With 60-70% Treatable by Medication, Improved Social Awareness Is Crucial
March 26 (Wednesday) marks Purple Day, an international epilepsy awareness day initiated in 2008 by a young Canadian girl who suffered from epilepsy. She suggested wearing purple to raise awareness and strengthen solidarity among patients.
Epilepsy is a chronic neurological disorder characterized by temporary abnormal excessive brain cell activity causing seizures and impaired brain functions. It can develop at any age, with risk factors varying by age group. For infants and toddlers, congenital abnormalities, perinatal brain injuries, and infections causing febrile seizures are common causes. Among adults and the elderly, trauma, strokes, and brain tumors are primary risk factors.
Professor Hwang Kyung-jin of the Department of Neurology at Kyung Hee University Hospital stated, "Epilepsy has historically been misunderstood as incurable, spirit-related, or a psychiatric illness, leading to significant societal isolation. Many patients have difficulty even visiting hospitals." He further emphasized, "Regardless of its cause, epilepsy is a neurological condition and not something for which individuals should blame themselves or feel discouraged."
Hwang also highlighted that despite significant awareness initiatives and the official name change from the stigmatized term 'ganjil' (癇疾), meaning convulsive disease, to 'epilepsy,' patients and families continue to suffer due to lingering social prejudices.
The hallmark symptom of epilepsy is seizures, often accompanied by limb tremors or speech difficulties, with some patients losing consciousness during episodes. Severe seizures can lead to convulsions, stiffening of the body, and foaming at the mouth.
"Short, isolated seizures generally resolve within minutes without causing brain damage, although some may temporarily become confused or fall asleep," explained Professor Hwang. "However, immediate medical attention is necessary if seizures last more than five minutes in adults or three minutes in children."
Diagnosing epilepsy relies heavily on patient history, though patient recollection might be unreliable, making eyewitness accounts essential. Further diagnostic accuracy is achieved through electroencephalography (EEG) and magnetic resonance imaging (MRI). EEG measures subtle electrical brain activity through scalp-attached electrodes, aiding in identifying epilepsy types and guiding medication selection.
"Medication is the primary treatment for epilepsy, effectively managing symptoms in approximately 60-70% of cases. Medications can sometimes be discontinued after two to three seizure-free years," Hwang emphasized. He also cautioned, "Selecting appropriate medications varies significantly depending on the epilepsy type and patient characteristics, and potential side effects necessitate professional medical consultation."
Surgery becomes an option for medication-resistant epilepsy, involving targeted removal of the problematic brain region. If surgical removal isn't viable, alternative treatments like vagus nerve stimulation (VNS) or deep brain stimulation (DBS) are employed. VNS provides mild electrical stimulation to the vagus nerve, reducing seizure frequency and severity. Though less effective than surgery, it is minimally invasive and has fewer complications.
Professor Hwang further advised, "In addition to accurate diagnosis and treatment, meticulous lifestyle management is essential. Alcohol consumption, irregular sleep patterns, and strenuous exercise that rapidly elevates heart rate can trigger seizures and should be avoided."
