Understanding epilepsy

International Epilepsy Day takes place on Monday 11th February. Let’s take some time to look at this sometimes misunderstood condition affecting over 600,000 people in the UK.

Epilepsy is characterised by recurrent seizures caused by surges of electrical energy in the brain. Causes vary by individual, with a genetic tendency, structural change, or a combination responsible. Structural changes can be anything from injury to developmental problems, infections, strokes, and tumours.

With two broad categories of seizure, five sub-categories and over 40 types of epilepsy overall, managing the individual experience is crucial.

Identifying the condition

The initial challenge with epilepsy is recognising its visible symptom, seizures. Electric signals are part of our neural system, so bursts and overloads are inevitable. We have a natural ability to resist the effects, known as a ‘seizure threshold’, and for most people, it is high enough. For others, neurological differences and changes mean that they are susceptible.

Focal seizures occur in one part of the brain and can spread, whereas generalised seizures take over both sides from the start. The types of seizure each cover a varying combination of violent muscle contractions, loss of consciousness, drowsiness, stiffness, limpness, and absent-mindedness.

The Epilepsy Society has produced an excellent Just Diagnosed booklet to help patients navigate this complex journey to understanding their condition.

Living with epilepsy

It’s essential for all involved to know that treatment for epilepsy is not a cure – it exists to control the symptoms. However, with the right anti-epileptic drugs (AEDs), complete control is possible for up to 70% of sufferers.AEDs reflect the individualistic nature of epilepsy, being dependent on the type of seizures, the underlying cause, other conditions and medications, lifestyle, and patient preference. Where possible, patients should only be taking one type of AED at a time.

While AEDs are most common, neurosurgery, vagus nerve (major neural pathway) stimulation and dietary changes have all been cited as treatment.

Managing epilepsy treatment through the pharmacy

The potential for completely individualised treatment programmes heightens the importance of pharmaceutical aftercare. The Pharmaceutical Journal has published drug-specific advice, as well as notes on changes, updates, and advances.

Consistency is at the core of taking AEDs, which can bring familiar challenges for pharmacists and patients alike. The fact that treatment comprises management rather than cure means that the pharmacist plays an ever-present role in patients’ lives.

Adherence is a crucial area as always, not least because seizures can cause memory problems. Furthermore, it is sometimes necessary to change a patient’s medication, which can cause confusion. Reminder services such as Healthera’s app are useful tools to recommend to those taking AEDs.The American Journal of Pharmacy Benefits has studied the positive effects of a pharmacy-led intervention, such as improved patient knowledge, quality of life and adherence. It’s so crucial for pharmacies to close the gap by not only increasing their education but by making sure patients know that we can help with virtually every step of the diagnosis, treatment and review journey.

Useful resources

Epilepsy Society

     Website: www.epilepsysociety.org.uk

     Phone: 01494 601 400 (Mon to Tues, 9am to 4pm; Weds, 9am to 7:30pm)

     Email: helpline@epilepsysociety.org.uk

Pharmaceutical Journal

     Website: www.pharmaceutical-journal.com

Medicines and Healthcare products Regulatory Agency

     Website: www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate