Five things you didn’t know about epilepsy
Epilepsy is a multifaceted set of conditions and affects each patient differently. Here are five things you may not know about epilepsy.
- It’s not the same condition for everyone
‘There are many forms of epilepsy, many different causes and just as many ways that seizures manifest, so it is a bit simplistic to think of it as a single condition,’ explains Dr James Butler, a neurologist based at Mediclinic Constantiaberg.
Often the cause of epilepsy is unknown. Sometimes it is linked to head trauma, genetic factors (passed down from parents or grandparents), developmental brain abnormalities (problems during pregnancy or birth), infection, or even strokes or brain tumours. Essentially anything that disturbs your brain’s nerve impulses or ‘wiring’ can lead to epileptic seizures.
Seizures can also differ drastically depending on which part of the brain they occur in, and range from different types of generalised seizures, affecting both sides of the brain, to focal seizures, occurring in one part of the brain. You also get seizures that begin as focal seizures and progress to generalised ones, called secondary generalised seizures.
Some seizures may not even look like an epileptic episode but rather the patient will ‘zone out’ for a while and may blink rapidly. These are called absence seizures.
Seizure triggers may differ between people and can include, among others:
- Flashing lights (photosensitive epilepsy)
- Missing meals
- Alcohol consumption
- Stress (commonly)
- Sleep deprivation
- Incorrect dosage of pharmaceuticals
- It can sometimes be prevented
Because epilepsy is sometimes caused by poor prenatal care, infections, brain trauma or conditions related to lifestyle disease such as strokes, it stands to reason that at times, it is preventable. Some general guidelines include:
- Reducing your risk of brain trauma by driving safely
- Reducing your risk of strokes by not smoking and by exercising and eating healthily
- Ensuring you see a specialist regularly during pregnancy to reduce your child’s risk
- Minimising your chances of infection by washing your hands regularly and cooking food thoroughly
- Women are more at risk for certain types of seizures
Hormonal changes can cause some women with epilepsy to have more seizures when they menstruate, according to the Centers for Disease Control and Prevention.
This form of epilepsy is called catamenial epilepsy. Women with epilepsy should be encouraged to take note of their cycles and see if a certain time in their cycle coincides with a spike in seizures.
Interestingly, some women with catamenial epilepsy find that their seizures dissipate during pregnancy owing to the ‘absence of cyclical hormone variations’ or periods. Women who suffer from catamenial epilepsy should work with a gynaecologist and neurologist to ensure they receive the most holistic treatment for their epilepsy.
- It’s a good idea to keep exercising
Exercise is known to be good for your brain as well as your body. Exercise is rarely a ‘trigger’ for seizure activity. In fact, regular exercise may improve seizure control, according to a recent information pamphlet on the Centers for Disease Control and Prevention website. Depending on the exercise you do, you may need to take special precautions if you have epilepsy, such as wearing protective gear.
- Treatment may include dietary changes
Dr Butler explains that treating epilepsy requires a personalised approach where the ‘treatments are as wide ranging as the epilepsies themselves’. One possible treatment option is the ketogenic diet or the modified Atkins diet.
This diet forces the body to burn fat instead of carbohydrates. The liver converts the fat into ketone bodies, which replace glucose as an energy source in the brain. This state of ketosis can reduce the frequency of seizures. Dr Butler cautions that while it may be achievable to modify a child’s diet, adults may find it harder to adhere to the ketogenic diet. Any dietary change of this magnitude should always be discussed with a physician.