Health

France has several hundred thousand epileptics of all ages. This disease generates medical consultations, care, prescriptions, etc. A few points of reference and concepts are useful to understand what it is.

WHAT IS EPILEPSY?

It is a chronic neurological disease that manifests itself through seizures linked to excessive activity of the nerve cells in the brain. An epileptic seizure corresponds to all the manifestations that result from it. Depending on the areas of the brain affected by this hyperactivity, the manifestations will not be the same.

WHEN IS IT CONSIDERED TO BE A DISEASE?

A single seizure in itself does not constitute an epilepsy-disease. It is the occurrence of regular (or repeated), spontaneous seizures that leads to talk of an epileptic disease, and this outside of any acute medical condition.

There are multiple forms of epilepsy depending on the type of seizures, their location and their duration.

HOW DOES AN EPILEPTIC SEIZURE MANIFEST?

The brain has different areas, each with specific functions. During a seizure, the symptoms are short-lived, for example, muscle twitching in an arm or leg, or speech difficulties.

The possible consequences will therefore be different depending on the type of seizure.

It should be noted that the most common signs are loss of consciousness with tremors, but they can be minimal.

THERE ARE TWO TYPES OF SEIZURES:

Generalized seizures

Grand mal:

• Fall.
• Stiff body.
• Loss of consciousness.
• Convulsions lasting several minutes.
• Risk of biting the tongue.
• Leakage of urine.

Petit mal:

• Limited to young children (between 5 and 10 years old).
• Loss of consciousness for a few seconds.
• Staring and loss of attention.

Partial seizures

Simple:

• Without loss of consciousness.
• Temporary loss of language.
• Odd sensations and partial tremors (limited to one part of the body or one limb).

Complex:

• Loss of consciousness with loss of contact, often associated with automatic gestures (flapping of feet or hands, or mouth movements).

ARE THERE FACTORS THAT PROMOTE SEIZURES?

A drop in the level of calcium or sugar in the blood can cause epileptic seizures in a baby, just like a fever.

In a child, a strong fear or intense joy can be involved.

In addition, in an adult or adolescent, stress, nervousness, lack of sleep and fatigue can trigger seizures.

HOW IS EPILEPSY DIAGNOSED?

First, the doctor will ask questions about the duration and frequency of the seizures, their context, and their course.

Then, he will examine the person concerned.

Different tests may be prescribed for you. They will be explained to you by your doctor.

This will be supplemented by an electroencephalogram (EEG) performed at your doctor's office or at the hospital. The EEG consists of placing different electrodes on the head and recording the electrical activity of your brain. This test is painless. The recording may be perfectly normal outside of the seizures, and will be repeated if necessary.

In children, an awareness EEG performed at the hospital, by stimulating the brain with light for example, will allow us to search for and/or reveal possible anomalies.

More specialized radiological tests such as a scanner or Magnetic Resonance Imaging (MRI) with injection of contrast agent, may be prescribed to look for the cause of this epilepsy. MRI and CT scans are techniques that allow you to obtain very detailed images of your brain and also of your body.

SHOULD YOU GET TREATMENT IF YOU HAVE EPILEPTIC?

The decision to start treatment is made on a case-by-case basis.

Under the effect of treatment, seizures decrease in frequency and/or disappear completely in a certain number of patients. When seizures are well controlled by antiepileptics, it is finally possible to stop the medication in a certain number of situations and this, without recurrence. Recovery with disappearance of seizures and cessation of treatment is therefore possible. You are therefore not necessarily epileptic for life.
You do not necessarily become epileptic following an epileptic seizure. Repeated epileptic seizures require a medical assessment. Stress, lack of sleep or fatigue can trigger seizures.

Author: Mateo BARAHONA