Epilepsy and pregnancy ...
 

People with epilepsy suffer periodic convulsions or fits during which they lose consciousness for anything from a few seconds to a few minutes. There are many forms of epilepsy, each with its characteristic symptoms making it different from the rest. Regardless of its type however, they all stem from the same source - a problem in the brain's communication system.
Information is transferred within the brain through electrical impulses which are passed from cell to cell. As each brain cell "fires", it activates a neighbouring cell and this in turn stimulates the next cell along the course. In the case of the brain cells being more active than normal, they no longer follow the orderly passage of electrical messages. The result is a sudden burst of abnormal electrical activity within a group of cells which is the start of a seizure. This can be known as a partial seizure, which is limited to only one part of the brain, or a generalized seizure, which affects a larger area, often the entire brain.

Having experienced a single seizure, does not automatically render you an epileptic. In fact, anyone can have a seizure under certain conditions, namely alcohol or drug withdrawal or even very high temperatures in children. To be diagnosed with epilepsy, one would had to have experienced at least two fits within a two year period.

People with epilepsy experience recurrent fits because their brains are more easily excited than others, however most epilepsy is of unknown cause. It is thought to be linked to head injury, infection, lack of oxygen, blood vessel disturbances, intoxication or chemical imbalance.

Symptoms:

The appearance a seizure takes will depend heavily on the area of the brain in which it arises, and how widely and rapidly it spreads. Generalized seizures occur suddenly, without warning, and probably the most common and well-known of these is the "grand mal" attack. During this, the patient falls to the ground unconscious with the muscles of the entire body stiffening and jerking uncontrollably. Saliva may bubble from the mouth and bowel and bladder control may be lost. The seizure usually lasts between 1 and 4 minutes, after which consciousness slowly returns - this ranging anywhere from 5 minutes to half an hour. Following a seizure it is very common for the patient to feel drowsy and complain of a headache, this is usually cured after a good nap though. Unfortunately for some, these after-effects last for a period of one week or sometimes more.

Another, very different kind of generalized seizure is the "absence" or "petit mal" seizure. During this, the person or more commonly, the child experiences a loss in consciousness where she is unaware of the goings on around her. Lasting only between 2 and 30 seconds, the child may simply appear to be daydreaming or her eyes may blink rapidly and her body twitch slightly. Fortunately, the outlook for these children is quite good - more than half outgrow this condition.

Partial (or focal) seizures, in which the sudden burst of electrical activity is confined only to one part of the brain, characteristically begin with a specific "aura", this determined by the part of the brain involved. This "aura" may consist of involuntary movement of part of the body, a sensation of fear or unpleasant taste or smell which is often accompanied by small chewing movements. These actions will gradually merge into normal behaviour, after which the person will feel confused, and have little or no recollection of what happened.

How common is the problem?

The disease tends to run in families with both sexes equally likely to be affected. In the case of one parent suffering from epilepsy the risk to the child is about 1 in 40. This increases to 1 in 20, where both parents have the disease.
Children and teenagers are more susceptible or seizure-prone, however they do often outgrow this condition. In fact, as many as three-quarters would have done so before reaching the age of 20. Absence and focal seizures can begin at any age, although they seem to be more common in patients under the age of 18 years.

How to help a person during an attack

• Don't try and hold the person down or attempt to stop them from jerking or thrashing about. Only restrain them if they are likely to injure themselves - if they are near a swimming pool for example.
• Do not force anything between their teeth in the attempt to prevent them from biting their tongue. Contrary to popular belief, it is not possible to swallow your tongue, and trying to prevent the impossible will only result in you damaging the patients mouth, breaking teeth or having your fingers badly bitten.
• Move as many objects as possible or pad them with towels or blankets to prevent injury.
• Once the seizure has passed, wipe any froth or blood from the person's mouth and check that she is breathing normally.
• Lie her in the recovery position - on her stomach with her head turned to one side and one knee bent out to the side.
• In the event of the fit lasting more than about 3 minutes, or recurring almost immediately - seek immediate medical assistance.
• The person is likely to be drowsy and confused after the attack, let her sleep undisturbed, while you arrange a clean set of clothing in case she's wet or soiled herself.

Fact File:
• Treatment with drugs successfully controls seizures in over 50% of people with epilepsy, provided they take their tablets exactly as prescribed.
• Alcohol increases the risk of seizures, and may be the sole cause when taken in excess.
• Flickering TV screens, disco lights and tree-lined streets should also be avoided.
• Consuming large amounts of fluid can too precipitate a seizure.
• Drowsiness, hunger and even boredom can result in an attack.
• The frequency of seizures can be dramatically reduced by keeping a 'seizure-diary' for a few months. This will help you identify what triggers the attacks.
• Many have mastered a technique, whereby they are able to 'abort' the seizure during the initial stage of the aura by practising a form of mental distraction.
• Unfortunately, all anticonvulsive drugs have some side-effects, but usually these are outweighed by the advantages of improved seizure control.
• Seizures may occur several times a day to one every few years.
  It is very important that one takes the medication regularly - stopping it suddenly may result in a seizure.
• Approximately 1 person in every 100 suffers from some form of epilepsy.
   

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