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Epilepsy: Separating fact from fiction about seizures

August 28, 2018 | Indranil Sen-Gupta, MD
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Can dogs really detect an oncoming seizure? Do you know what to do if someone is having one?

Most people think epilepsy is a rare condition, but it’s actually quite common, afflicting about 1 in 100 people, or 1 percent of the world’s population.

Epilepsy is actually a group of neurological disorders involving unpredictable seizures that are triggered by abnormal electrical activity in the brain.

We’re not sure what causes epilepsy in every case, but there may be numerous causes, including:

While every age group may be affected, epilepsy is most common in newborns and in older adults.

Types of epileptic seizures

A seizure can be triggered when electrical firing patterns in the brain are disturbed.

The seizures can be focal or generalized:

  • Focal seizures start in one part of the brain and can cause people to experience intense emotions, dreamlike states or altered awareness, or repetitive body motions, such as chewing or lip smacking.
  • With generalized seizures, electrical seizure activity spreads rapidly throughout the brain, leading to loss of consciousness. People may also experience convulsions or strong body contractions.

This second type, generalized seizures — which may progress to minutes-long grand mal seizures that involve violent body shaking — is what most people think of when they think of epilepsy.

Since many people seem to have a limited understanding of the condition, I’d like to address some of the most frequent myths about epilepsy:

MYTH: You can swallow your tongue during a seizure

Absolutely not — it’s impossible to swallow one’s tongue. But it is possible for a person to bite their own tongue during a convulsive seizure.

MYTH: You should force something into the mouth of someone having a seizure

Never put anything into a person’s mouth to try to prevent them from biting their tongue.

MYTH: You should restrain someone having a seizure

Never restrain someone having a seizure.

Instead, bring the person to the ground, lay them on their side and allow them to have the seizure. If they’re in danger of falling out of a window or over a balcony, of course, move them to safety. Clear any nearby objects that might fall break or injure the person.

Most seizures stop by themselves within several minutes. If a seizure lasts more than five minutes or if the person is having back-to-back seizures without returning to normal in between, it’s time to call 9-1-1 for assistance.

MYTH: Dogs can sense when someone is about to have a seizure

The jury is still out on whether dogs can predict seizures, but having an animal around can be a source of comfort, reducing stress that might provoke seizures as well as signaling for help during long seizures.

MYTH: Epilepsy is contagious

Although epilepsy may be genetic or may result from infections that have caused brain injury, there is no way to develop epilepsy from being near a person having epileptic seizures.

MYTH: People with epilepsy are disabled and can’t work in physically demanding or stressful jobs

There are some jobs — such as airline pilots — where epilepsy is prohibitive, but people whose seizures are well controlled can function in pretty much any profession.

Multiple treatments for epilepsy

  • Medications. The fact is that an estimated 70 percent of people with epilepsy have their seizures well controlled by medication — either with one or two drugs.
  • Surgery or stimulator. If someone continues to have seizures despite adequate doses of two seizure medications, it’s time to explore non-medication options such as brain surgery or stimulator devices. These may help the 30 percent of patients who experience ongoing seizures despite medication.

I want people with epilepsy to know that there are multiple treatment options available in addition to medications, and also that managing epilepsy involves more than just controlling seizures.

Our multidisciplinary team of epilepsy coordinators, neurologists, dietitians, neuroradiologists, neurosurgeons, neuropsychologists and others help our patients address the full range of physical, lifestyle and societal effects of epilepsy. To schedule an appointment, call 714-456-6203 or request an appointment online.

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