“Deriving accurate figures on the epidemiology of epilepsy in low- and lower-middle income countries is very difficult – there have been very few surveys to gather the sort of data we need, and such studies tend to be expensive, especially for countries whose health research funding is likely to be very limited.
However, the research we do have shows that the burden of epilepsy in these regions is at least double that found in high-income countries, and sadly, adequate facilities for diagnosis, treatment and ongoing management of epilepsy are virtually non-existent in many of the world’s poorest regions. Many people with epilepsy or their families do not even know that they have a disorder that can be controlled with biomedical treatment, so it is vitally important that awareness is raised and medical care improved in these regions.”
Types of seizures
There are three types of diagnoses a doctor might make when treating a patient with epilepsy:
Idiopathic – this means there is no apparent cause.
Cryptogenic – this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
Symptomatic – this means that the doctor knows what the cause is.
There are three descriptions of seizures, depending on what part of the brain the epileptic activity started:
Partial seizure – this means the epileptic activity took place in just part of the patient’s brain. There are two types of Partial Seizures:
Simple Partial Seizure – the patient is conscious during the seizure. In most cases the patient is also aware of his/her surroundings, even though the seizure is in progress.
Complex Partial Seizure – the patient’s consciousness is impaired. The patient will generally not remember the seizure, and if he/she does, the recollection of it will be vague.
Generalized Seizure – both halves of the brain have epileptic activity. The patient’s consciousness is lost while the seizure is in progress.
Secondary Generalized Seizure – the epileptic activity started as a partial seizure, but then it spread to both halves of the brain. As this development happens, the patient loses consciousness.
What are the symptoms of epilepsy?
The main symptoms of epilepsy are repeated seizures. There are some symptoms which may indicate a person has epilepsy. If one or more of these symptoms are present a medical exam is advised, especially if they recur:
A convulsion with no temperature (no fever).
Short spells of blackout, or confused memory.
Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme tiredness.
For a short period the person is unresponsive to instructions or questions.
The person becomes stiff, suddenly, for no obvious reason
the person suddenly falls for no clear reason
Sudden bouts of blinking without apparent stimuli
Sudden bouts of chewing, without any apparent reason
For a short time the person seems dazed, and unable to communicate
Repetitive movements that seem inappropriate
The person becomes fearful for no apparent reason, he/she may even panic or become angry
Peculiar changes in senses, such as smell, touch and sound
The arms, legs, or body jerk, in babies these will appear as cluster of rapid jerking movements
The following conditions need to be eliminated as they may present similar symptoms, and are sometimes misdiagnosed as epilepsy:
A high fever with epilepsy-like symptoms
Narcolepsy (recurring episodes of sleep during the day and often disrupted nocturnal sleep)
Cataplexy (a transient attack of extreme generalized weakness, often precipitated by an emotional response, such as surprise, fear, or anger; one component of the narcolepsy quadrad)
Fugue states (a rare psychiatric disorder characterized by reversible amnesia for personal identity)
Psychogenic seizures (a clinical episode that looks like an epileptic seizure, but is not due to epilepsy. The EEG is normal during an attack, and the behavior is often related to psychiatric disturbance, such as a conversion disorder)
Breath-holding episodes (when a child responds to anger there may be vigorous crying and subsequent apnea and cyanosis – the child then stops breathing and skin color changes with loss of consciousness)