How to rescue seizure patients, by experts

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By Paul Adunwoke

Seizure health condition has been described as a sudden, uncontrolled burst of electrical activity between brain cells, which causes temporary abnormalities in muscle tone or movements such as stiffness, twitching or limpness, behaviours, sensations or states of awareness.

Health experts explain that seizure could be prevented by avoiding certain activities that could trigger it. They also highlight the use of Vagus nerve stimulators, surgical implants that send electrical impulses to the brain and anti-seizure medications, as being capable of preventing seizures. Common preventive measures of seizure include avoidance of bright light in people with photosensitive epilepsy, avoidance of psychostimulants, avoidance of excessive alcohol consumption, ensuring drug compliance, and prompt treatment of other medical conditions like hypertension and diabetes.

A consultant physician and neurologist, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Dr. Ikechukwu Aganweze, notes that seizure can be associated with loss of awareness or some behavioural changes, and becomes a disorder when it has an increased tendency for reoccurrence. He observes that the prevention of seizures depends on the seizure type, aggravating factors, causes, ages of the patients and presence of other medical conditions. He explained that the early signs and symptoms of seizure depend on the seizure types.

Aganweze identifies common clinical manifestations of seizures to include involuntary jerking of a limb or all parts of the body, which can be preceded by strange or unusual signs, upward eye-rolling, tongue-biting, involuntary urination or defecation, foaming from the mouth, fracture of one or more of the limb bones, loss of awareness or loss of consciousness, and transient weakness of one or more limbs, among other symptoms. Dr. Aganweze also notes that the difference between epilepsy and seizure is that epilepsy is the increased tendency to develop recurrent spontaneous seizures after having a first episode of seizure 24 hours before, whereas, seizure is the jerking involuntary movement due to abnormal electrical discharge in the brain neurons. “The latter is the action one sees and witnesses, while the former is the increased tendency of repeated episodes of seizure that graduate to epilepsy,” he said.

Speaking on treatment for seizure, Aganweze said drug treatment involves the use of antiepileptic drugs (AEDs), for instance, carbamazepine, sodium valproate, phenytoin, and levetiracetam, among others.

He explained that there are other non-drug treatments like diet modifications. Examples are the ketogenic diet and the use of such food supplements as pyridoxine and folic acid. “Treatment of underlying health conditions causing the seizure is very important. An underlying health condition or chronic disease is a medical condition or disease that interferes with daily life or activities of individuals that could trigger seizure. Examples of chronic diseases include obesity, heart disease, cancer, hypertension or high blood pressure, lung disease and diabetes, among others.

He said: “For now, no study has shown any sex discrimination in terms of prevalence or epidemiology of the seizure health condition. My advice for sufferers of this condition is to seek prompt medical attention, which is the key to management. The neurologist plays a central role in the management where drug compliance should be encouraged. It is necessary to also avoid aggravating factors or triggers as much as possible. Patient education is very important and public enlightenment programmes to discourage the stigma associated with the disease are also important. Beyond these is a need for advocacy from stakeholders and public support groups to help those with seizure disorders. Psychotherapists should be involved in patients’ care as a significant percentage of the sufferers have some affective disorders like depression, anxiety or both. However, there should be occupational therapy for those who are actively working but have difficulty performing optimally due to the disease.”

A psychiatric social worker at the Federal Neuro-Psychiatric Hospital, Yaba, Lagos, Ajetunmobi Temitayo, described seizure health condition as “a neurological condition, an epileptic fit, or a sudden attack of illness.” Temitayo said that temporary confusion, staring spell, and jerking movement of arms and legs are early signs and symptoms of seizure health condition. She noted that there is no cure for seizure just like some other mental illnesses, but that it can be managed with drugs.

She advised on how to help anyone hit with the attack: “When it happens, ease the person to the floor, turn the person gently on to one side, clear the area around the person of anything hard or sharp objects, put something soft and flat under his or her head to avoid hitting the head on the floor, remove eyeglasses if there are any, till the person comes round.”

Temitayo noted that seizure isn’t peculiar to any sex or age, explaining that it can happen to both young and old, male and female, so far as something is wrong with the brain nerves.

Temitayo explains the many types of seizure: “Tonic seizure is where muscles in the body become stiff. Atonic seizure is where muscles in the body are relaxed. Myoclonic seizure includes short jerking in parts of the body while clonic seizure involves shaking and jerking parts of the body. Some of the causes include anything that interrupts the normal connection between nerve cells in the brain, such as high fever, high or low blood sugar, alcohol intake or drug withdrawal. I will advise people to always eat well, exercise and stop smoking. These may prevent the condition from degenerating to epilepsy later in life.”

For Public health physician and social worker at Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Dr. Bukola Popoola, seizure is hereditary and could also occur due to injuries at birth, stroke, head injuries, fever and infections such as meningitis. She confirmed that seizures affect people of all age groups and gender. “What triggers seizures include stress, lack of sleep, heavy use of alcohol, substance abuse and flickering lights, among others. 

Popoola said symptom types and intensity depend on the type of seizure. She listed some examples of general symptoms including extended blank stare, and rapid blinking and eyes rolling upward. She said: “The patient may experience fear, anxiety or a feeling that you have already lived this moment, known as deja vu. He or she can also experience uncontrollable jerking body movements, repetitive movements of body parts usually head and arms; legs falling suddenly for no apparent reason, loud scream, tongue biting, frothing at the mouth, loss of consciousness or awareness and body control tainted with a temporary confusion.”

For the seizures whose causes are known, Popoola said they could be prevented by getting adequate sleep, reducing risks like smoking, alcohol misuse, drug abuse among others, managing your blood pressure to avoid progression to stroke, managing your blood sugar level if diabetic, avoiding delay in seeking healthcare intervention for children with fever and avoid flickering lights if prone to seizures. ”

Popoola explained that the main objective of treatment for seizure is to ensure the patient achieves a seizure-free state. For instance, to ensure that the patient is assessed by a doctor and depending on the type and cause of the seizures, the treatment could be psychological, which includes relaxation therapy, psychosocial therapy, and behavioural therapy. She also said that there are groups of medications called anticonvulsants that may be given to seizure patients just as surgery may be effective for some children who have seizure. “For people who experience seizures or epilepsy, to prevent injury, avoid certain activities like swimming, driving, heights, use of fire and power tools until you have been assessed by a doctor.

“Avoid self-medication. Avoid triggers that could lead to seizures. Most importantly, your doctor is the best source of information for questions and concerns related to the condition. Avoid false information. ”

Advising people around seizure patients, she disclosed that the important first aid care includes staying calm, time the seizures, protecting them from harm, moving harmful objects out of their way, protecting them from falling, safely cushioning their heads, loosening tight clothes, and placing them in a recovery position. Once seizures stop, turn them on their sides, and call for medical help. Reassure and provide comfort…

“Please, avoid putting anything into their mouth, so they do not aspirate. Do not try to hold them down and avoid giving food or drink until patient is fully awake or alert.”

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