DEFINING EPILEPSY

Sir,

In relation to a letter to the Editor entitled ‘Is Epilepsy a demon or disease,’ published on November 5, 2011, I would like to respond with a few answers to the questions posed by the writer.

Demon or Disease
Epilepsy (sifo sekuwa) is not a demon or mental illness but a medical condition which is a brain disorder where a person has repeated seizures over time. Seizures are episodes of disturbed brain activity resulting from abnormal electrical activity in the brain (as below figure) that causes sensory disturbance, temporary loss of consciousness, or convulsions (kunklinklita).

Curable or Manageable
Whether epilepsy is curable or not, it depends on the cause of epilepsy. It is like a fever, just a symptom, if you find out the underlying disorder and remove the cause, then the seizure can be cured. But the most common type – about two thirds of patients – is called idiopathic epilepsy and the cause is unknown.There are many causes of epilepsy, including: prolonged labour resulting hypoxia encephalopathy, fever, infection, heredity, head injury, brain tumor and so on. So it is important that the first fit attack should be well examined.

The risk of epilepsy is about four to eight per cent higher in people who have parents or siblings with the disorder. Some epilepsy in childhood is benign and stops before 18 years old . It shows that epilepsy is not a communicable disease. However, the Anti Epileptic Drugs (A.E.Ds) help to suppress the symptoms
Vulnerable groups
 Seizures are common in children when they have fever, pregnant mothers (eclampsia), heavy alcohol/substance/drug users. This proves that anyone can develop epilepsy at any stage of life.
Job eligibility:

Of course, some jobs are too risky to epileptic patients to do. For example, cooking with open fire alone, working with heights and driving a vehicle if not certified by doctors to be seizure-free. Seizures can subside with AEDs. When a person is seizure-free for more than two years and a doctor will help you to wean-off from AEDs. In such cases, the person can be able to perform any kind of work depending on their ability and skill.

 The Psychiatric Clinic at Mbabane Government Hospital is welcoming members of the public and people living with epilepsy to attend the last presentation for the year on Epilepsy first aid which will be held on December 5 from 8am to 9am in the hospital conference room. Entry is free. For contacts: Psychiatric unit in MGH +268 24042111 ext 2302 or edouardoshabangu@gmail.com
 
Dr Wen, Mbabane
Dr Hsiu Wen Chang is a Neurologist,Taiwan Medical Mission in MGH

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