Why epileptic patients are at risk of psychiatric disorders

Maria's disfigured face cannot hold a straight smile. Her brown skin is dotted with black scars that have decorated her life.

Part of her mouth is stitched, which explained why she could not articulate some words.

“How old are you Maria?” we prod after bonding.

“I…I don’t know,” she answers, her eyes roving the room. She adds she cannot remember even the year she was born.

Maria, whom we learn later is 41 from medical records, is epileptic, a neurological disorder that causes abnormal brain activity leading to seizures, convulsions, violent tremors and even loss of consciousness.

She has had so many seizures that her nephew Allan Njoroge, who has become her caretaker says, she behaves almost like a retard.

“This is someone you can give one shilling and she will think she can do a lot of things with it,” he says.

Neurological degeneration-progressive loss of the functions of brain neurons- is one of the long term impacts of repetitive seizures in epileptic patients, as detailed in a 2017 study by Suny Downstate Medical Centre in New York, US.

Such can make one have poor judgment in decision making and Maria has been a victim. A report from Kiambu District hospital shows she was treated after a rape incident in October 2018.

It was not the first time as Maria is said to have a son whom she got at 23 also as a result of rape.

Njoroge says she vanished from home, in Mwihoko, Githurai area, only for almost week only for him to get a call from a friend that someone resembling Maria had been spotted convulsing at a matatu yard.

Prof Lukoye Atwoli, Associate Professor in psychiatry at Moi University said just like physical illness can cause psychiatric condition, it is also possible for the inverse to happen.

In this case, epilepsy being a neurological disorder can lead to psychiatric related illness because of the impact of the seizures on the brain.

“When someone has an epileptic seizure there is deprivation of oxygen in the brain, and when this occurs overtime, one may have end up with a psychiatric condition,” he explained.

He added: “You know the brain is expected to support the whole body and the body is also supposed to support the brain.”

A 2016 study by Fahad Salih Algreeshah et al titled Psychiatric Disorders Associated with Epilepsy, agreed that the incidence of neurobehavioural disorder is high in patients with epilepsy than the general public.

The study published on the Medscape journal states that antiepileptic drugs can also play a role in the genesis of psychiatric symptoms in these patients.

“As neurologists, we tend to focus on seizure control, and psychiatric comorbidities are often underestimated. Recognizing psychiatric manifestations is an area that needs improvement,” reads the study.

Mood disorder, suicidal ideas, anxiety disorder and depression disorder are some of the psychiatric illness epileptic patients are prone to.

Fred Kiserem, who runs an epilepsy and mental health support group that supports Maria and is also living with the condition says he never knew of the impact of the disease until he encountered Maria.

“Maria’s seizures have made her thinking to be like that of a small child. A soda and some snacks is just enough for a man to seduce her,” said Kiserem.

And just like Maria, Kiserem also is not supposed to be too excited or too sad as it is one of the triggers for seizures.