CLASSIFICATION OF EPILEPSY

Each one of us do suffer a seizure at one point in our lives but that does not mean one has epilepsy but if a pattern of the behaviour to be looked at below are noticed then a doctor must be consulted immediately. Non-epileptic attacks or seizures are seizures that look more like those of epilepsy but they are not caused by epilepsy. They may be caused by a physical cause such as hypoglycaemia (low blood sugar) and faints. The cause may also be a psychological cause such as panic attacks which may be brought by very frightening situations and the person may loss consciousness, have palpitations, feel light headed during the attack but over time the attack may come up independently of the fearful situation.

Another psychological cause of non-epileptic attacks is the delayed response to extreme stress. This attack will begin with over breathing and followed by crying which is uncontrolled the person may not have memory of what have happened. Some people will experience an attack when unable to cope with emotional demands like the loss of a loved one or a very bad break up. This is called an emotional cut-off. But over time the attacks may occur even in non-stressful situations.

The types of seizures are generally divided into two main categories, namely generalized seizures and partial seizures.

PARTIAL SEIZURES or FOCAL EPILEPSY

This occurs when the electrical activity in the brain is limited to one area and there is normally no loss of consciousness and the person can explain the seizure. Partial seizures include;

1. Simple partial seizures- movement or sensation in the part of the body controlled by the affected area of the brain is affected. Consciousness is not lost or affected, but the person may experience an altered sense of perception. It is often described as a “funny feeling”, “pins and needles feeling”, numbness or jerking in one limb or down one side of the body.

2. Complex partial seizures- it is a non-convulsive seizure, which may start with an aura (visual, auditory, taste, smell, etc). During this type of seizure the person may display abnormal behaviour or movements. For example, plucking at clothes, lip smacking, loss of sense of time, wandering around aimlessly or compulsively. Consciousness is altered during the seizure and can last for a few minutes. A complex partial seizure can be mistaken for a psychiatric episode by inexperienced onlookers, due to the abnormal behaviour that the person may exhibit during the seizure.

GENERALIZED SEIZURES

This occurs when excessive electrical activity in the brain encompasses the entire organ, during which there may be loss of consciousness. The person will not be able to recall what has happened during and after the seizure.

Generalized seizures include the following;

1. Generalized Tonic clonic seizures This kind of seizure will usually begin with a loud cry caused by air in the lungs forcing its way out through the voice box and the body stiffens and jerks violently. The person may produce excess saliva forced out through tightly shut teeth. This normally does not hurt but the person will feel tired because the muscles have been working hard during the seizure.

2. Tonic seizures The person will lose consciousness and the body will suddenly stiffen causing sudden falls due to the tightening of muscles. Here there is no convulsion and recovery is quick.

3. Atonic seizures It is the sudden loss of all muscle tone, causing the person to go limp, lose consciousness and fall to the ground. It is also known as “drop attacks”.

4. Absence seizures It is most common in children and involves blank staring and failure to respond with possible twitching and blinking of eyelids, or chewing. This is often mistaken for daydreaming. The loss of consciousness is brief and the duration will be a few minutes.

5. Myclonic seizures The whole body will suddenly jerk and the person will be totally unaware of what is happening for a brief moment the person may be thrown of balance if standing. This seizure often occurs in the morning.

HELPING A PERSON DURING AND AFTER A SEIZURE

Some people get a warning before a seizure and some know what triggers their seizures and try to avoid whatever triggers the seizures as much as possible, but for others it’s a different case, seizures catch them unaware and remember that during seizures consciousness is lost.

DURING THE SEIZURE

Put something soft under the persons head such as a rolled cardigan or coat to avoid head injury

Move the person away from any object that may harm them.

Do not put anything in the person‘s mouth during the seizure (a person having a seizure cannot swallow his tongue)

Do not restrain the person.

Do not disturb the movement of the body

Keep calm and reassure people who may be around

Time the seizure. A seizure normally should not be more than 5-6 minutes ,once it passes that time call an ambulance

AFTER THE SEIZURE

After the seizure, turn the person to the side this position is normally referred to the ‘recovery position’ to keep air passage clear

If the person wanders around the room gently lead them back to their seats.

Calmly reassure the person

If the person is confused after the seizure help to re-orient him.

Wipe away any excess saliva around the person’s mouth

Allow the person to rest/sleep this is essential

For more information please contact the Swaziland Epilepsy Organization at 404 7028 during office hours. Email us at admin@epilepsy.org.sz