On a calm, bright morning, in a certain place of worship, people gathered to pray. While people listened to the sermon that was being preached, there was a sudden loud bang accompanied with screams. With subsequent panic by those who were very close to the source of the distraction, the attention of everyone was drawn to a young lady who lay on the floor, jerking and had some whitish foamy secretion drooling from her mouth. Perplexed by the sight, many started to pray, those who knew her by name called out her name, a few others ran further away from the scene, gripped with fear. The crowd was divided into those who were witnessing such occurrence for the first time and those who knew what it was. The jerky body movements, stretching of arms, legs, and drooling of saliva amongst other things lasted a few seconds before the young lady fell into a deep sleep. Everyone dispersed, while many whispered amongst themselves the possible causes of the condition.
Epilepsy is a disorder of the nervous system, which causes abnormal behaviour, sensation and may lead to loss of consciousness. According to John Hopkins medicine, epilepsy is defined as having “two or more unprovoked seizures.” It can affect anyone irrespective of age, sex, ethnic or religious background, race, educational or social status. While the severity of epilepsy may vary from a blank stare or twitching of parts of the body in mild cases, there may also be more serious seizures involving falls, biting of the tongue and other severe injuries.
Over the years, there have been misconceptions about epilepsy both locally and globally. Some of these include:
• Epilepsy is a curse
• People living with epilepsy can predict the future
• Epilepsy is contagious
• Putting salt in their mouths during a seizure can stop the seizure
• Forcing a spoon through their teeth to hold down the tongue during a seizure prevents them from swallowing their tongues
• Epilepsy is associated with witchcraft.
As a result of the misconceptions and cultural beliefs, there is a lag between diagnosis and treatment of epilepsy. This may also be because of the preference by many affected to visit traditional healers, and this increases the burden of the disease in the society. There is a generally perceived negative attitude towards persons living with epilepsy in the society, as they may be treated differently in areas like schools, places of worship, marriages, social groups, and so on.
One may say that epilepsy could be stigmatizing for persons living with it in certain societies and this may be largely due to its unpredictability and spontaneity. For instance, a seizure can happen at any time or at any place and cannot be controlled by the individual. Because epilepsy is a chronic disorder, its effects might constitute agitation, self-consciousness, timidity and unsettling moments, amongst others, in persons living with it. Consequently, there is need for health education which will lead to improved awareness on the condition and ultimately lead to better ways of management and improved outcome.
Being caused by an aberration in the activity of the brain, seizures may affect the brain-programmed processes. Some symptoms may include: blackouts or confusion of a short duration, blank stare, loss of awareness, eye blinking or lip smacking( commoner in children), stiffening of the muscles (especially muscles of the back, arm or legs) which may lead to falls, loss of muscle control (also leading to sudden fall), jerky movements of the face, neck and arms, shaking, loss of bladder control, biting of tongue and psychic symptoms like fear and anxiety, amongst others. There may be seizures that arise due to abnormality in the activity of one area of the brain. Tthese may not cause loss of consciousness but may affect the arm or leg leading to involuntary jerky movements, altered smell, feel, taste, sound or look of things. In contrast, there may be seizures that involve loss of consciousness.
The exact cause of epilepsy is unknown but some factors that may predispose to its development includes: prenatal brain damage, developmental disorders (like autism, neurofibromatosis), infectious diseases like AIDS, viral infections that affect the brain (for instance, encephalitis), brain conditions like tumour, stroke, head trauma, genetic factors, age (commoner in children and older adults).
Depending on the severity of the seizure, there are several complications that may arise. Some of those complications include injuries to the head or fractures on account of repeated falls, drowning if seizures occur while swimming or bathing), car accidents (due to loss of consciousness or involuntary movements), emotional/psychological problems like depression, anxiety, low self-esteem, amongst others and in extreme cases, there could be sudden unexpected death.
Helpful first aid measures to assist a person with seizures include gently rolling of the person to lie on the side, making the immediate environment of the individual clear and safe, loosening tight clothing on the individual, placing something soft under the individual’s head, calling for help. DO NOT put anything into the individual’s mouth, restrain or move the person unless they are in danger. There should be regular visits to the doctor on a follow-up basis by people with epilepsy. There should be strict adherence to the policies by persons living with epilepsy as regards driving, water safety and so on. Adequate support should also be provided for people living with epilepsy from the society and government.