Dan was visibly upset. As he and Andy stood in the hall, he started talking about their mutual friend, Rick. “In the middle of class, Rick suddenly got this zoned-out expression on his face. I looked him right in th eye and spoke his name, but he just blinked, I think he’s on drugs.”
Andy shook her head. “Actually, he’s not on drugs. Rich has eepilepsy.”
“Well, I know he’s an epileptic, but…”
“Dan, Rick is not an epileptic. He’s got epilepsy. There’s a big difference. You wear glasses, but I donht call you a myopic.”
Dan looked uncomfortable. “Well, I knew about the epilepsy, but he didn’t look like he was having a seizure. There were no convulsions.”
“I thought the same thing, but Rick set me straight. There are many kinds of epileptic seizures. When Rick ‘zones out,’ he told me that he’s having an absence seizure.”
Ignorance Is Not Bliss
Unfortunately, most of us understand very little about epilepsy. In fact, Rick told his friends later: “Some kids are afraid that they could catch it from me, which just isn’t true. Others even think that having epilepsy is like being mentally ill. That’s really crazy. Epilepsy itself is enough of a challenge, but the real grief comes from the way people treat me.”
Epilepsy is a broad term for many different kinds of seizure disorders. According to the Epilepsy Foundation of America (EFA), about 2.5 million people in the United States have some form of epilepsy. Although it primarily affects children, young adults, and people over age 65, anyone can get it at any time. Most people with epilepsy wear Medic Alert tags.
A seizure is a sign that the brain’s electrical system is temporarily not working properly. It is a symptom of epilepsy, just as a runny nose is a symptom of a cold. For a minute or so there is a disordered flurry of electrical impulses in just one area or across the entire brain.
The result of those “disorderly” impulses may be a brief episode of blank staring, a period of confusion or altered consciousness, muscle spasms, automatic or unconscious behavior, a sudden fall–or a convulsion, which is what Dan mistakenly considered the only kind of seizure.
Simple partial seizures affect only one part of the brain. People having simple partial seizures do not lose consciousness, but may see, hear, smell, or experience feelings that are not real. They also may not be able to control their body movements.
Complex partial seizures also affect one area of the brain for a brief time, but they often produce a kind of behavior in which consciousness is lost or clouded. The individual having the seizure is unaware of his actions and may suddenly walk around without purpose–or do things that don’t make sense. In some cases, the seizure may produce shouting, crying, or running behavior. A friend in Rick’s epilepsy support group told him that he often know when he is about to have a seizure. Things seem out of focus just before a seizure begins.
Rick has had absence seizures since third grade. They produce brief losses of awareness that look like daydreaming. Sometimes absence seizures area accompanied by repetitious movements such as blinking or movement of the face or arms.
Generalized tonic-clonic seizures are the most dramatic seizures. According to the EFA, an individual having a tonic-clonic seizure may suddenly cry out and then fall unconscious. The body stiffens, and then shakes or jerks uncontrollably. Bladder and bowel control may be lost. Breathing is quite shallow–and may even stop briefly during the seizure–but will return to normal when the shaking movements end. When the seizure ends, usually after a minute or teo, the person is often confused and tired.
What You Can Do
There are no first aid steps that can stop a seizure or end it more quickly. The seizure itself actually triggers mechanisms in the brain to stop it. A person who has just had an absence or a simple partial seizure needs reassurance above all else. Rick says simply, “Be a friend.” When the seizure is over, tell him what happened and let him know what he missed during the conversation or the lesson. Then move along. You might try explaining the incident to others who do not understand.
If you see someone having a complex partial episode, the same rules apply. For example, if he’s wandering aimlessly around the cafeteria, you may speak to him softly, take his arm gently, and lead him back to his seat. If he resists, do not grab, hold, or yell. Just make sure he is not in danger. If he is agitated and appears upset, stay back until the seizure is over. Them be reassuring and friendly.
Although you can’t stop a tonic-clonic seizure once it begins, what you can do is extremely important: If the person has not yet fallen, help ease her to the floor. Call for help or send someone to get the nurse or another adult. Clear the area all around so she won’t bang into anything. Loosen her collar. Place something soft and flat under her head, like a folded sweater or jacket. If possible, turn her gently on her side. This will help keep her airway clear. In the rare event that seizure last more than fice minutes, or if she seems to go directly from one seizure to another, call for an ambulance.
Rick says that the myths surrounding – epilepsy also carry over into first aid treatment–and can do real harm. “Some uninformed people believe that you can swallow your tongue during a seizure, but it’s hust not possible. So, DON’T try to hold her tongue, and DON’T try to force anything between her teeth. You can really hurt someone by doing that. The same goes for trying to hold the person still: DON’T try to restrain her movements. You can’t.”
What Causes Epilepsy?
According to the EFA, in about 70 percent of all cases, there is no known cause of epilepsy. Of the remaining 30 percent, the most frequent causes are severe head injuries, brain tumors, strokes, poisoning (including use of illegal drugs or excessive use of alcohol), severe brain infections, adn brain damage at birth. Although there’s not much you can do to avoid most of the causes of epilepsy, you can reduce your chances of acquiring the condition by making sure that you always use seat belts in cars; wear helmets when rollerblading, biking, and motorcycling; and avoid illegal drugs and alcohol.
In any case, epilepsy is generally diagnosed after a person has had a couple of seizures. The doctor makes a diagnosis by getting a complete health history and learning about the kind of seizure the person had. In addition, the doctor will probably perform a painless brainwave test called an electroencephalogram (EEG). Any irregular or special patterns on the recording will help the doctor determine the correct diagnosis.
Living Well With Epilepsy
Once epilepsy is diagnosed, most patients are given drug therapy. There are more than 20 anti-epileptic drugs available (a new drug was released this year), and nearly 85 percent of all people with epilepsy achieve full or partial control of seizures–as long as they take their medications regularly.
In most cases, epilepsy doesnht stop anyone from doing anything. Rick is on his high school’s basketball and track teams. His seizures are not totally under control, but the doctor says it’s OK to compete. In Rick’s case, physical activity is not associated with increased seizures.
Rick is enrolled in driver education and is hoping to take his driver’s test this June. All 50 states allow people with epilepsy to drice as long as they can prove that they have had no seizures for a period of time (from three to 24 months).
The big challenge for Rick will be in overcoming society’s negative attitudes about epilepsy. Too many people with epilepsy still find themselves unemployed or stuck in jobs below their ability. But thanks to the Americans with Disabilities Act, which outlaws unfair discrimination, and thanks to a new generation of young people who are better informed about seizure disorders, there’s hope that the future will bring new understanding and a better life for people with epilepsy.