It used to be thought that epilepsy was linked to the phases of the moon (hence the origin of the word ‘lunatic’). The truth is that epilepsy is a medical condition with a physical cause. People with uncomplicated epilepsy are no more likely to suffer psychiatric disorders than anyone else.

You can tell someone with epilepsy because they have a typical epileptic personality

In the middle of the last century when little was known about epilepsy it was thought that epilepsy was always inherited and always led to a deterioration of the brain and to imbecility and crime. At that time there was no treatment for epilepsy and it was very common for people with severe epilepsy to fall and suffer head injury during their seizures. Many became brain damaged because of these frequent injuries. Later, at the turn of the century, the only anticonvulsant which was available was bromide. At that time it was not possible to monitor the amount of bromide in the blood and so people had very high bromide levels and became toxic, with a consequent deterioration in their behaviour and intelligence. It was these two factors which led to the myth that all epileptics had the same deteriorating personality. We now know that unless there is associated brain damage, people with epilepsy have personalities which are like anybody else.

All patients with epilepsy are violent or criminals

This myth is really an extension of the previous one. At the turn of the century some people became violent either because they were suffering from bromide poisoning, or because they had become brain damaged by frequent falls during severe, uncontrolled seizures.

The myth was perpetuated for a time because some early studies of people in prison found that there were more people with epilepsy than would be expected. However, it is now thought that, in many cases, the epilepsy was caused because of head injuries. It was also demonstrated that their personality was such that even before they had epilepsy, they tended to get into fights. Taking this into account, the number of people with epilepsy who are in prison is no greater than in the general population. The truth is that people with epilepsy are no more likely to be violent or criminal than the rest of the population.

People who have epilepsy are mentally handicapped

This is untrue. Although many people who have learning difficulties also have epilepsy, only a few people who have epilepsy also have learning difficulties. These are the few who have severe brain damage, which causes both their learning difficulties and their seizures. But few people with epilepsy have brain damage of this severity.

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Epilepsy

medical treatment (anticonvulsant medication, anti-epileptic drugs)

surgery

More controversial possibilities include:

naturopathy

acupuncture

dietary management

Surgery

It is often asked if surgery will produce a cure for epilepsy. While the use of surgery to treat epilepsy has increased over the past decade, it is still only useful for a small proportion of people with epilepsy, mainly those with temporal lobe seizures. Even in this group of patients, surgery is only useful if the fits cannot be controlled by medication and if the fits are localised to one side of the brain.

Hypnosis

There is little place for hypnosis in the management of epilepsy. The only exception is the patient who has a long warning (aura) prior to the seizure. If the aura lasts long enough, it is possible to teach the patient self-hypnosis and it is conceivable that the patient may be able to prevent the seizure. This is hardly ever the case, however.

Naturopathy

Naturopaths feel that epilepsy is due to a deficiency of the B group of vitamins and possibly zinc. Some success is reported in absences (petit mal) but less so in other forms of epilepsy. Acupuncture

The role of acupuncture in the management of epilepsy is controversial. Acupuncturists see epilepsy as a liver problem because they feel the liver controls muscular rigidity. There is no good evidence that acupuncture helps people with epilepsy.

Dietary treatment

For patients with myoclonic epilepsy or infantile spasms who have failed to respond to medication, the use of a ketogenic diet may be of value. This diet, which is not very palatable, acts by increasing the blood concentration of a variety of acids in the body which, it is suggested, results in some chemical changes in the brain. This may reduce the tendency for brain cells to discharge and also prevent the spread of discharges within the brain. Most people who have been heavily involved in treating children with epilepsy will have had very occasional success with this form of treatment. However, taking into account all patients who have been treated with a ketogenic diet, the results have been disappointing.

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Epilepsy