Epilepsy in the African context is looked down upon and stigmatized as a disgraceful illness.
According to WHO approximately 10% of the global population can experience at least one epileptic seizure living a normal life span with 50 million experiencing recurrent seizures. This figure might easily be an underestimated number due to the many who experience partial seizures that remain unreported or unrecognized, especially in Africa.
Epilepsy is a chronic neurological condition characterized by recurrent seizures.
Seizures occur when there is abnormal brain activity and can take the form of violent muscle spasms, loss of consciousness/awareness, and unusual behavior or sensation.
Generalized tonic-clonic epilepsy which occurs with very overt symptoms wherein one loses consciousness and experiences violent shaking is that which most people associate with the term epilepsy in the general population. However, there are numerous forms of epilepsy. Temporal lobe epilepsy is one of these the most common but most easily unrecognized form of epilepsy.
Temporal lobe epilepsy is characterized by changes in effect, behavioral patterns, personality, and psychotic behavior. Given that the temporal lobe of the brain is responsible for emotions and memory, temporal lobe epilepsy results in symptoms that elicit unprovoked anxiety/fear, joy, anger/irritability/aggression, or periods of irrational rage. Memory challenges such as deja vu or jamais vu may also occur. At times due to the loss of awareness one may lose time, spot what they are doing, and stare in the air whereas others experience automatism. This seizure may last for 30 seconds to 2 minutes after which the person feels disoriented. They may feel fatigued and sleepy and find it hard to recall what happened. This is often very confusing for the individual and those around them.
In itself epilepsy is not a psychological disorder however especially temporal lobe epilepsy is highly comorbid with mental health difficulties such as depression and anxiety. 44% of children with temporal lobe epilepsy are considered at risk for depression. Due to the similar area affected by TLE and anxiety, there is an even higher vulnerability for the development.
People with epilepsy are 5 times more likely to have behavioral problems. This withstanding, prior to a diagnosis being made one can easily misjudge and label a child problematic. It is therefore important to identify behavioral problems and follow up with an intervention program. When the behavioral problems and changes observed are rather sudden and extreme this could be a sign of illness and it is imperative to rule out possibilities.
By Zawadi Kimari,
Chiromo Hospital Group