Epilepsy is a neurological disease characterized by recurrent epileptic seizures or seizures. Despite being a disease that is not talked about much in the community, it is estimated that 1 in 26 people could be diagnosed with epilepsy in their lifetime. According to national statistics, approximately 3 million adults and more than 400,000 children in the United States have epilepsy.
Epilepsy is usually diagnosed after a person has had two or more unprovoked seizures. Seizures caused by fever in children between the ages of 6 months and 6 years, for example, are considered provoked and therefore are not considered epilepsy. Epilepsy can also be diagnosed if the patient has only had an epileptic seizure but it is understood that the risk of recurrence in the near future is very high. To determine this risk, the patient’s medical history, family history and studies such as an electroencephalogram or magnetic resonance images are used, if it is considered indicated.
An epileptic seizure occurs as a result of the abnormal and sporadic functioning of a group of hyperexcitable neurons. The clinical manifestation of brain electrical activity dysfunction varies from one patient to another depending on which part of the brain is affected. The patient may lose consciousness and not remember anything about what happened during a crisis. In other cases, the events may not affect consciousness and may not necessarily be violent seizures, but may cause brief confusion, involuntary movements of some part of the body, and unusual sensations, among other things. It is important to understand that, although there are factors such as lack of sleep that can cause seizures in patients with epilepsy, the patient cannot voluntarily control their events and needs the attention of a health expert to determine the appropriate treatment. Epilepsy is not a mental illness and it is not contagious. It can develop as a result of genetic, autoimmune conditions, strokes, tumors, infections, trauma, and much more.
About 68% of epilepsy patients respond to medications called anticonvulsants or antiepileptics. Despite all the medications available today, about 30% of patients fail to control their attacks with these medications. When the patient does not respond to traditional medications and on some other occasions, other treatment options such as special diets or surgical interventions are offered. The main goal of treatment is to achieve control of all seizures with the least amount of medication possible. However, the treatment of epilepsy must always be multidisciplinary and it is not only about drugs. It is important to recognize that for many patients, epilepsy can also affect their ability to process information, their memory, their attention, their emotional state, their behavior, their self-esteem, and even their ability to socialize and get a job. Comorbidities or additional diseases related or not to epilepsy are of equal importance as are the number or intensity of the seizures. With the help of your primary care physician, your neurologist or epilepsy specialist, other specialists and family members, you seek to achieve the best possible quality of life for each patient and their loved ones.
During the pandemic we are facing, many patients and families care more than ever about their lives and those of their loved ones. In these difficult times, it is imperative to remain calm and follow the advice of health experts. Suffering from epilepsy has not been associated with a higher incidence of mortality or complications such as diabetes, being overweight and heart disease, among others. However, we know that anyone is susceptible to the virus and its complications. Therefore, the necessary precautions must be taken to avoid contracting it with the use of masks, hand washing and social distancing. Like any other virus or infection in the community, when a patient with epilepsy contracts the coronavirus, the risk of having more attacks during the time of infection increases, which could result in hospitalization.
Despite the fear many have of leaving their homes and visiting the doctor, it is crucial to maintain communication with your doctor during these times. Doctors’ offices and hospitals are doing everything they can to take the right steps for everyone’s safety. If your epilepsy seems to be getting worse, you need to notify your doctor, make a follow-up appointment, either online or in person, and visit the hospital in an emergency.
The Hispanic community has been found to be more vulnerable during these times of the coronavirus. Health disparities exist not only in relation to the pandemic, but also with many other diseases, including epilepsy. During these times, it is more important than ever to stay informed and seek help when needed, whether through support groups, family, friends, or organizations like the Chicago Epilepsy Foundation (Epilepsy Foundation of Greater Chicago). The foundation offers countless resources for patients and families dealing with epilepsy. We encourage you to seek help and use the resources available. Know that you are not alone in this fight.
For more information visit online epilepsychicago.org
Dr. Rebecca García-Sosa is Assistant Professor of Pediatrics in Neurology and Epilepsy at the Ann & Robert H. Lurie Children’s Hospital.