By Dr. Richard Nyako, M. D., ph D.

I am sure we have all been reeling from the shocks of the videos brought out by the investigative journalist Anas Aremeyaw Anas.

Watching the videos brought sadness to my spirit, not for the usual reasons but especially from a medical and neurological viewpoint. There was a young lad called Yaw, who suffered a broken vertebrae and was left to die. There were others with cerebral palsy and other ailments that form my specialty. That is why I wish to educate people on the basics of neurological problems because I realized that many called into the radio and TV shows asking the meaning of some of the things seen in the documentary.

Some of those kids had epilepsy and seizures, which are common and serious neurological conditions affecting all ages. It can be a frightening experience for the individual, on-lookers and family members. Epilepsy is said to be an illness of various shapes and sizes. Most people who have seizures do not have epilepsy. A person who experiences two or more seizures can be classified as having epilepsy. Most seizures have unknown etiology or cause. In children and young adults it may be due to brain tumors or scars and in the elderly it is usually due to cerebrovascular diseases such as stroke.

Categories of epilepsies and seizures

Those kids with these issues would, broadly, have one of about four different types of epilepsy or seizures: partial, generalized, convulsive, hysterical and status epilepticus (on-going recurrent life-threatening seizures).

Seizures occur as a result of abnormal electrical activity in one or several parts of the brain. The location of this high voltage activity in the brain characterizes the type of seizure that the individual presents with.

A seizure may be difficult to recognize for several reasons. It may be brief spells with no loss of consciousness or confusion or may be brief starring spells with brief loss of consciousness and /or no confusion. It may also be associated with brief episode of confusion and/or automatic behavior such as pacing the floor, buttoning and unbuttoning clothes, picking at objects, repetitive behavior such as buying same thing over and over, writing same thing over and over, getting lost in familiar places and so on. Finally, it may also be drop attacks, dizzy or fainting spells or stiffening of the body. A seizure is typically recognized if it is associated with generalized shaking of the body with eyes rolled up “in the head” with incontinence of bladder / bowel or tongue biting. But these often occur at night while a person is asleep. Some patients have an aura such as same music in ears, funny odors, uncontrolled laughing, partial undressing in public, dreamy states, anger, unwarranted fear, visual distortions/ hallucinations and so on. Some seizure may be precipitated by organic causes such as high fever (especially in children), brain infections, tumor, stroke, blood clot, in the brain, etc. Whatever the cause, if seizure becomes recurrent, one after another, this is a medical emergency and requires emergency treatment, in the hospital. They should not be kept at home! What to do Most importantly, do not panic. Make sure the person has clear airway, turn person to left side, and open their mouth gently if biting the tongue. Do not restrain forcibly just move/keep harmful objects away. When the seizure is over, let the person sleep. When awake, administer regular medication and seek medical attention if necessary. If seizure becomes recurrent take him/her to hospital emergency room right away. Diagnosis Seizures are diagnosed by history taking and physical examination by the doctor. Blood Tests, EEG (Electroencephalogram), CT Brain Scan or MRI Brain Scan may be helpful. Medications are available and patients must carefully seek medical advice. That said vitamins such as folic acid or vitamin K (especially in pregnant women) are also necessary. Avoidance of alcohol and a good night’s sleep will do a world of good as well. The type of medications prescribed depends on the type of seizure or epilepsy. One may require more than one seizure drug to keep seizures under control. These drugs have side effects and what is known as therapeutic levels. Therefore your doctor will order blood tests periodically to monitor your blood chemistry and medication levels. If you have side effects such as rash, dizzy spells or loss of balance you need to contact the doctor’s office immediately or come to the clinic. If the medication is not controlling the seizures you need to call or come to the clinic. EEG is an important test that helps in the diagnosis and treatment of seizure disorder / epilepsy. The test measures the electrical activity in various areas of the brain. It can localize the focus of the abnormal electrical activity. However a normal EEG does not mean you do not have a seizure problem. The test in itself is non-invasive and does not hurt. It may be a little uncomfortable. Wire electrodes are attached to different areas of your head with a glue-like gel to hold them in place. You only need to lie still on your back for 30 minutes or so and to try to go to sleep. To sleep during the test is important, so you may be asked to sleep only a few hours the night before the test. CT or MRI Brain Scan may be required depending upon the physical examination and symptoms and signs. These tests take a picture of the brain to see if there are any structural abnormalities that the doctor should be concerned about. In most cases the test may turn out to be normal and nothing further needs to be done other than treat your symptoms, i.e. the seizure problem. If you know of other persons who have similar problems or suspect may have a seizure disorder / epilepsy, please, tell them to go to the nearest clinic or hospital for diagnosis and treatment or referral to our clinic. Epilepsies/seizures when under control improve the quality of life and ability to work and make a living. The Ghana Neurological Foundation will hold its maiden annual week celebrations in October and we are all encouraged to help create awareness for these mostly misunderstood diseases especially amongst deprived children.

Dr. Richard Nyako, M. D., ph D. is the founder of the Ghana Neurological Foundation located on Tema Harbour Road. You can send your health-related emails to richardanyako@yahoo.com