by Hanalise Huff, PGY-1
November is National Epilepsy Awareness month! About 3 million people in the United States have the diagnosis of epilepsy and about 1 in 100 people in the United States have had at least one unprovoked seizure. That is a whole lot of people! That means someone you know or maybe even are related to has experienced a seizure. As a future child neurologist I think this is a great time to spread awareness and understanding of a seemingly scary diagnosis.
For any of you who have had a seizure or witnessed someone else have a seizure, they can be very frightening-especially if it is your child or another loved one. Often times the person’s body is shaking and they do not respond to his or her name. For many of us this is terrifying, but for others this is a part of his or her life. By better understanding the disorder, we can make it less scary and be better equipped to help those with the diagnosis.
What is a seizure? A seizure is a sudden surge of electrical activity in the brain. Brain cells, or neurons, send information from one area of the brain to another area through electrical impulses that either excite or inhibit other neurons. This is the brain’s interesting form of communication. Normally these neurons are in a beautiful balance where they are equally excited and inhibited. However, this balance can be interrupted and there may be either too much or too little activity resulting in uncontrolled surges of electrical activity. This disruption of the electrical communication between neurons results in a seizure.
Seizures come in many forms. The classic type of seizure, a tonic clonic seizure, involves rhythmic tightening and releasing of muscles resulting in the typical “shaking” appearance. Some seizures may involve the whole body at once, some may involve just one side of the body and others may start in one part and spread to the rest of the body. Another, more unusual type of seizure involves brief staring spells that can last just seconds.
One of the more common types of seizures seen in the hospital setting is the febrile seizure. A febrile seizure is a tonic-clonic seizure occurring in a child between the ages of 3 months and 5-6 years when they have a high fever. Febrile seizures occur in 2-5% of all children. Most of these children do not need to be treated unless they have repeated episodes of multiple febrile seizures, have unusually long seizure (>15 minutes) or they live in a remote area with poor access to medical care. The good news is that the vast majority of these children with febrile seizures will not have seizures with fever after age 5.
Now if you have had one seizure, does this mean you have epilepsy? No. Someone is said to have epilepsy if they experience two or more unprovoked seizures separated by at least 24 hours. About 50% of people who have one seizure without a clear cause will have another one, often within 6 months of the first. If there is a known cause for your seizure such as brain injury then you are twice as likely to have another seizure.
You may be wondering how dangerous seizures are. It is very rare for a person to die from a seizure itself. The main danger of having a seizure involves what happens during the seizure. Since most seizures render a person unconscious and involve uncontrollable limb movements and shaking, it is common for people to be injured with bruises, cuts, burns and falls. Additionally, swimming alone poses a danger of drowning in the case that a seizure occurs while in the water. Lastly, having a seizure while driving may pose a risk to the life not only of the epileptic person driving but those around him or her. It is essential to work out a safety plan with your doctor that allows for the most flexibility in daily life while also keeping you and those around you safe.
Some helpful tips for making your home safer for you or a loved one with epilepsy include: cooking with a partner, taking showers instead of bath, not swimming without a buddy, using non-breakable dishes, using the microwave for most cooking, consider using a seizure alert monitor or sharing a room so others can hear if a seizure happens, move your bed away from walls, night tables and other sharp or hard objects and using caution with hot foods and liquids. And if you see a loved one having a seizure, the best thing you can do is roll that person onto his or her side to prevent aspiration and avoid putting anything into his or her mouth. Watch the clock and if the seizure has not stopped in 5 minutes, call 911 or take that person directly to your local emergency room.
Despite all of these precautions, it is very much possible to live a normal life with epilepsy. Thanks to new research there are many wonderful medications, and even surgeries that control seizures every day for epileptics around the world. The national epilepsy foundation suggests 4 behaviors to help prevent uncontrolled seizures: 1) take medications as prescribed 2) get enough sleep 3) limit alcohol and 4) strive to stop seizures!
Harbor UCLA Medical Center can help in the optimization of you or your loved one’s seizure prevention plan. The hospital has two outstanding child neurology attendings, Dr. Kenneth Huff and Dr. Agnes Chen, who have years of experience working with children with seizures. Additionally, the hospital has one child neurology fellow, Dr. Farah Villanueva who has gained ample experience working with both children and adults with epilepsy. The hospital provides all the basic tools for families dealing with epilepsy such as an EEG machine for diagnosis and weekly child neurology clinic where children with epilepsy can be seen regularly to optimize their seizure treatment. With the help of your neurologist, it is very possible to conquer you or your loved one’s seizures using a treatment plan that works best for you!
Resources:
1. Epilepsy.com