Misconceptions: ‘You’re not possessed, you’re epileptic’

Naming epileptics from history, experts say most patients not aware of their disorder.

KARACHI:

Epilepsy, which is often attributed to supernatural or religious consequences, is one of the most misunderstood medical conditions, says the consultant neurologist at Aga Khan University Hospital (AKUH), Dr Mughis Sheerani.

Speaking at a seminar on Wednesday, he said in many instances epileptics have been labelled as ‘possessed’ which proves that a grave lack of awareness is responsible for such misconceptions. Naming well-known men in history who suffered from the disorder, such as Socrates, Lenin, Alexander the Great, Napoleon Bonaparte and Alfred Nobel, he said a few people are aware of their epilepsy.

About 1.7 million people in Pakistan suffer from the condition. Worldwide the number of people is around 50 million - most of who live in the developing world.

People with epilepsy are vulnerable to recurring seizures caused by sudden changes in the electrical activity of the brain. In 75 per cent of the cases, epilepsy can be managed, but unfortunately most people are unable to get proper treatment or medication.

Pinpointing the actual cause of epilepsy has proven to be difficult task for doctors. In most cases, however, it is believed that a person’s genes predispose them to the condition.

On the other hand, an epileptic seizure is thought to be caused by environmental or personal triggers. The most common include a lack of sleep, stress, strong emotions, intense exercise, flashing lights (such as video games), fever and menstrual cycles.

There are times, however, when seizures occur for no identifiable reason.

Epileptics are not only at risk of seizures but are also 20 to 50 per cent more susceptible to developing mood disorders, explains Dr Farah Khan, an AKUH consultant psychiatrist.

According to her, the most common disorders are depression and dysthymia (chronic depression in which a person’s moods are regularly low).

Seizures and mood disorders often occur at the same time, making it extremely important for epileptic patients to consult a psychiatrist.

In such cases, a neurologist-psychiatrist partnership to treat the patient is extremely important, stressed Dr Khan.

Although medication is the preferred form of treatment, patients who get intractable seizures - not controlled by three medications over one to two years - can be treated surgically, emphasises Dr Ehsan Bari, the AKUH consultant neurosurgeon.

Senior neurology coordinator nurse at AKUH, Haroon Daniel, spoke about how family members may need counselling to help them not only understand and work with the person suffering from epilepsy but also assist the person in activities, such as climbing ladders or swimming.

Highlighting the importance of handling epileptic episodes calmly, Daniel stressed that during a seizure, a patient should not be restrained and nothing should be forced between the teeth.

Instead, the person should be turned to one side to prevent choking and sharp objects in the vicinity should be removed.

Published in The Express Tribune, June 9^th, 2011.