Education, awareness during epilepsy monthby Michael BakerPublic Relations During November, the medical community observes National Epilepsy Month, drawing attention to a potentially debilitating disease that affects the brain’s basic functions. From 6:30 to 9 p.m. Thursday, Nov. 4, a free educational program was held at the Harper Student Wellness Center. Open to the public and highlighted by guest speaker Bobbie Staten, R.N., the program taught attendees how to deal with epilepsy and care for those who live with the disease. According to Jonathan Halford, M.D., assistant professor of neurology, epilepsy is a neurological condition physically characterized by abnormal electrical discharges within the brain. “The brain contains billions of nerve cells, and the easiest way to understand epilepsy’s effects is to think of those cells as people at a cocktail party,” he said. “When the brain functions normally and its nerve cells are all doing their own tasks, it’s like the murmur of a crowd at a party—no distinguishable sound. But when all of the nerve cells suddenly start doing the same thing, like everyone chanting in a crowd, a brain malfunction called a seizure takes place.” Although 2 to 4 percent of people in the United States will experience a seizure in their lifetimes, approximately 1 percent has epilepsy (a tendency to have recurring seizures). Television and movies have inspired wildly stereotypical views of seizures, including uncontrollable shaking and foaming at the mouth, but many patient’s symptoms are much subtler. “Epilepsy manifests in numerous ways, so sometimes it’s hard to diagnose the disease. Many of its symptoms are just simple movements or sensations that could suggest various medical conditions,” Halford explained. Some of the less obvious symptoms include abnormal movements, loss of consciousness, and staring spells. The latter may occur for only a few seconds at time, and may not be noticeable to others. Among the more telling symptoms, a person in the grip of an epileptic seizure may repeat certain phrases or simple movements, smell strange odors, or see odd shapes. The person also may experience sudden, repeated, unexplained memories. “Unusual symptoms such as staring spells, repeated memories or strange feelings may occur during epileptic seizures,” Halford said. “The key thing is that the memories or feelings are stereotyped, the same thing over and over again. It’s not like a daydream, which often changes. These episodes are often exactly the same, disruptive and out of context.” The average seizure last from one to two minutes, but the relatively small window shouldn’t be underestimated. “Epilepsy can be very disabling. Many of us take for granted how reliable our brains are, but people with epilepsy don’t have that luxury,” Halford asserted. “Driv-ing, swimming, climbing ladders—all of these activities are relatively simple for most people, but for someone with epilepsy, they can be quite dangerous if a seizure were to occur.” Epilepsy’s causes fall under three main areas: genetic, brain injuries and neurodegenerative disorders. Some epilepsy syndromes are highly genetic, meaning that a person’s epilepsy could be traced back to a history of epilepsy in his or her family. In other cases, brain injuries such as head trauma or brain infections can elicit epileptic seizures. Neurodegenerative disorders such as Alzheimer’s disease also can cause seizures. Preventing the disease is often impossible, since its causes are generally uncontrollable factors; people can’t predetermine their genes, and brain injuries happen by chance more often than not. But Halford offered hope for those with epilepsy, in the form of treatments. “Medications to combat epilepsy have come a long way in the last decade,” he said. “In the last 10 years, 10 new epilepsy medications have been approved. They’re much better for many reasons, but especially with respect to their decreased number of side effects.” He added that the first step for any person with epilepsy to take is to get a thorough neurological evaluation. This includes an exam by a neurologist, an electroencephalogram (comm-only known as an EEG, it detects abnormalities in the brain’s electrical activity), and an MRI scan of the brain. Regarding the MRI, Halford suggested that patients ask specifically for a seizure protocol MRI, as regular MRI scans often don’t pick up subtle brain abnormalities in patients with epilepsy. The examination process can help identify a patient’s eligibility for surgical treatment as well. Surgery provides an important option for a significant portion of people with epilepsy. “Studies have shown that if someone fails to respond to two seizure medications—and 30 percent of people with a common form of epilepsy fall into this category—then a third medication is unlikely to work,” Halford said. “In that case, they need to be evaluated for surgery.” The risk involved in surgery is low, he explained, approximately equivalent to the risk during a patient’s lifetime of dying from an epileptic seizure in his or her sleep. More than 60 percent of selected patients who receive surgical treatment remain seizure free, while many of the rest experience what Halford called “significant reduction” in their frequency of seizures. “Patients don’t have to languish with the disease,” he said. “Surgery can make a big difference in epilepsy care down the line, getting people back to a normal life.” For information on MUSC's epilepsy programs, visit http://www.musc.edu/neurology/clinical_neuro/epilepsy.htm.
For general information on epilepsy, visit http://www.epilepsyfoundation.org/.
Friday, Nov. 5, 2004
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