Epilepsy: Know the facts and what to do in an emergency

It may be one of the world’s oldest known medical conditions, but people still fear and misunderstand epilepsy and many are reluctant to talk about it. This fear is understandable: When you witness someone having an epileptic seizure, the experience may be traumatic, especially if you don’t know what to do or what to expect. We provide some guidelines should you be in a situation where you can provide assistance.

Epileptic seizures can happen quickly and unexpectedly. As someone who experienced just such an incident recalls: “We were sitting at the kitchen table making small talk when my friend suddenly started saying things that made no sense. The next moment his body stiffened and he fell over backwards. He started convulsing, and we rushed to get a pillow to support his head and ensure that he didn’t hurt himself. After about a minute, the convulsions stopped and soon after, his breathing returned to normal.

“Even though the seizure lasted no longer than a minute, it felt much, much longer. I knew, however, that panicking or losing control wasn’t going to help the situation,” he said.

Types of seizures

As this incident illustrates, seizures happen suddenly and occur as a result of a abrupt surge in the brain’s electrical activities. Depending on which part of the brain is affected, it may manifest as a loss of awareness, unusual behaviours or sensations, uncontrollable movements or loss of consciousness. Seizures are further divided into focal (where only a part of the brain is affected) and generalised (where the entire brain is affected) seizures.

In this case it had been an example of a generalised tonic-clonic seizure. Also called a grand mal or convulsive seizure, this type of seizure involves a loss of consciousness and violent tonic (stiffening) and clonic (twitching or jerking) muscle contractions. This is the type of seizure most people associate with epileptic seizures.

Other types of seizures include absence (a brief lapse of consciousness), tonic, atonic (sudden loss of muscle tone causing the person to fall), clonic and myoclonic (characterised by brief shock-like jerks) seizures.

Causes

Epilepsy can result from head trauma, developmental disorders, genetic irregularities or infections such as meningitis. However, in about half of all cases, the cause is unknown.

How to help someone who is having a seizure

1. Remain calm.
2. Time the seizure.
3. Look for any type of medical ID describing the person’s condition.
4. Place a small, soft support under their head.
5. Stay with the person until they are awake and alert after the seizure.
6. Once the seizure is over, help the person to sit upright in a safe place. Tell them what happened as soon as they are alert and can communicate.

Phone an ambulance if –
   -   The seizure lasts longer than five minutes;
   -   The person has never had a seizure before;
   -   The first seizure is followed by another;
   -   The person has difficulty breathing or waking after the seizure;
   -   The person is injured during the seizure;
   -   The seizure happens while the person is in deep water; or
   -   The person has a known health condition (e.g. diabetes) or is pregnant.

Medical aid cover for epilepsy

Epilepsy qualifies for prescribed minimum benefits (PMB), which are provided for in the Medical Schemes Act to ensure that members of medical schemes have access to certain minimum health services, regardless of the benefit option they have selected. Medical schemes must cover the costs of the diagnosis, treatment and care of PMB conditions such as epilepsy in full without any limits or co-payments.