Understanding epilepsy
Even in the 21st century, epilepsy remains shrouded in myth. Centuries-old misconceptions persist, fueling fear, misunderstanding, discrimination, and social stigma. As the country celebrates National Epilepsy Awareness Week, it’s time to shine the spotlight on the scientific facts about epilepsy and ways to better manage it.
Epilepsy is a chronic noncommunicable disease (NCD) of the brain characterized by recurrent seizures caused by excessive electrical discharges in a group of brain cells, according to the WHO. Seizures are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function.
The World Health Organization (WHO) estimates that around 50 million people worldwide have epilepsy, making it one of the most common neurological diseases globally. A local study “Treatment gaps and challenges in epilepsy care in the Philippines” published early this year in the international journal Epilepsy & Behavior estimates a 0.9% prevalence of epilepsy in the country, representing nearly a million Filipinos.
Epilepsy is not contagious. It is also not true that people with epilepsy are mentally ill or emotionally unstable, or are less smart. Epilepsy is a functional, physical problem — not a mental one. It can develop at any age. Having a seizure doesn’t automatically make a person epileptic; other factors can provoke a seizure, such as binge drinking, sleep deprivation, or a new medication.
A person is diagnosed with epilepsy when he or she has two or more unprovoked (“out of the blue”) seizures that occur more than 24 hours apart, according to the Cleveland Clinic’s “13 Common Epilepsy Myths, Debunked.”
Contrary to what we sometimes see in movies, one should never put anything into a person’s mouth or force it open if they are having a seizure. “This could actually injure them,” the Cleveland Clinic explained. “Roll the person on one side, keep him or her a safe distance from any nearby objects, and let the seizure run its course. If you see any signs of distress or if the seizure persists for more than a couple of minutes, call [emergency medical services].”
Although many underlying disease mechanisms can lead to epilepsy, the cause of the disease is still unknown in about 50% of cases globally, the WHO added.
Identified causes of epilepsy include brain damage from a loss of oxygen or trauma during birth and low birth weight; congenital abnormalities or genetic conditions with associated brain malformations; severe head injury; stroke; an infection of the brain, certain genetic syndromes; and brain tumor.
The Centers for Disease Control and Prevention (CDC) emphasize that most people with epilepsy live a full life. People with epilepsy must adhere to best possible seizure controls and live safely to reduce the risk of early death, the CDC added. This means avoiding risk factors such as having more serious health problems (i.e., stroke or tumor) that may also cause seizures, falls, or injuries; and seizures that last more than five minutes which happens when one suddenly stops taking the appropriate medicines.
Regular exercise is rarely the cause of seizures. According to the CDC, safely engaging in exercise and sports, in fact, improves overall health.
There are, on the other hand, real seizure triggers that vary from person to person. These include missing medications, being sick with another illness, flashing lights, menstrual cycles or other hormonal changes, and alcohol or drug use, according to the Epilepsy Foundation.
Remember that epilepsy can be managed. The WHO states that up to 70% of people living with epilepsy can become seizure-free with the appropriate use of anti-seizure medicines, including recently introduced ones with safer long-term profiles. Lastly, surgery to prevent future seizures is also an option.
A person who has a seizure for the first time must speak with a healthcare professional. Once diagnosed, learning how to recognize seizure triggers, getting enough sleep and lowering stress levels will also help in managing epilepsy.
TEODORO B. PADILLA is the executive director of the Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its Members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.