Overview:
Dr. Manoj Sharma, a Professor of Social and Behavioral Health and Internal Medicine, as well as President of Health for All, Inc., answers queries on caring for a loved one with epilepsy.
Dhaval’s Story
Jignesh* is a 38-year-old, first-generation immigrant from India who owns a motel in the Midwest. His wife, Hansaben, * is a 34-year-old homemaker. They immigrated to the US about 10 years back and have a son, Dhaval, * who is 11 years old and goes to school. Recently, a rather Dhaval experienced unusual movements of the body, and lost consciousness for a few minutes. He recovered from this episode of unconsciousness but said he did not remember anything. Since this first episode, a somewhat similar event recurred once more within a month. Back in India, the family had heard that such occurrences were due to possession by spirits. They are extremely worried about Dhaval and approached us looking for some insights into his condition.
Q: What is wrong with Dhaval?
Dr. Sharma: Jignesh and Hansaben, what you are describing seems to be two episodes of seizures (abnormal body movements). Seizures are common in a medical condition known as epilepsy. Having a single episode does not mean one has epilepsy, but having two unprovoked episodes at least 24 hours apart may indicate epilepsy. The diagnosis must be made by a healthcare provider.
In the United States, according to the Centers for Disease Control and Prevention (CDC), about 3.4 million people have epilepsy. Out of this, about 3 million are adults and 470,000 are children. Worldwide, about 50 million people have epilepsy. According to the World Health Organization (WHO), it is estimated that the prevalence of those requiring active treatment is between 4 to 10 per 1,000 people.
Contrary to some myths associated with this condition, epilepsy is not contagious, and it is not a mental disorder. It is a chronic neurological condition that causes seizures due to abnormal signals produced in damaged brain cells.
Q: Does his condition have anything to do with spirits?
Dr. Sharma: Absolutely not! The exact cause of this condition is not known. It can happen due to brain damage such as something in the prenatal (during pregnancy) or perinatal (after birth) period, genetics, a head injury, an infection in the brain, or a tumor in the brain. There is no need to blame anyone or think about any supernatural causes for this condition. It is worth noting that with proper medication, seizures can be controlled. One should also take measures to prevent triggers for seizures from occurring, such as reducing stress, ensuring regular sleep, avoiding the use of any alcohol or illicit drugs, eating healthy meals on time, avoiding overexertion, avoiding dehydration (drinking lots of water and fluids), and taking prescribed medication on time.
Q: Do we need professional help?
Dr. Sharma: Most certainly, you need to consult your primary care provider, who would likely refer Dhaval to a neurologist. Besides taking detailed medical history and checking blood chemistry, they may order an electroencephalography (EEG) that measures electrical activity in the brain and can identify any abnormal electrical patterns. Often, magnetic resonance imaging (MRI) is also conducted to rule out any tumors or blood vessel abnormalities. The most common treatment for this condition is through anti-seizure (anticonvulsant) drugs. About 70% of people with epilepsy become free of symptoms after treatment with drugs, and if they remain so, the medication can even be stopped after two years. Some people may require surgery, which is often safe and effective.
Q: What should we do if this happens again?
Dr. Sharma: That is a very good question, and as parents, you should know the essentials of first aid in the event of a seizure. First, you should be calm and not panic. Then you should remove anything around the person that may cause injury (such as eyeglasses, pointed objects, etc.) and gently turn them to the side with their mouth pointing to the ground so that the airway is not blocked. Do not put anything in the mouth or restrain the person. Note the duration of the seizure. If the seizure lasts for over five minutes, seek medical help or call 911. Once the seizure is over, help them sit, comfort them, and explain what happened.
Q: Will Dhaval be able to lead a normal life?
Dr. Sharma: As I mentioned, people with epilepsy can live relatively normal lives with proper management. However, it does have an impact on life due to the potential for seizures and injuries, Side effects of medications, social stigma and discrimination, and challenges with employment, relationships, and social interactions. Therefore, you must prepare yourselves and Dhaval to be strong. Hopefully, if Dhaval indeed has epilepsy, he would be among the 70% of people who respond to anti-seizure medications, and then he would be among those who can remain symptom-free for two years and possibly cut down on the medication.
Q: Can Indian philosophy help us as a family cope with his condition?
Dr. Sharma: All of us have some problems or others. Some seem larger while others seem smaller. But in the long run, all problems get solved. The Indian scripture Bhagavad Gita provides great insights into coping with so-called “misfortunes,” which in essence are just manifestations of the mind. Maintaining equanimity between likes (raga) and dislikes (dvesha) is what wise people practice.
Q: Can you refer us to some additional resources in this area?
Dr. Sharma: Here are some additional resources from which you can find more information:
- Cleveland Clinic’s website on epilepsy
- Mayo Clinic’s website with a video explaining epilepsy
- Epilepsy Foundation’s website on myths and misperceptions about Epilepsy
- Centers for Disease Control and Prevention’s website on first aid for seizures
- Stress management book with individual chapters on various aspects of managing stress
If you have questions, reach out to Dr. Sharma at editor@indiacurrents.com
*Names changed upon request
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