health talk:with Dr Johannes Marisa
So many people have experienced seizures, some of which have been attributed to witchcraft, evil spirits or other unknown beliefs. Children have been tormented, especially in cultures that value a lot of traditional beliefs. People should know that a seizure is a sudden, uncontrolled electrical disturbance in the brain which can cause changes in your behaviour, movements or feelings and sometimes levels of consciousness. Epilepsy, which is one of the causes of seizures, has about five million people diagnosed of it globally every year.
What are the common causes of seizures?
lBrain infection, including meningitis or encephalitis.
lHigh fever in children (febrile convulsions, which can appear when temperature is about 38 in children between six months and five years).
lBrain injury that occurs to the baby during labour or childbirth.
lCongenital brain defects.
lBrain tumour.
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lAbnormal levels of sodium and glucose in the blood.
lDrug abuse like excessive use of alcohol, cannabis and other drugs like “broncho” or cocaine.
lAbnormal levels of sodium or glucose in the blood. It is, therefore, wise to do glucose checks or electrolyte checks, preferably urea and electrolytes.
Symptoms of seizures Presentation of seizures differs with some cases having symptoms and signs that are mild while others have severe, frightening presentation. A lot of caregivers panic on noticing seizures depending on manifestation. The following signs and symptoms may appear:
lTemporary confusion.
lA staring spell.
lUncontrolled jerking movements of the arms and legs.
lLoss of consciousness and awareness.
lCognitive and emotional symptoms such as fear, anxiety or déjà vu.
Types of seizures Seizures may be classified as focal or generalised, based on where abnormal brain activity begins.
Focal seizures Focal seizures result from abnormal electrical activity in one area of your brain. Focal seizures can occur with or without loss of consciousness. Symptoms of focal seizures may be confused with other neurological disorders such as migraine, narcolepsy or mental illness.
Generalised seizures These seizures appear to involve all areas of the brain. Different types of generalised seizures include:
Absence seizures: Previously called petit mal seizures, these often occur in children and are characterised by staring into space or subtle body movements such as eye blinking or lip smacking Tonic seizures: Cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to collapse.
Clonic seizures: These are associated with repeated or rhythmic, jerking muscle movements. These usually affect the neck, face and arms.
Myoclonic seizures: They appear as sudden brief jerks or twitches of your arms and legs Grand mal seizures (tonic-clonic): The most dramatic of them all and can cause an abrupt loss of consciousness, body stiffening and shaking and sometimes loss of bladder control.
When then to see a doctor?
Be alert and see a doctor immediately about seizures if any of the following occurs: lThe seizure lasts more than five minutes. Higher chances of aspiration.
lBreathing or consciousness does not return for some time after seizure stops.
lA second seizure stops.
lThere is high fever. Be careful about malaria, meningitis, encephalitis.
lYou are pregnant. May be a sign of eclampsia in the event of high blood pressure, oedema, proteinuria in pregnancy.
lYou are a diabetic.
lYou have injured yourself during a seizure: Some bite their tongues with resultant deep cuts that may need surgical intervention to stop bleeding. lYou are experiencing heat exhaustion.
Seizure first aid It is prudent for you to know what first aid can be given to a person with a seizure to avoid avoidable complications like aspiration. Take some of the following steps:
lCarefully roll patient onto one side lPlace something soft under their head.
lLoosen tight neckwear.
lAvoiding putting your fingers and other objects in the person’s mouth.
lDo not try to restrain someone having a seizure.
lClear away dangerous objects if the patient is moving.
lIn the case of children with febrile convulsions, remove heavy clothing and cool them with wet towels to lower temperature.
lStay with the person until medical personnel arrive.
lTime the seizure.
lStay calm.
Diagnosis Tests may include the following:
lNeurological examination
lBlood checks
lLumbar puncture
lElectroencephalogram
lCT scan
lMagnetic resonance imaging
lPositron emission tomography
lSingle-photon emission computerised tomography.
It is not witchcraft per se, but seizures that can be traced to numerous things. Take action early so that complications are avoided. Avoid driving if you have epilepsy because of the inevitability of accidents one day!
lDr Johannes Marisa is a medical practitioner, educationist and public health expert who can be contacted on [email protected].
