Dr. Bhathal is a recognized specialist in Neurology and Child Neurology in Barcelona, with extensive experience in the prevention and treatment of epilepsy. His extensive training includes several specialization studies in different areas of Neurology, as well as a Fellowship in Epilepsy at the Montréal Neurological Institute (Canada).
Why does epilepsy occur?
Epilepsy is a disease of the brain, specifically affecting its gray matter (where neurons are grouped). Its main manifestation is to produce epileptic seizures repeatedly until a treatment, usually pills, is applied.
Epilepsy causes seizures because it affects a certain network of neurons. These have an altered electrochemical functioning that makes them hyperexcitable, and when they synchronize (fire all at the same time), they produce the seizure.
Are we all susceptible to epilepsy?
Any cause or injury that affects the brain can produce epilepsy.
There are many causes that affect the brain and produce epilepsy, but in almost half of them, no obvious lesion is detected. The rest are usually trauma injuries, stroke, malformations, tumors, perinatal damage, infections, and genetic causes.
It is a relatively common disease, but in most patients it is completely controlled with medication. Thus they can lead a normal life.
Is there a genetic component to epilepsy?
Indeed, a small proportion is suspected to have a genetic cause. Most genetic diseases that produce epilepsy do not generate an evident brain lesion, but others do (for example tuberous sclerosis, or certain cortical dysplasias). They are often accompanied by other neurological and other organ symptoms. We have identified the genetic alterations of many of these epilepsies, so we can diagnose them correctly with specific blood tests.
How do we know we are having an epileptic seizure?
The manifestation of the seizure depends on the brain area affected and there are many types, but we can say that the main thing is the alteration of consciousness and involuntary body movements.
The most recognizable type is the convulsive seizure: loss of consciousness, falling to the floor with convulsions, often accompanied by hypersalivation, tongue biting and sphincter relaxation. Probably the most frequent type is the focal seizure, where there is alteration of consciousness (disconnection, or absence), without fall or loss of body tone, often accompanied by subtle movements (tremor, blinking) or strange behavior.
How to react to an epileptic seizure?
First aid in case of a seizure.
1- Remain calm, as hasty action can be dangerous.
2- Try not to injure the person during the seizure by removing dangerous objects from the surrounding area (edges of furniture, sharp objects, etc.) and place something soft under the head to prevent the person from hitting the floor.
3- Loosen clothes around the neck (ties, shirts, etc.).
4- Safety posture: the patient should be carefully positioned on his side to facilitate breathing and to avoid choking.
5- Observe the duration of the epileptic seizure.
In the vast majority of cases, this type of seizure ends within two to three minutes, after which the person gradually recovers.
Wait by the person’s side until the seizure is over. Let the person rest until he or she recovers and check that he or she is gradually returning to normal.
What not to do during an epileptic seizure:
1- Do not try to immobilize the person by force during an epileptic seizure.
2- Do not insert any object in the mouth in an attempt to prevent the tongue from moving backwards, as it can be dangerous if the object is swallowed and becomes lodged in the airway, in addition to possible oral and dental lesions when trying to force it in.
3- Water, food or pills should never be given by mouth during the seizure or shortly thereafter since possible vomiting with altered consciousness can be very dangerous. Likewise, once the epileptic seizure is over, the administration of sedative medication is not useful.