Truth and lies about the Sacred Disease

This illness has many names: "divine," "sacred," "demonic," "Moon," "bad," "black sickness", "shakes", "grievous suffering," "punishment of Christ." It is unparalleled in terms of myths surrounding it. Which of them are true and which are false?

Myth #1

Epilepsy is a mental illness that should be treated by psychiatrists.

20-30 years ago, epilepsy treatment was considered a prerogative of psychiatrists, but thanks to the efforts of the Russian Society of Neurologists it was moved to the field of neurology. According to leading epileptologists (specialists who treat the disease) it is well justified. The origin of the disease (especially in adults) is closely related to strokes, tumors, vascular lesions of the brain, cranial trauma, tick-borne encephalitis, metabolic disorders (uremia, hepatic failure, hypoglycemia), etc. There are three forms of epilepsy. Symptomatic (in which the patient has a structural defect of the brain), idiopathic (when such changes are absent, but there is a genetic predisposition to the illness) and cryptogenic (where the cause of the disease cannot be identified).

Myth #2

Epilepsy is always accompanied by seizures.

Currently there are approximately 40 different forms of epilepsy and various types of attacks, including a considerable proportion of those without seizures. They are most often seen in childhood and early adolescence. In this case patients suddenly freeze, their eyes become glassy, there may be trembling of eyelids and throwing of the head back. Typically, these seizures only last 5-20 seconds and often go unnoticed. This cannot be said of convulsive seizures whose approach patients often feel a few hours or even days earlier, experiencing general discomfort, anxiety, irritability, sweating, feeling cold or hot. Patients with serious cases of the disease may experience up to 100 seizures a day, while others experience them once a year or once in a lifetime. In some patients seizures only occur at night, during sleep.

Myth #3

Epilepsy is always hereditary.

Most forms of this illness are not hereditary. The risk of having an epileptic child if one parent suffers from this illness is no more than 8%.

Myth #4

Epilepsy is not dangerous or life threatening.

Alas, epilepsy belongs to the category of extremely dangerous diseases. In the first place it is dangerous for older patients, when an epileptic seizure may lead to serious disturbances of the heart rhythm, breathing, and ultimately result in a coma or death of the patient. Not to mention the mechanical injuries (fractures, contusions) and burns that people falling into convulsions may get. The unpredictability of these attacks and having to live in constant expectation of them is one of the reasons of the low quality of life in patients. No less dangerous, according to experts, are seizure-less attacks. This is especially true for the developing child's brain, which due to continuous seizure activity undergoes irreversible damage. However, treatment of this disease in childhood in most cases is more successful than in adults.

Myth # 5

Epilepsy is a disease of adults.

In fact, 70% of epilepsy patients debut in childhood and adolescence. The incidence among children is up to seven deaths per 1,000. The most frequent cause of the disease in infants is oxygen deficiency during pregnancy (hypoxia), and congenital malformations of the brain, intrauterine infection (toxoplasmosis, cytomegalic inclusion disease, rubella, herpes, etc.), and rarely birth trauma. The second peak in incidence of epilepsy is observed among the elderly and old people and is caused by a number of neurological diseases, first of all strokes.

Myth #6

Epileptic seizures are provoked by emotional stress.

This is not always the case. An epileptic seizure can be provoked by alcohol intoxication and even overheating in the sun, especially among patients sensitive to light flashes. Approximately 50% of the patients in this group experience seizures only when watching TV (especially light shows), looking at the flashing monitor (while gaming), disco lights, flashing lights of the passing traffic, etc. A major precipitating factor for the occurrence of seizures is a breakage of the sleep pattern - going to bed late, forced wakefulness during the night (due to night shifts or parties) or early, forced awakening. Epilepsy patients may be also affected by travel involving the change of time zones of more than two hours.

Myth #7

Epilepsy is incurable.

Earlier, epilepsy was indeed regarded as an incurable disease. However, with the development of neuropharmacology most patients have hope. In 60-70% of cases anticonvulsants that must be taken for many years and sometimes for life, allow patients to lead a normal life, study, and have healthy children. In some patients, especially in children, epilepsy can disappear with age. The success of treatment depends on correct diagnosis and accurate dosing. Preference is to mono-therapy (treatment with one antiepileptic drug). However, there are forms of epilepsy that are poorly treatable, the so-called resistant forms. In these cases, patients are prescribed two or three drugs, and if necessary - a surgery on the abnormal areas of the brain.

Myth #8

We say "epilepsy", but mean "dementia."

A great deal of people with epilepsy suffered from this confusion. This diagnosis prevented people from admission to schools and colleges, or from getting a job. Epileptologists never get tired of repeating: there are no special restrictions for these patients. Most of them do not differ from healthy people in the periods between the seizures. Moreover, often the attacks occur in passive, relaxed moments, whereas mental activity helps to reduce epileptic activity. Physical activity is very good for these patients (especially games), apart from swimming and cycling. The only activities that are not allowed are those associated with extreme conditions: driving a car, service in the police, fire brigade, on in the security of the important objects, work with moving machinery, chemicals, or near water.

Alexander Orlov

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Author`s name Dmitry Sudakov