The HEALTH : April 2020 | Page 26

26 The Health | April, 2020 | Issue | Knowing more about epilepsy It's important to address the myths surrounding epilepsy the pharmacology of epilepsy S IXTY-five million people around the world live with epilepsy with nearly 80% of them found in developing countries, including Malaysia. It is estimated that epileptic patients make up one per cent of the overall Malaysian population, with an estimated 230,000 diagnosed cases, affecting all races, ages and gender. In 2004, there were nearly 199,000 cases. Epilepsy is a chronic non-communicable disease of the brain characterised by recurrent seizures, and it can affect people of all ages. International Epilepsy Day was celebrated on Feb 4 at the Auditorium Tunku Jaafar, UKM Medical Centre (PPUKM). The Health caught up with Professor Dato’ Dr Raymond Azman Ali, Senior Consultant Neurologist & Physician and Professor Dr Tan Hui Jan, Consultant Physician & Neurologist, Head of Neurology Unit at PPUKM on educating the public on epilepsy. Creating awareness is important Dr Raymond believes it’s important to celebrate people around the world with epilepsy, showing them that they are not alone thus ensuring they do not feel excluded from society. “Today is actually a celebration of the international epilepsy day which is normally held on the second Monday of February every year. It’s an event for the public. We invited the patients, the caregivers, healthcare workers, nurses, medical students, hospital attendants. Anyone can come and listen to the talk,” explains Dr Raymond. The purpose of the talk at PPUKM was to increase awareness of epilepsy in the community and promote how to care for epilepsy patients. The talk covered three different but crucial topics; how to differentiate seizures from simple faints, myths surrounding epilepsy and the pharmacology of epilepsy. Is it a seizure or a faint? According to Dr Raymond, some people have features of a seizure; movements and unconsciousness but actually they are not seizures. This applies vice versa in the case of fainting. He likens it with an example of a blank stare. “School children who suddenly go into blank stares will be brushed off as daydreaming by the teachers. Of course, this upsets the parents who then bring their kids to hospital and the child is soon suspected of having epilepsy. The child is then sent to the neurologist and this is where we come in,” he explained. Seizures such as those are actually easily treated and there are medications in the market to make them disappear. Unfortunately when left treated, this will lead to a drop in academic performance since the child will go blank several times in class leading to a lack in attention. “If someone falls to the ground, goes unconscious, develops jerking movements, bites his tongue and wets himself, all these can actually be symptoms of a simple faint. The difference in a real seizure is when unconscious, they don’t know where they are. But in simple faints, they know where they are. Usually the reasons for fainting are due to standing in the hot sun for too long or fear of blood taking. This is why we have the lecture, so people don’t jump to conclusions and label someone epileptic.” Separating fact from fiction about seizures Some myths about epilepsy are centuries old, but they still persist and have a bad stigma all over the world. “If someone sees a person having a seizure at the side of the road, they simply act as audiences and have no clue what to do. They are worried it might be contagious. Some people believe it’s the work of the devil and don’t want to see doctors,” worries Dr Raymond. Dr Tan encounters this on an almost daily basis. The most common myth is people tend to believe epilepsy is contagious. “There are a lot of causes, genetic, developmental, brain tumor and scar tissue of the brain. For patients who come to us, we will take an EEG (electroencephalogram) and also a brain scan. This will tell us if there is a lesion in the brain that can cause the seizures.” A lot of the myths surrounding it have to do with management of epilepsy. One of them is when the patient has a fit. A lot of parents will place things in their mouth. Dr Tan has seen it all. Fingers, fork, spoons have gone in the mouths of epileptic patients. “This is very dangerous. We should not put anything in the patient’s mouth. In fact just make sure the patient has turned to the right, cradle the head, remove anything surrounding the head, make sure the patient is breathing and let the fit abbott by itself. Usually the patients will be tired after that, so sleep is essential,” she explains. “Many patients only take the medication when they have the fit. That is also wrong. We have to make sure the patient take the medication regularly because we cannot predict when the fit will come.” People with epilepsy are still being treated unfairly, trapped in discrimination and isolation. Sadly, epilepsy remains a hidden disease for many years due to the attached stigma. — The Health