WHAT IS EPILEPSY?
Epilepsy is a tendency to have recurring fits or seizures. A fit or seizure is a brief, usually unprovoked disturbance of consciousness, behaviour, motor function or sensation.
It happens because of a chemical imbalance within the brain, which leads to the brain’s messages becoming disorganised.
This imbalance can occur in any part of the brain.
The type of fit or seizure a person experiences depends on the part of the brain in which the abnormal activity starts and the parts to which it may spread.
WHO HAS EPILEPSY?
Epilepsy can happen to anyone at anytime in their lives.
Every working day 105 people in the U.K. will be told they have epilepsy.
It is more common in childhood and in later life.
According to recent research the incidence rate is about 1:131
The outlook can be positive. Potentially 70% could be seizure free with optimal treatment.
WHAT CAUSES EPILEPSY?
For the vast majority of people with epilepsy no known cause is identified- this is known as idiopathic epilepsy.
Where causes are identified they fall into two main categories:
Brain injury, malformation or disease
Hereditary factors- Although most people have no family history of epilepsy, some types of generalised epilepsies such as absence epilepsy, juvenile myoclonic epilepsy and generalised tonic clonic epilepsy on waking, have a hereditary component.
PARTIAL OR FOCAL SEIZURES?
Epileptic activity starts in one small area of the brain. The seizure may be simple or complex.
SIMPLE PARTIAL SEIZURES
The seizure mimics the normal function of the part of the brain that has been disturbed. The seizure is usually brief. Consciousness is not lost. Possible symptoms are intense feelings of sudden fear or happiness. Unpleasant smells, tastes or stomach sensations can occur. These are often called ‘an aura’. There may be symptoms affecting movement. The head may be drawn to one side. The hand or arm may become stiff and is drawn upward. There may be jerking movement in the limb affected. Physical sensations may be experienced. Perhaps a tingling or warmth down one side of the body. Vision may be affected. Flashing lights, balls of light, or strange colours are typical symptoms affecting half of the vision.
COMPLEX PARTIAL SEIZURES
These can develop from simple partial seizures or consciousness may be impaired from the outset affecting the person’s inability to function normally. They can be brief and occasionally more prolonged. Such seizures can result in complicated automatic behaviours or automatisms. These can include pulling at, putting on or removing clothing; picking up objects; chewing or lip smacking and aimless repeated movements. Sometimes perceptions can change and things can appear bigger or smaller than they really are. This can be very frightening and difficult to explain to others. Perhaps even harder to accept are auras which relate to just feeling detached from one’s environment. On recovery the person may be agitated and confused. After the episode the person usually remembers nothing.
The activity causing a simple or complex seizure may spread to other areas of the brain and may sometimes become a generalised seizure.
Epileptic discharges involve both hemispheres of the brain simultaneously, consciousness is lost.
ABSENCES (formerly called ‘petit mal’)
- These bare brief periods of interrupted or clouded consciousness, easily mistaken for inattentiveness or daydreaming.
- They mainly affect children.
- There is no warning.
- The person will stop what they are doing
- The person will simply stare into space
- Slight flickering of the eyelids can be seen
- Eye blinking, eyeball rolling, face pulling or facial twitching can occur
- Seizures can be very frequent, sometimes occurring several hundred times a day
- Short intervals of loss of consciousness usually last only seconds so muscle tension is not affected and the person does not collapse
TONIC CLONIC SEIZURES (‘grand mal’)
- The person will lose consciousness and fall to the ground, often with no warning
- The person may cry out (they are not in pain)
- Breathing stops
- The arms & legs go stiff – the tonic phase
- This is followed by jerking – the clonic phase
- There is a build up of saliva, which may look like foam, around the mouth.
- The person may bite their tongue or cheek
- The person may be incontinent
- The seizure may last for several minutes*
Only call an ambulance if one seizure follows another without full recovery in between
The person remains unconscious for over 5 minutes
The person has injured themselves and requires medical treatment
WHAT CAN YOU DO IF YOU SEE SOMEONE HAVING A CONVULSIVE SEIZURE?
- Remember to keep calm:
- Clear a space around the person. Remove sharp or dangerous objects.
- Use something soft to cushion their head.
- Try to loosen clothing around the person’s neck
- Let the seizure take its course.
- As soon as possible turn the person on their side into the recovery position maintaining an airway.
- Reassure the person.
- Respect their dignity and discourage onlookers.
- At the end of a seizure reassure the person and explain what has happened.
- Check for confusion or injury.
- Stay until recovery is complete.
- Ensure a safe return to routine or place of safety/ area of privacy.
PLEASE DO NOT
- Force anything into the person’s mouth or between their teeth.
- Restrict or restrain the person in any way.
- Move the person unless they’re in danger.
- Give them anything to drink.