Living with Epilepsy Among Children and Adults

Epilepsy maybe an ancient brain disorder but it is still considered a widely prevalent affliction affecting millions of Americans today. In 400 B.C., Hippocrates referred to it as an organic brain process. The word itself comes from a Greek term,"epilepsia", which means "to be seized by forces from without". Epilepsy affects approximately between 1.25 to 3 million people in the United States. The cumulative risk of developing epilepsy from birth through age 20 is approximately 1% and reaches 3% at age 75. Incidence of new cases is estimated to be 200,000 each year. We should also note an expected rise in the incidence of epilepsy among war veterans in Iran and Afghanistan who suffered head trauma. Aside from cancer (e.g. breast,colon,pancreas) we should elevate its rank as one of the major concerns in our society. Our late Senator Edward M. Kennedy considered a major bill to support research funding to find cure.

What is Epilepsy?Epilepsy is a complex symptom and not a disease. It is caused by an excessive and disorderly neuronal discharges. A seizure can be a symptom of an old or recent cerebral trauma, developmental defects (encephalitis,meningitis),cerebrovascular disease,infections(brain abscess,middle ear and sinus infections), tumor malignancies,alcohol or drug abuse and others.Classification of seizures are in two(2) broad categories. First is the "partial seizure" which begins in a small location in the brain. Here the epilepsy syndromes can be found on the four (4) lobes of the brain:frontal,parietal,temporal and occipital. Second is the "generalized seizure" that are bilaterally asymmetrical and without a local onset. Epilepsy can be detected by clinical manifestations,electroencephalographic (EEG) recording and laboratory examination which includes neuroimaging (MRI,CT scan). The EEG is a helpful diagnostic tool in distinguishing a seizure from a non seizure activity. It gives information of the epileptic location. Also, factors that commonly triggers seizures are fever, emotional stress (anxiety&depression),sleep deprivation,alcohol withdrawal,drug intoxication,menstrual cycle, hyperventilation and even flickering lights.

Sudden Unexplained Death. There are apparently healthy adults with long standing epilepsy between 20 to 40 years of age who can die in their sleep. It was estimated that the risk of "sudden unexplained death" is approximately 4 times greater in patients with symptomatic epilepsy. Some of these patients have experienced cardiac arrhythmias,pulmonary edema,suffocation and cerebrovascular disease. On the other hand,"status epilepticus" is a single,continuous seizure lasting 30 minutes or longer. Frequency is highest in children and in adults older than 60 years old.

How to deal with psychological and social issues

It is a fact that there are psychological concerns of having epilepsy. Anxiety and depression are common precipitating factors among children and adults. Patients need emotional support by giving them opportunities to discuss their problems with health professionals like social workers and counselors. Children are at high risk for drowning either on bathtub or pools. Parents must supervise their bathing,swimming,bike riding and other recreational activities because seizure could occur at anytime. Some epileptic children have photoconvulsive response to flickering lights which includes television ("television epilepsy"), video games, or using a computer. This type of seizure is common among female teens. Children develop cognitive and behavioral problems from recurrent seizures due to the early age of onset and the side effects of anti epileptic drugs which leads to learning disabilities. The child should have special education resources such as speech,physical and occupational therapy. School personnel should be properly informed of the child's condition to monitor seizure frequency in order to help physicians on proper assessment. Meanwhile,adults with epilepsy experienced loss of driver's license. Patients may re-apply for driving privileges if they are seizure-free within 3-12 months along with a letter from their physician. It is also suggested to use public transportation for epileptic patients and deal with a life without driving privileges. The Americans with Disability Act and Federal Rehabilitation Act prohibits employers from discriminating against persons with disability who could perform the job with "reasonable accommodations". Persons with epilepsy should only be excluded on jobs that pose a danger to them when having a seizure like driving,operating machinery and working at high places. The Department of Labor and Epilepsy Foundation of America are good resources for employment advice. Income assistance to disabled people are Supplemental Security Income (SSI), Department of Veterans Affairs and veteran groups like Disabled American Veterans.

One of the largest epilepsy centers in the US since 1989, the NYU Langone Medical Center is being managed by Dr. Orrin Devinsky. He is the co founder of the website www.epilepsy.com and the Epilepsy Therapy Project. He is also the founder of an organization called FACES (Finding A Cure for Epilepsy and Seizures) which focuses on research of new treatments. Another organization is CURE (Citizens United for Research in Epilepsy) which is founded by Susan Axelrod.