November 20, 2009 Jeff Hoelscher
FOR IMMEDIATE RELEASE (573) 884-1608
COLUMBIA, Mo. — One of the most common neurological conditions, epilepsy affects approximately three million Americans. Yet many myths and misconceptions hinder understanding, diagnosis and treatment of the disease.
David Lardizabal, M.D., a neurologist and medical director of University of Missouri Health Care’s Epilepsy Program, would like to use November, designated as Epilepsy Awareness Month, to separate fact from fiction.
“In terms of frequency, epilepsy is one of the top neurological disorders, and yet it is undertreated,” said Lardizabal. “Most people associate only loss of consciousness or violent muscle contractions, such as a grand mal seizure, with epilepsy. These types of seizures occur when abnormal electrical activity affects both sides of the brain.”
Some seizures affect a small part of the brain and may produce only visual or sensory symptoms. In these cases, a person may not associate the symptoms with epilepsy because the symptoms are not as dramatic as a grand mal-type seizure.
Epilepsy is a seizure disorder characterized by abnormal electrical activity in the brain that affects how a person feels or acts for a short period of time. Seizures are a symptom of epilepsy and can be related to an injury or family tendency. Severity of the seizure will depend on what area and how much of the brain is involved.
There are several kinds of seizures related to epilepsy. The most well known is the grand mal seizure, in which an individual loses consciousness and usually collapses. Loss of consciousness is followed by violent jerking, after which the patient goes into a deep sleep. During a grand mal seizure, injuries to the individual can occur.
Other types of seizures consist of less dramatic symptoms. Absence seizures, for instance, cause a short loss of consciousness, usually only a few seconds. The individual typically stares blankly during the seizure and then resumes his or her activity after only moments, unaware of the seizure except, perhaps, for the feeling that they have “lost time.”
“Because most epilepsy diagnoses occur in childhood, absence seizures can be confused with attention deficit disorder or even misdiagnosed as ADHD,” said Lardizabal. “This further confuses the diagnostic process and is precisely why specialists need to be involved in evaluating the patient.”
Other seizures such as myoclonic, clonic and tonic seizures cause rhythmic jerking or stiffening of the muscles. While not as severe as a grand mal seizure, these types of seizures can be dangerous because an individual is vulnerable to having an accident.
“Some patients have had motor vehicle accidents,” said Lardizabal. “This is why epilepsy patients who are poorly controlled with medications are not allowed to drive.”
MU Health Care’s Epilepsy Program offers patients convenience and accessibility in diagnosing and treating the disease.
The epilepsy program is a multidisciplinary team comprised of a neurologist, psychiatrist, neuropsychologist, social case worker and several diagnostic specialists.
“Having this group work together allows us to diagnose and manage the patient holistically,” said Lardizabal.
Before testing begins, team members interview the patient to identify any risk factors associated with epilepsy. This can include childhood trauma, a history of blackouts, or some kind of previous seizure.
“The gold-standard test is the electroencephalogram, or EEG,” said Lardizabal. “The test is painless and non-invasive and records brain waves to look for abnormalities. An MRI of the brain is needed to identify possible structural abnormalities associated with the seizure such as a tumor or stroke.”
Once diagnosed, epilepsy can be effectively treated through anti-seizure medication or surgery.
“We tailor treatment to each individual patient,” said Lardizabal. “Different medications work better for some patients than others. And there can be side effects. The goal is no seizures and no side effects.”
“Understanding the type of epilepsy a patient has will require proper work-up and treatment,” said Lardizabal. “But because there is misunderstanding associated with the disorder, many people who might achieve better seizure control haven't gotten the help they need.”
For more information about epilepsy or to make an appointment with the epilepsy program at MU Health Care, call (573) 882-1515.
David Lardizabal, MD, a neurologist and medical director of University of Missouri Health Care's Epilepsy Program
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