Dispelling the myths about 'fits'

... Old remedies no help for persons having an epileptic seizure

Arthur Hall, Senior Staff Reporter

For decades, Jamaicans have accepted that the way to help someone having an epileptic seizure, popularly referred to as 'fits', is to take off their left shoe and cover their nose.

Other Jamaicans swear that something has to be inserted into the mouth of the person having the seizure to ensure that they do not choke on their tongue, while still others say a preacher or a 'mother woman' must be called to chase out the demons causing the seizure.

More harm done

But all these are myths that could do more harm than good to the person having an epileptic seizure.

"This is a good opportunity to dispel those myths. The reality of the situation is that putting any object in the mouth of someone having a seizure is to be discouraged. It is the reason so many people with epilepsy have lost their teeth," Dr Amza Ali, consultant neurologist and president of the Jamaican League Against Epilepsy, told a recent Gleaner Editors' Forum.

"All you need to do is to protect the airway, and that means putting the person on their side. You should loosen any necktie and give the person space and air," added Ali, as he recounted a recent case at the Kingston Public Hospital where the parent of a child who was having a seizure requested the traditional shoe-over-the-nose technique.

"This is a patient I have been treating for 10 years. So it just goes to show that no matter how you educate, old habits die hard, but we want to say again that putting a shoe over the nose does not work," said Ali.

He said apart from allowing the person air, the seizure should be timed, and if possible, recorded and shared with medical personnel.

"The more information you can retain about the seizure, the better will the medical official be in determining how to treat it.

"The vast majority of seizures don't last for more than two minutes or so. If a seizure goes on for five or 10 minutes, that is major, and medical attention should be sought," said Ali.

He was supported by consultant paediatrician Dr Roxanne Melbourne-Chambers who noted that children with epilepsy are often stigmatised.

According to Melbourne-Chambers, it is another myth that children who have epilepsy are mentally or physically impaired and should be consigned to a life outside of the formal education sector.

She expressed concern about the attitude of some parents who have to deal with children who suffer from epilepsy.

"A number of times, children are diagnosed and parents give up," said Melbourne-Chambers.

But the consultant paediatrician expressed some level of understanding for the parents who struggle to cope with a child who might have seizures.

"It is such a terrifying experience to see someone convulse, and because it is related to the brain, it means that the brain is sick and the child's expectations become capped and limited," added Melbourne-Chambers.

"There is a lot of misunderstanding in schools, and children are not allowed to participate fully once they are diagnosed with epilepsy. We need to empower these children to reach their full potential," Melbourne-Chambers said.

Equal achievement

She pointed out that while some children with epilepsy could suffer some cognitive problems, the large majority can achieve equal to children who do not have this disease.

"Epilepsy is not a life sentence, and most people with epilepsy can have their seizures controlled once the right diagnosis is made," declared consultant paediatric neurologist Dr Judy Tapper.

"These people can live normal or near-normal lives, and most of the children we see with epilepsy do live near-normal lives," added Tapper.

Epilepsy is caused by a wide variety of conditions related to a problem with the brain. In most cases, it can be treated with medication, although in some cases a surgical procedure is necessary.

About five to six in every 1,000 Jamaicans had been diagnosed with epilepsy, although that number could be underreported.

• What is epilepsy?

Epilepsy is a disorder characterised by recurring seizures, which are caused by electrical disturbances in the nerve cells in a section of the brain.

While the cause or causes of many cases of epilepsy are unknown, the condition is thought to result from nerve injury, brain injury, or lesions.

• Caring for an epileptic child:

1) The child should be allowed to lead as normal a life as possible.

2) The child should never swim alone, even in shallow water.

3) The climbing of trees should be discouraged.

4) If the child has a seizure, DO NOT place anything over the child's nose or in the child's mouth.

5) DO NOT panic if the child is having a seizure.

6) Seek medical attention for the child and stick to the medication schedule from the doctor. Most children outgrow the seizures or remain seizure-free on medication.

• Dr Judy Tapper, Consultant paediatric neurologist

Most people with epilepsy can live normal lives once they take their medications. Having seizures does not mean they have any mental illness or any disability.

• Dr Tammy Haynes-Robinson, Clinical psychologist

If you have epilepsy, to stave off the development of depression or anxiety, it is best to start by being informed and joining an association or support group to ensure that your psychological and emotional well-being is up to par, because oftentimes you will feel like you cannot cope or manage it.

• Dr Amza Ali, Consultant neurologist

Epilepsy is common, it's under-recognised, it's often missed, it's undertreated, and there is much to be done in Jamaica. Putting a shoe over the nose of someone having a seizure does not work.

• Nora Perez, President, Jamaican Epilepsy Association

I would like to encourage all persons with epilepsy and families who have a person with epilepsy to learn more about the illness so we can dispel all the myths about it.

• Dr Roxanne Melbourne-Chambers, Consultant paediatrician

Epilepsy is not caused by evil sprits or demons. The treatment is medical and the treatment is in large part successful.