Dr. Ogunnubi
So much has been said and is still being propounded and believed about the health condition called epilepsy. As a specialist in this aspect of health, what is it really about?
When you talk about epilepsy, in very simple layman’s term it’s abnormal discharge in any part of the brain because the brain has wires which we call neurons; they are like wires, they conduct electricity and this wire sometimes is like a current carrying loads of electricity and before you know it, at times, they may be of high voltage. In epilepsy, what happens is that when neurons in some parts of the brain are of high voltage, the thing will now spark and fire. And when it sparks and fires, it can now manifest in different ways.
Please, what are these different ways?
It can manifest in a motor way and if it happens this way, the person will be jerking. The body, the legs, the hands, head, everything will freeze, and be contracting and that is the one people usually call epilepsy.
But do you also know that the brain, that is those wires I mentioned, they are neurons but I will call it wires so that every reader will understand, if it over charges, it can also cause another form of epilepsy in the behavioural type which we call psychic epilepsy. The person is still having the same cause of epilepsy but this time around it is not a motor function; it is a behavioural and psychic form. What happens to that patient is that he or she can be in a state of automatism in which he will be doing something that he won’t be aware he can move from here to Ojuelegba, he will kill somebody and come back and will sit down at home after everything when the discharge has stopped if you say what happened, he will not remember because everything he did was at that point of discharge. There are other forms of epilepsy but unfortunately, as a result of our culture people cannot explain it because it is something that is happening inside the brain, people just see people that have epilepsy and say that it is from the devil, it is a curse and begin to run away from the person especially those that have motor type. They will say don’t let the saliva touch you, they go and put ashes around the person and he or she is highly stigmatised and that is why you have a lot of suicide. I’m working on a study on study in epilepsy and discovered its overwhelming presence and because of this social stigma. But between you and I, epilepsy is a medical condition caused by abnormal discharge in the neuron of the brain.
What really causes the abnormal discharge? Could the lifestyle of the patient be a part of it?
You have asked a big question but there are many causes of epilepsy. Let’s start from pregnancy. If a pregnant woman has some infections such as HIV, rubella, there’s no immunization during pregnancy, or they gave birth to the child and there’s no immunization against this diseases it can affect this part of the brain and this abnormal discharge can occur. Delivery problems could also be responsible. Some babies may be when their mothers got pregnant she was busy eating all sorts of junks the baby now became so big or the mother had diabetes such a baby should be delivered through caesarian operation but you now see the baby being delivered through normal form of delivery.
So what happens?
The baby gets stuck in the birth carnal and before you know it, there would be prolonged labour and can affect the brain such a baby when he grows up can develop epilepsy. Another problem is after giving birth to a baby, everybody is happy greeting the mother and maybe during the naming ceremony while everyone is carrying the baby, the baby falls down or he or she is carelessly put by the side of the bed and the baby rolls off and falls down, the baby at that time cannot complain at that time. He or she cries a little and they quickly take him or her back, only for epilepsy to creep in years later. I have a case of a patient with epilepsy who was left with the house help some years ago, the baby fell down several times in the househelp’s hands, the parents never knew, the house help went away only for the baby to grow up and started having epilepsy. Further retrospective history made them get the house help and she confessed that the baby fell down one time along the staircase and the mother never knew. So, intrauma- head injury through an accident even in an adult can lead to such a condition. The adult may survive the road accident but may have suffered a head injury which would make him start having epilepsy in future. Another thing is cancer. There are some cancers that when in the brain, it would be irritating that part and would be causing abnormal firing of that neuron and that’s why when you do brain scan, ECG, you’ll see the result of this problem.
Please, epilepsy is not a spiritual problem, it is not evil from mother-in-law, father-in-law, it is a medical condition that requires medical care. And there are lot of medical care for it.
What are the symptoms of this health condition?
We have aura. Someone will just realise that where he is is strange, we call it generalisation. Or you yourself you feel or discover you’ve changed from the environment, it’s called personalisation and in the process of either of these two environmental changes the person would begin to have epilepsy. In some, they realise that their intestine or stomach is twisting, it may be a sign that epilepsy is about to occur. We call it seizure and it’s when you have two or more seizures that it becomes epilepsy. If it is only one, it’s called seizure and when more than one, it’s called epilepsy. Some, they will just realise that their limbs are very weak, they wouldn’t be able to move their legs, and some, because majority of epilepsy occurs in the night, they are usually undetected. The ones that occur during the day, you see the person foaming in the mouth, the eyes closed, the person urinating on him or herself, that’s the common ones many people know but the ones at night which are less known does occur very well. People who have it during the day must have been having it in the night without knowing thus present themselves late to the hospital. We have different types such as generalised in which you have loss of consciousness, will be urinating among others. We also have the petite one in which someone can just be sitting and holding something and the thing he’s holding falls down, he starts blinking, within two minutes he is okay and he continued his activity; it’s still epilepsy. Someone is looking at the board and suddenly everything is blank, even if he is talking to someone and everything about him just goes blank, he could be having seizure.
How can they be managed?
People must always be attentive to their friends, relatives and people around them for any persistent thing as this and encourage them to go to the hospital for investigation. We have basic, biological and social management. The first thing is to first control that seizure because the more you continue to have seizure, the more it damages the brain. There are drugs for this purposes and once taken, stabilises the condition. It cannot be cured, but can be controlled because whatever has caused it may still be there bit if it is the one caused by cancer and you’re able to remove the pox, blood, that one is curable. But if it is a brain injury, then you simply have to control the episodes of seizure. Maybe it occurs everyday, the control mechanism would reduce it to the barest minimal episode. After that, the patient has to prevent or stay away from things that cause that seizure. Tell them not to go to where there is too much bright light, that is why when you watch some movies, they warn ahead that the movie is not for people with certain health conditions because when it begins to change scenes, it could affect someone with epilepsy. It is not good for people with epilepsy to be changing channels or go to places with loud noise where drums and all sorts of noise take place. Some people go to church and end up having seizures. They must know and avoid whatever makes them have these seizures. Again, they must avoid driving or operating machines because they don’t know when a seizure could occur. We’ve seen the case of a driver with almost 40 passengers in a bus who had epilepsy and the bus was just going and resorted to an accident. Who knows, some of the accidents on our highways could be as a result of epilepsy fit.
What is the prevalent rate of this condition in Nigeria?
At least three out of every 10 persons in the Nigerian population have it but they don’t know thus don’t take care of themselves. You don’t know if the driver driving you to the East or North has epilepsy and you’ll just get to Lokoja bridge and the man has a fit and you think he’s still there and the bus is just going and could resort in an accident. Early detection and care is still the best way to manage this condition. Don’t go to native doctors, native healer or spiritualist who’ll tell you that call on the name of God and you shall be saved.
Are you saying spiritual healing is not valid in this case?
What I am saying is that call on the name of God but go to the hospital for management as God responds to our actions of faith. He made the Physicians.
How can this condition be prevented from occurring in the first place?
Mothers should attend antenatal sessions. There should be good obstetrics practice, government should equip our hospitals, so that mothers and babies would be saved from this condition among others. Women should stop attending Traditional Birth Attendants where for three days a woman is still labouring. I can tell you, such a child is likely going to have epilepsy or cerebral palsy.
Why?
Because cerebral palsy can cause epilepsy and epilepsy can cause cerebral palsy because they have almost the same cause. That is, pre-natal, intra-natal or post-natal cause, among other causes.
Is epilepsy hereditary?
Yes, it could be. Studies have shown that there are some genetic traits that makes one to be prone to epilepsy.
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