Epilepsy

• Tonic-clonic: these are the most recognisable type of seizures. They cause someone to suddenly lose consciousness before the body starts jerking and shaking. The person is not aware of what is happening and cannot control their body movements. A tonic-clonic seizure usually lasts 30 seconds to five minutes.
  
  
• Focal: these seizures usually affect only one part of the body, depending on where in the brain the seizure is occuring. They can cause hallucinations, disturbances in  sensations such as numbness or tingling and repetitive movements like picking at clothes or skin, staring or swallowing. These symptoms usually last for less than one minute.

Seizures occur when there are sudden, uncontrolled bursts of electrical activity in the brain. The reason why this occurs is not known in the majority of patients, but in some patients, seizures occur because of damage to the brain, for example after a head injury, brain tumour, stroke, poisoning or infection.

In some people with epilepsy, certain factors can increase the risk of having a seizure. These are known as 'triggers' and include:

• ​Lack of sleep
• Stress
  
• Flashing lights
• Loud noises
• Drinking alcohol​
  

D​iagnosis
Epilepsy is diagnosed based on information on events that happened during the seizure.

Some tests may be ordered to confirm the diagnosis, type of seizure and cause:

• Electroencephalogram (EEG) - this test records electrical activity in the brain via electrodes attached to the patient's head. 
  
  
• ​Computerised Tomography (CT) or Magnetic Resonance Imaging (MRI) - these scans may be required to look for changes in the brain that are causing the seizures, such as tumours.

Treatment
Some types of epilepsy only occur in childhood and the person may outgrow the seizures as they get older. However, t​he majority of patients require long-term treatment to control their seizures.

Treatment includes:

• ​Medication known as anti-epileptic drugs (AEDs) helps control and prevent seizures. There are many different types of AEDs available and treatment needs to be carefully managed to find the best combination for each patient to prevent or reduce the frequency of seizures while minimising side-effects.
  

• Identifying and avoiding triggers - this is usually done by keeping a seizure diary to track when seizures occur and identify things such as lack of sleep and flashing lights that might be triggers. Lifestyle changes can then be made to reduce the person's exposure to triggers, thereby reducing the frequency of their seizures.
  

• ​Surgery may be considered in patients who do not respond to anti-epileptic drugs and have repeated seizures. This involves removing a portion of the brain where the seizures occur.

• ​Stay calm
• Time the seizure
• Place something soft under the person's head and loosen any tight neckwear if possible
• Remove nearby sharp or hard objects
• When the seizure is over, turn the person onto their side
• Stay with the person for 15 to 20 minutes to ensure their breathing has become normal again and they are conscious
• DO NOT place anything in the mouth
• DO NOT restrain the person
• DO NOT move the person unless they are in danger, e.g. in a road

• The seizure lasts more than 5 minutes 
• There are repeated seizures and the person does not regain consciousness in between
• It is the person's first seizure
• The person is pregnant
• The person has difficulty breathing after the seizure
• The person was injured during the seizure or the seizure occured in water
  

Singapore Epilepsy Foundation provides support for persons with epilepsy and their caregivers, and increases public awaress of the condition. For more information contact 6334 4302 or visit https://www.epilepsy.com.sg

Epilepsy Care Group (Singapore) provides education and counselling for persons with epilepsy and their caregivers, and raises public awareness about epilepsy.