Demystifying epilepsy key to proper care

One of the most common but little-understood neurological disorders is epilepsy. Epilepsy is characterised by a tendency to recurrent unprovoked seizures.

This condition, one of the oldest known to mankind, is spread across the world with no regard for age, social status, race or geographical location. Social stigma around this condition leads to many shunning mainstream healthcare for alternative help. Others believe it is a sign of possession by divine, supernatural forces, witchcraft or other such misconceptions and myths.

This affects health seeking, leading to poor treatment adherence and follow-up.

Close to 70 million people worldwide suffer from epilepsy, with 90 per cent of these in low- and middle-income countries, and 20 per cent of the global burden in Africa.

Locally there is an incidence of up to 82 per every 100,000 suffering from this condition. The numbers may be higher considering chronic misreporting and missed diagnoses.

The name epilepsy itself comes from the Greek word ‘epilambanein’, meaning to ‘seize or attack from above’ indicating that this view about its origins is a worldwide misnomer.

According to The Atlas of Epilepsy Care in the World, 2005, Kenya had a treatment gap of close to 80 per cent as highlighted by the four A’s of available, accessible, affordable healthcare and lack of awareness.

Some of the common causes or risk factors to epilepsy includes but not limited to; infections like meningitis, cerebral malaria and febrile illnesses in children, traumas like head injury and birth asphyxia, metabolic ones like pyridoxine (vitamin B6) deficiency and inborn challenges of metabolism.

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Toxins like alcohol, carbon monoxide poisoning and certain drugs are others.

There are several types of seizures based on the site of excessive neuronal discharge in the brain and some of the other names for seizure includes, convulsions, fits and attacks.

According to the Kenya national guidelines for management of epilepsy 2016, it’s a seizure occurring more than two times 24 hours apart in a year than can be considered as epilepsy.

There has been an expanded definition to include; those patients who after having a single isolated seizure, may be considered to have a risk of seizures similar to the risk after two seizures during the next ten years and patients presenting with characteristics of an identifiable epilepsy syndrome.

This expanded description is vital in a bid to encourage early initiation of treatment without waiting for and running the risk of second seizure. There, however, have been improvements in the level of awareness and available treatment modalities with recent evidence has shown that 70 per cent of children and adults with epilepsy can be successfully managed.

The writer is a licensed psychologist/psychiatrist clinical officer and lecturer KMTC Meru Campus