seizures.
3. Unknown onset seizure
These are simply seizures in which the area of onset is unknown.
There are many other designations of seizure type, as well.
The seizure types listed above are based upon where in the brain the seizure starts.
Other names for seizure types may be based upon the person’s level of awareness during the seizure (focal awareness, focal impaired awareness, awareness unknown, generalized); or what happens with body movements during the seizure (eg.: tonic-clonic, motor onset, non-motor onset, focal to bilateral tonic-clonic, etc).
Descriptions of the type of seizure can help doctors as well as patients and families understand what is actually happening to a person during a seizure and may give clues as to the underlying cause of the seizure.
What causes a person to have epilepsy?
First, not all seizures are epilepsy.
A person may have a seizure due to a head injury, an illness or another cause that does not lead to recurrent seizures, or epilepsy.
One of the most common types of seizure that does not lead to epilepsy is the childhood febrile seizure, in which a young child (less than 6 years old) has a brief seizure triggered by fever.
While these seizures are very scary, they do not lead to epilepsy or other brain-related problems.
Epilepsy itself may occur due to genetic causes, brain injury, infection, autoimmune problems, metabolic causes, structural causes in which the brain isn’t formed properly, lack of oxygen during birth, maternal drug use duringpregnancy, progressive brain disease, heart or blood vessel disease affecting blood flow to the brain, or other factors.
Regardless of the cause of epilepsy, the seizures themselves can have a significant impact on the life of the person who has them.
It is important for people with epilepsy to follow the recommendations of their neurologist regarding which activities are safe and which are not.
For example, they may not be able to safely drive a car or swim.
People with atonic seizures may need to wear a helmet.
It is important to understand that people with epilepsy can be very intelligent and can typically go to school, have a job and lead a normal lifestyle.
Epilepsy is NOT contagious, and there is no reason at all to fear the person with epilepsy.
What can we do to help those with epilepsy?
First, do not treat your friend or colleague any differently than anyone else.
People with epilepsy are normal people.
However if you witness someone have a seizure, there are some things you can do to help, using the “three S’s”:
Stay. Stay with the person and time the seizure. Call 911 if the seizure lasts longer than 5 minutes, if the person turns blue or has trouble breathing, is in the water, is pregnant, is sick, is injured, is not acting normal after the seizure, if they ask you to get help, if it is their first seizure, or if you have any doubt as to whether you should call 911 or not. Seizures can be life-threatening in some cases, so err on the side of caution and do not hesitate to seek help.
Safe. If you can safely do so, move the person to a safe place (eg out of the water or the street). Do not restrain the person having a seizure and DO NOT put anything in the mouth. It is a fable that a person may swallow their tongue during a seizure; this is impossible.
Side. Roll the person onto their side, if possible, so that they do not aspirate anything into their lungs.
Thankfully, there are many potential treatments for epilepsy, including avoidance of triggering factors (e.g strobe lights, lack of sleep, stress may be triggers), medications, surgery and even dietary changes.
Many people with epilepsy can live a completely normal life and may be cleared by their neurologist to drive andto do most other activities once the epilepsy is well-controlled.
What can we do to help?
First, do not hesitate to be a friend to those who have epilepsy; they are no different than you and I.
We can stay informed, and therefore know better what to do if we witness a seizure.
We can tell a person if we think they may be having staring spells or other easy-to-miss types of seizure.
We can donate to the National Epilepsy Foundation, which is an organization which is seeking to find cures and better management for people who have epilepsy.
Dr Mary Ulrich is a board-certified Pediatrician at Pediatrics in Brevard, Melbourne office. Dr. Ulrich is also the medical director for Aveanna Prescribed Pediatric Extended Care facility in Melbourne as well as the medical director for Space Coast Early Steps.
This article originally appeared on Florida Today: What is epilepsy? Here's why it occurs, what you should do if it happens
