Epilepsy, the common name for a group of seizure disorders, affects 1 in every 100 Canadians. For those experiencing or witnessing a seizure for the first time, it is often a very frightening and confusing experience. For those caring for an individual with epilepsy, life is often fraught with fear of another seizure and potential injury. For those living with it, it can affect their quality of life and comes with social stigma and lack of understanding from the general public.
But while Canadians are commonly brought to the emergency department as a result of seizures, not all of these seizures are caused by epilepsy. Some seizures can be caused by temporary illness including metabolic abnormalities, a high fever in children, drugs, infection, or even a mass. Once this underlying condition is reversed, the individual may never have a seizure again.
Our CowanHealth partner, Novus Health, have shared with us the facts and misconceptions regarding the diagnosis and management of epilepsy.
Epilepsy can begin at any age and is a set of neurological disorders resulting in seizures. These seizures are caused by changes in the electrical transmission in the brain that often manifest in involuntary body movements or abnormal sensations. In some cases, this can be a very dramatic presentation with the person losing consciousness and having full-body convulsions. These involuntary movements can result in injuries such as tongue biting and even broken bones.
There are many myths and misconceptions regarding diagnosis and managing epilepsy. There are also many myths regarding what one should do if witnessing a patient having a seizure. Let’s discuss some of the facts around this.
Once a person reports having had some form of involuntary convulsions or sensations, they will have to undergo further tests to determine if the seizure was caused by a reversible medical condition. This may include brain imaging, blood tests, and the most conclusive test, which is an electroencephalogram (EEG). This test monitors the electrical activity in the brain to detect any abnormal (or epileptiform) brain waves and is the so-called gold standard test for diagnosing epilepsy.
There are many effective medications used in the treatment of epilepsy. In some refractory cases, a surgical procedure may be an option.
Many individuals are misinformed on how to respond when someone is having a seizure in front of them. The first thing to do is to make sure that they are in a safe environment and position. The safest position, if possible, is to put them on their side. It is crucial to avoid putting anything in the seizing person’s mouth, as this can only lead to further injury to the seizing person and/or the person caring for them. In most cases, calling 911 will be instrumental in ensuring the patient is transferred to the hospital for an assessment and further treatment.
Seizures are a common sight in the emergency department. After ruling out any injury from the seizure and treating any potential underlying medical cause, such as an infection, electrolyte abnormality, or drug-related cause, your treating physician will ensure you understand what to do if you have another seizure. At this point, you should not drive or operate heavy machinery—in fact, it is an ER physician’s legal obligation to report the seizure to the Ministry of Transportation. The Ministry will require that you get medical clearance from a neurologist before you get behind a wheel again. You should also not work at a height or swim unattended.
From there, you will receive a referral for further testing. It is rare for your emergency provider to start any anti-seizure medication before further testing is completed since, at that point, the exact cause of your seizure may be unknown.
Many individuals diagnosed with epilepsy have a great quality of life and are able to live seizure-free for long stretches of time. If you or a loved one is diagnosed with epilepsy, it is important to educate yourself about triggers that may provoke seizures. This may include sleep deprivation, drug or alcohol use, or missing a dose of anticonvulsant medication. There are many local and national epilepsy support groups available that can provide further support and resources for those caring for someone with epilepsy or living with it themselves. Some of these include www.epilepsy.ca and www.canadianepilepsyalliance.org. Remember, you are not alone in this; the first step to getting the most out of life with epilepsy is to simply ask for help and resources!
Don’t forget to wear purple on March 26th for Purple Day, supporting epilepsy around the world!