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Other
Articles:
Epilepsy in
the Workplace
Multiple Sclerosis
The word “epilepsy” derives from the Greek word “to be
seized”. It is a
generic term that refers to a wide variety of seizure conditions. There are very well known individuals in history such as
Julius Caesar, Socrates, Vincent van Gogh, Dostoyevsky, and
others who had active seizure conditions, as do a number of present
day celebrities, sports figures, and political figures (e.g.,
Margaux Hemingway, Buddy Bell, Tony Coelho).
These individuals were or are quite obviously very productive
persons contributing significantly to society.
A
seizure involves a disruption of the normal activity of the brain
through neuronal instability. Neurons
become unstable and fire in an abnormally rapid manner, similar to a
misfiring engine, with the excess electric discharges resulting in a
seizure. The seizure
may be confined to one area of the brain (partial seizure) or take
place throughout the entire brain (generalized seizure).
It is of interest that the most common generalized seizure,
formerly known as a “grand mal” seizure (now known as a
tonic‑clonic seizure), is often easier to control than a
partial seizure. A
majority of the individuals coming to specialized epilepsy centers
for treatment have partial seizures which can be more difficult to
control -- although usually functionally safer.
The causes of epilepsy are wide ranging and include
infectious diseases in a pregnant mother, parasitic infections,
vascular diseases, birth trauma, etc.
The genetic causality for epilepsy is only within a range of
1-2%. It must be
remembered that epilepsy involves recurring or more than one
seizure -- for various medical reasons any number of individuals
may experience a singular seizure.
Establishing a seizure diagnosis involves medical
history taking and evaluation
by a neurologist, but generally awake and/or sleep
electroencephalograph (EEG) assessment.
It is important to note that precise seizure diagnosis can
involve not only both types of EEGs, but may involve magnetic
resonance imaging (MRI), computerized tomography (CT) scanning, or
even 24 hour EEG video monitoring. The MRI can now be the first step in diagnostic sequence,
preceding EEG. Many
individuals with the correct diagnostics and medication can have
their epilepsy easily managed.
The vast majority of individuals with epilepsy can have
complete seizure freedom or good seizure control.
Individuals with recurring seizures should always be referred
to a neurologist. If a
neurologist cannot achieve seizure control with an individual over a
nine month period, referral to a specialized epilepsy center should
be made. During the
1990s, a number of new medications including Gabepentin, Lamotrogine,
and Topiramate have been developed‑‑a third generation
of medications. Some of
the newer medications can be used individually or as “add on”
drugs usually without negative side effects.
A number of individuals in our society with continuing
seizures are often not adequately medically treated.
In addition to anticonvulsant medications, some individuals
can benefit dramatically from use of a vagal nerve stimulator (VNS)
or epilepsy surgery relative to seizure freedom or improved control.
First
Aid for Seizures
Since the majority
of individuals with epilepsy have partial seizures which typically
involve a short period of disorientation (e.g., 30 seconds) or
brief cessation of activity; first aid concerns are minimal.
These individuals simply need to be watched during the period
of seizure, or gently guided (not restrained) to a chair with
reassuring statements. For individuals who have a generalized tonic‑clonic or
grand mal seizure involving loss of consciousness, a period of
rigidity, and convulsions, the most important first aid concern is
that the seizure be timed.
Emergency medical aid is not required unless the seizure
length approaches five minutes.
Most of these seizures last slightly over a minute.
Most persons will require some time in order to orient and
compose themselves post‑seizure.
When possible they should be turned on their sides for
comfort and any harmful items moved out to the way.
It is often dangerous to individuals with seizures to try to
place something in their mouths during a seizure (e.g., to prevent
biting their mouths) and simply not necessary.
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