Understanding Epilepsy
Introduction
How long has epilepsy been known?
What do the following people have in common: Julius Caesar, Dostoyevski, van Gogh, Joan of Arc, Edward Lear, Gustav Flaubert and Alexander the Great? The answer is that they have all been said to have had epilepsy.
Why are people often reluctant to discuss their epilepsy?
Today there are people from all walks of life who have epilepsy. It is therefore surprising that prejudice and stigmatisation result in many people not disclosing their epilepsy even to friends, employers and members of their own family.
Unpredictable and frightening
Epilepsy has undoubtedly achieved its unenviable position in the mind of some people perhaps, largely, because it is unpredictable, sometimes dramatic and frightening. Although there are many different types of seizures, as is explained later, it is the convulsion – the falling to the ground, frothing at the mouth, flailing of the limbs – that comes to most people’s minds when the word epilepsy is mentioned.
Historical beliefs
It is this dramatic event that has always fuelled people’s imaginations. Epileptic seizures are mentioned in the earliest Babylonian and Hebrew tracts. In Ancient Greece, at a time obsessed with gods and spirits, Hippocrates was one of the first to try to dispel the mysticism of epileptic seizures. He firmly believed that epilepsy originated in the brain and even went as far as condemning those charlatans who proposed that epilepsy was caused by demonic possession.
Yet, for the next 2,000 years, it was this theory of demonic possession and other equally fanciful and primitive beliefs that led to people with epilepsy being shunned, even locked away, and often subjected to painful and humiliating ordeals in the name of a cure.
Historical treatments
In the account of the death of Charles II, there is a description of the treatment of his seizure; this included bleeding him, giving him substances that made him sick and repeated enemas, shaving his head, blistering his skin and then finally forcing an unpleasant concoction down the dying king’s throat.
Even as recently as the start of the twentieth century, circumcision and castration, vascular and gastrointestinal operations were proposed as cures for epilepsy. It was not until the mid-part of the nineteenth century that the first effective drug, potassium bromide, was introduced, and from that time drug treatment has allowed most people with epilepsy to lead normal, seizure-free lives.
Modern attitudes
There is still, to a certain extent, a stigma attached to what is a common condition. Almost every one of us will know someone who has epilepsy, although the person may not have disclosed the fact. In modern society, stigma usually relates to a fear of the unknown, the apparent loss of control, the anxiety to an onlooker that seizures are a prelude to death, or the associated inconvenience and embarrassment.
How common is epilepsy?
Epilepsy is very common. Each year in the United Kingdom about 25,000 people develop epilepsy; most are either children or elderly people (epilepsy infrequently starts between the ages of 20 and 50).
There is about a 1 in 30 chance of developing epilepsy during a lifetime. However, only 1 in 200 people has active epilepsy (300,000 people in the UK). This implies that most people with epilepsy get better, and indeed this is the case; in about 6 of every 10 people the condition resolves.
Epilepsy affects males and females almost equally, although certain types of epilepsy are more common in one or other sex. It affects all classes and all races.
Thus, epilepsy is common and treatment is frequently successful. This is an important message for all those who develop it.
KEY POINTS
• There are many types of epilepsy and seizures
• Epilepsy usually begins in childhood or old age
• Epilepsy is common, but usually resolves
• Many famous people have had epilepsy
• It is a condition that many do not disclose, partly because of the embarrassment and stigma unfairly associated with the condition
