Epilepsy is a long-term brain condition that causes recurrent seizures. A seizure happens when there is a sudden burst of abnormal electrical activity in the brain. Depending on the area of the brain involved, seizures can cause convulsions, loss of consciousness, unusual movements, changes in behaviour, strange sensations, or brief periods of staring and unresponsiveness.
Epilepsy is one of the most common neurological conditions in Uganda and affects both children and adults. Unfortunately, many people living with epilepsy face stigma and misunderstanding. The good news is that with proper diagnosis, treatment, and support, most people with epilepsy can live healthy, productive lives and have their seizures well controlled.
If you or a loved one has experienced repeated seizures, Hope Plus can connect you with a licensed healthcare provider within minutes. A healthcare provider can assess the symptoms, arrange investigations if needed, and guide you on treatment, follow-up care, and seizure safety.
Key Takeaways
- Epilepsy is a condition that causes repeated, unprovoked seizures.
- A person is usually diagnosed with epilepsy after having at least two seizures on different days within a year.
- Seizures can be convulsive (with shaking) or non-convulsive (without shaking).
- Most people with epilepsy can achieve good seizure control with medication.
- Treatment should not be stopped suddenly without medical advice.
What Is Epilepsy?
Epilepsy is a disorder of the brain that causes repeated seizures.
Not every seizure means a person has epilepsy. For example, seizures caused by meningitis, severe malaria, head injury, or low blood sugar during an acute illness are not considered epilepsy.
Healthcare providers usually consider a diagnosis of epilepsy when a person has had at least two unprovoked seizures occurring on separate days.
What Causes Epilepsy?
Sometimes a clear cause can be identified, while in other cases no specific cause is found.
Genetic Causes
Some forms of epilepsy run in families and may be linked to inherited genetic factors.
Problems During Birth
Conditions affecting the baby’s brain during pregnancy, labour, or delivery may increase the risk of epilepsy later in life.
Examples include:
- Birth asphyxia (lack of oxygen during delivery)
- Congenital brain abnormalities
Brain Infections
Several infections can damage the brain and lead to epilepsy.
Examples include:
- Meningitis
- Encephalitis
- Neurocysticercosis (brain infection caused by pork tapeworm larvae)
Head Injuries
Epilepsy may develop after:
- Road traffic accidents
- Falls
- Sports injuries
- Previous brain trauma
Brain Tumours
Some brain tumours may trigger seizures.
Metabolic Disorders
Conditions that affect the body’s normal chemical balance can sometimes contribute to seizures.
Unknown Causes
In many people, no definite cause can be identified despite thorough investigations.
Types of Epilepsy
There are several different types of epilepsy, and symptoms vary depending on the part of the brain involved.
Generalised Epilepsy
In generalised epilepsy, seizure activity affects both sides of the brain from the beginning.
Consciousness is usually lost at the onset.
Tonic-Clonic Seizures (Convulsive Epilepsy)
This is the type of seizure most people associate with epilepsy.
Symptoms may include:
- A warning sensation (aura) before the seizure
- Sudden loss of consciousness
- Falling to the ground
- Muscle stiffness (tonic phase)
- Repeated jerking movements (clonic phase)
- Frothing at the mouth
- Tongue biting
- Loss of bladder or bowel control
- Deep sleep or confusion after the seizure
Absence Seizures
These seizures are most common in children.
Symptoms include:
- Brief loss of awareness lasting a few seconds
- Staring blankly into space
- Sudden interruption of activities
- Immediate return to normal activity afterwards
A child may have several absence seizures in one day.
Atonic Seizures (Drop Attacks)
These seizures cause a sudden loss of muscle tone, resulting in unexpected falls.
Tonic Seizures
These involve sudden stiffening of muscles.
Myoclonic Seizures
These cause sudden jerking movements, often affecting the arms or legs.
Focal Epilepsy
Focal seizures begin in one area of the brain.
Simple Focal Seizures
The person remains aware but experiences unusual symptoms such as:
- Jerking of one limb
- Strange smells or tastes
- Nausea
- Sweating
- Flushing
- Déjà vu sensations
- Abnormal feelings in part of the body
Complex Focal Seizures
These seizures affect awareness and behaviour.
A person may:
- Appear confused
- Perform repetitive movements
- Stare blankly
- Be unable to respond normally
Status Epilepticus: A Medical Emergency
Status epilepticus is a life-threatening emergency.
It occurs when:
- A seizure lasts more than 30 minutes
- Multiple seizures occur without regaining consciousness between them
- Seizures do not respond to emergency treatment
Immediate medical care is required.
Symptoms That May Be Mistaken for Epilepsy
Healthcare providers may consider other conditions that can resemble seizures.
These include:
- Fainting (syncope)
- Low blood sugar (hypoglycaemia)
- Low calcium levels (hypocalcaemia)
- Panic attacks
- Hyperventilation
- Functional neurological disorders (previously called conversion disorder)
How Is Epilepsy Diagnosed?
Medical Assessment
A healthcare provider will ask detailed questions about:
- The seizures
- Past illnesses
- Medications
- Family history
- Mental health
Witness accounts from family members can be extremely helpful.
Electroencephalogram (EEG)
An EEG records electrical activity in the brain and may help identify certain types of epilepsy.
It is particularly useful for:
- Absence seizures
- Focal seizures
Additional Tests
Further investigations may be requested depending on the suspected cause.
These may include blood tests or brain imaging.
First Aid During a Seizure
Knowing what to do can help prevent injury.
What To Do
- Stay calm.
- Move dangerous objects away.
- Protect the person’s head.
- Allow the seizure to run its course.
- Turn the person onto their side once the seizure ends.
- Check breathing after the seizure.
What Not To Do
- Do not restrain the person.
- Do not force anything into their mouth.
- Do not try to stop the movements.
- Do not leave the person alone.
Treatment of Epilepsy in Uganda
The goal of treatment is to prevent seizures while minimising side effects.
General Principles of Treatment
Start With One Medicine
Healthcare providers usually begin treatment with a single anti-epileptic medicine.
Increase Doses Gradually
Medicines are usually started at a low dose and increased slowly until seizures are controlled.
Regular Follow-Up
Patients are monitored regularly to assess:
- Seizure control
- Side effects
- Medication adherence
Psychological and Social Support
Living with epilepsy can be emotionally challenging.
Support from family, healthcare providers, schools, workplaces, and communities is important.
Common Medicines Used for Epilepsy
The medicine selected depends on the type of seizure and the patient’s age.
Carbamazepine
Often used for:
- Generalised tonic-clonic seizures
- Focal seizures
Possible side effects include:
- Skin rash
- Blurred vision
- Double vision
- Nausea
- Poor balance
Phenobarbital
Often used for:
- Tonic-clonic seizures
- Focal seizures
Possible side effects include:
- Drowsiness
- Lethargy
- Irritability
- Hyperactivity in children
Phenytoin
Used for many forms of epilepsy except absence seizures.
Possible side effects include:
- Drowsiness
- Gum enlargement
- Blurred vision
- Poor balance
- Skin rash
Ethosuximide
Used mainly for absence seizures.
Possible side effects include:
- Stomach upset
- Drowsiness
- Blood disorders
When Can Epilepsy Medication Be Stopped?
Some people may be able to stop medication if:
- They have been seizure-free for at least two years
- There is no ongoing cause of seizures
Medication should only be reduced gradually under medical supervision.
Stopping treatment suddenly can trigger severe seizures or status epilepticus.
Special Considerations for Children
Children with epilepsy should be assessed for:
- Learning difficulties
- Intellectual disability
- Behavioural problems
Healthcare providers may choose medicines that are less likely to worsen these challenges.
Epilepsy and Pregnancy
Women who are pregnant or planning pregnancy should seek specialist care.
Some epilepsy medicines require careful adjustment during pregnancy to protect both mother and baby.
Living Safely With Epilepsy
People living with epilepsy can often lead normal lives, but certain precautions are important.
Safety Tips
- Take medicines exactly as prescribed.
- Attend follow-up appointments.
- Avoid missing doses.
- Inform family members about seizure first aid.
- Avoid swimming alone.
- Take care around open fires and cooking stoves.
- Discuss driving eligibility with a healthcare provider.
Prevention of Epilepsy
Not all cases can be prevented, but the risk can be reduced through:
Good Antenatal Care
Proper care during pregnancy can help reduce birth-related brain injuries.
Safe Delivery Practices
Skilled birth attendance helps reduce complications that may affect the baby’s brain.
Preventing Brain Infections
Prompt treatment of infections such as meningitis can reduce the risk of epilepsy.
Preventing Head Injuries
Using helmets, seat belts, and practising road safety can help protect the brain.
When Should You Seek Urgent Medical Care?
Seek emergency medical attention if:
- A seizure lasts longer than 5 minutes
- Multiple seizures occur without recovery
- Breathing does not return to normal
- The person is injured during the seizure
- The seizure occurs in water
- It is the person’s first seizure
Frequently Asked Questions About Epilepsy
1. Is epilepsy contagious?
No. Epilepsy cannot be spread from one person to another.
2. Can people with epilepsy live normal lives?
Yes. With proper treatment and support, many people with epilepsy attend school, work, raise families, and live independently.
3. Should I put a spoon or object in the mouth during a seizure?
No. This can cause serious injury to the teeth, mouth, or airway.
4. Can epilepsy be cured?
Some people outgrow epilepsy or become seizure-free for many years. Others may require long-term treatment.
5. What should I do if I miss a dose of epilepsy medication?
Follow the advice given by your healthcare provider and avoid stopping treatment completely. If unsure, seek medical advice.
6. Can stress trigger seizures?
Stress, lack of sleep, illness, and missed medication doses may trigger seizures in some people.
7. Can a person die from epilepsy?
Most people with epilepsy live long lives. However, severe seizures and status epilepticus can be dangerous, which is why regular treatment and follow-up are important.
