A professor of Internal Medicine/Neurology at the Lagos State University Teaching Hospital, Ikeja, Yomi Ogun, says one seizure does not signify epilepsy.
She, however, said having two or more unprovoked seizures would identify one as having the condition.
Ogun spoke in reaction to a study by the United States National Institutes of Health, available online via the free digital repository, PubMed Central.
According to the study, when a person presents to the healthcare system with a first seizure, it is almost always a convulsive seizure, either generalised or focal.
Other seizure types such as absence or complex partial seizures typically occur several times before the person or family become concerned.
The study authors note that though epilepsy syndrome can be diagnosed after one seizure, a single seizure is insufficient for the diagnosis of epilepsy.
“The diagnosis of epilepsy addresses recurrence risk, whereas epilepsy syndrome is a broader concept encompassing age of onset, aetiology, prognosis, and response to treatment,” the NIH stated.
Physicians say some people experience symptoms similar to those of an epileptic seizure but without any unusual electrical activity in the brain. “When this happens, it is known as a non-epileptic seizure and it is most often caused by mental stress or a physical condition,” they said.
Speaking with PUNCH HealthWise, Prof. Ogun said everybody is ‘entitled’ to one seizure in a lifetime and that seizures can be provoked.
Ogun said, “One seizure does not mean epilepsy. Everybody is entitled to one seizure in a lifetime.
“I can engage seizure in you if I bring your sugar so low; that could trigger a convulsion or even reduce your oxygen concentration. When your sugar goes low, some electrolyte disturbance in you can make you throw a fit.
“Epilepsy must be two or more. It’s a recurrent tendency to seizures, and, usually, seizures are unprovoked.
“When children have a fever, they may have a convulsion. We call it febrile convulsion, but that doesn’t make it epilepsy because it is the fever that triggered the seizure.
“When you have a fever, if your fever threshold becomes very low, you can have a seizure,” he explained.
He said seizure episodes are a result of excessive electrical discharges in a group of brain cells.
“Epilepsy, basically, is like an electrical stomp in the brain. The brain triggers a lot of electrical activities. So, I liken epilepsy to electricity supply, which can come with high or low current.
“Such a period of high current is when someone throws a fit and the treatment is to get a stabiliser. With the medication, it can stabilise the electrical stomp in the brain,” he noted.
According to him, anyone can develop epilepsy, but it’s common in young persons below the age of 20 because some of them develop a fever.
The neurologist said epilepsy is not a spiritual attack and it is not contagious.
“Some people think when a patient is jerking, he’s throwing out some evil spirit and that is why people stay away and they start spitting at them.
“But we know that it has to do with electrical activities in the brain, some are excitatory and some are inhibitory.
“If you have too much of excitatory, the brain will be hyperfiring; if you have too little of the inhibitory, the brain will be hyperfiring; so it’s one of two things — either excess of excitatory or deficiency of inhibitory,” he said.
He said the characteristics of seizures vary, but symptoms include loss of consciousness, and disturbances of movement, blurry vision, or other cognitive functions.
The neurologist noted that many underlying disease mechanisms like brain damage from prenatal or perinatal causes, or head injury, can lead to epilepsy,
“We also advise pregnant women not to give birth in religious places in case of emergencies and to avoid head injury or trauma during birth. It is advisable that they go to the hospital when they want to deliver,” he said.
Ogun said there’s no cure for epilepsy, but the disorder is treatable with medications and other strategies.
“It is not curable, but it is treatable and it can resolve. This means that for the next 10 years, you are not going to have it, and then the next five years, you are on medication, and the next five years, you are not on medication.”
He added that in some patients, surgery is the best chance of complete control of seizures
A study published in the Open Journal of Psychiatry, led by the Chief Consultant Psychiatrist at the Federal Neuropsychiatric Hospital, Enugu, noted that there is the need for appropriate culture-congruent educational interventions to provide the right information about epilepsy and debunk the misconceptions and myths associated with it.
Epilepsy is a chronic non-communicable disease of the brain that affects around 50 million people worldwide, according to the World Health Organisation.
“It is characterised by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalised) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function,” WHO said.
The world health body added that nearly 80 percent of people with epilepsy live in low- and middle-income countries and three-quarters of people with epilepsy living in low-income countries do not get the treatment they need.
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