Majority of seizures can be treated, Utah epileptologist says
Jeffrey D. Allred, Deseret News
SALT LAKE CITY — Regardless of the cause, the first time a person experiences a seizure, they should seek medical treatment, according to doctors at Intermountain Medical Center.
"There is a horrible myth out there that if you see a person having a seizure, you should stick a wooden spoon in their mouth. You really shouldn't put anything in their mouth," said Dr. Jeffrey Bigelow, a neurologist and epileptologist at the hospital's epilepsy clinic.
While a seizure may appear to be traumatic, he said it is often over before there is much opportunity to do anything that would help.
Bigelow said to ensure that the victim is in a safe position, help them get to the ground, if necessary, loosen any tight clothing and call for help.
Emergency room doctors are capable of screening out non-epilepsy-related issues that would lead to seizures. Oftentimes, it is as simple as receiving intravenous fluids to restore a balance. Other times, brain scarring, trauma or previous injury can lead to epilepsy, a neurological disorder that can cause recurrent seizures.
"Anything wrong in your brain, you're going to be more likely than the general population to have epilepsy," Bigelow said, adding that the condition can sometimes be hereditary or genetic.
Epilepsy can be detected using relatively simple tests, including electroencephalography, or EEG, that tracks brain activity, or via MRI, which can detect lesions that can cause the condition. Better technology is leading to an increase in the ability to diagnose epilepsy, Bigelow said.
It is often helpful to have an observer's account of the seizure, as patients don't typically remember it themselves.
A variety of medications exist to treat epilepsy, including those that have been around a long time and one or two new drugs every year.
Some are available for specialized care and specific implications, and about 50 percent of patients can control their seizures with the application of the right medication. Another 25 percent are successful with the second or an additional medication taken at the right times. And the remaining 25 percent are harder to control.
"There are a lot of treatment options out there," said Jody Anderson, a nurse practitioner who works with Bigelow.
Another option, Anderson said, is the vagal nerve stimulator, a pacemaker-type device placed under the skin that sends an electrical impulse to the brain to disorganize seizure activity.
Other options include brain surgery, in which neurosurgeons reset the area of the brain that is causing seizures, Bigelow said. Up to 80 percent of those patients can become seizure free.
"With the right kind of surgery, it can be life-changing," he said, adding that it is important for seizure sufferers to receive treatment.
Sometimes, stress can result in a similar reaction to seizures, and such behavior can be treated with cognitive behavioral therapy and stress management techniques.
Bigelow works to educate patients and their families and to eradicate the stigma associated with epilepsy. In addition to driving laws, he said Utah used to have laws against epileptics getting married.
A common misconception also exists that those who suffer from seizures are spiritually possessed.
"Everyone experiences it differently," Anderson said. "The worry is that some people have been told that the way they are dealing with it is as good as it is going to get, and that is wrong for some people. Optimized treatment is available."
Bigelow and Anderson will be featured on Saturday's Deseret News/Intermountain Healthcare Health Hotline, where they will take questions from the public on epilepsy, seizures and other neurological problems. From 10 a.m. to noon, anyone interested in the free, confidential medical advice can call 800-925-8177 or post questions on the Deseret News Facebook page.
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