Iris Cole interviews Dr. Shamrit Oliel Maichilov about diagnosis and treatment of epilepsy in children/Walla system
Last night (Thursday) the entertainment industry was left in shock following the death of singer and actor Omer Detz at the age of only 30 after experiencing an epileptic seizure.
Detz was the eldest son of the singers Moshe and Orna Detz.
"The shock and pain are unbearable," the family members said, "we will thank you for considering our private grief."
We asked to check what epilepsy is, how is it recognized and what are the appropriate treatments for the disease?
Epilepsy is a chronic neurological disease, resulting from abnormal electrical activity of the brain cells.
The disease can appear in any person, at any age, and its causes are many and varied: starting from congenital developmental defects of the brain and genetic diseases, through cerebrovascular events or significant head trauma, and ending with infection or inflammation of the nervous system.
However, in half of the cases the cause of the disease is not known at all.
According to the Eyal Association that treats epilepsy patients, "SUDEP syndrome - SUDDEN UNEXPECTED DEATH IN EPILEPSY - is the sudden and unexpected death of an epileptic patient, who apart from the epilepsy was in his normal state of health. Sudden death from epilepsy is not common - it is reported in 1 in a thousand epileptic adults (meaning it does not occur in 99.9% of patients) and even less so in children.
Death is not related to an emergency such as a prolonged convulsion or a continuous sequence of seizures without recovery between convulsions (status epilepticus), drowning or poisoning but occurs for an unknown reason. In cases of sudden death from epilepsy No other reason for the event is found, even in the post-mortem examination. The death can occur in the presence of witnesses or in their absence, sometimes a convulsion is observed or there are signs indicating a convulsion before death."
Omer Detz/Shoka Cohen
Dr. Shamrit Oliel, director of the pediatric epilepsy service at Dana Hospital, was interviewed by the Walla website and explained that first and foremost, it is difficult to know if a child suffers from epilepsy, since there are types of loss of consciousness that are not epileptic, and types of events that do not involve a complete loss of consciousness, but are Definitely a convulsion. "Contrary to what may be common among people, a convulsion is not only jumping of arms and legs, and rolling of eyes and frothing at the mouth and falling, but many other things.
So it is very difficult to give guidelines", she explained, "I think that in any case there is any doubt, one should contact a medical professional".
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How do you recognize a convulsion?
As mentioned, there is a wide variety of convulsions, starting from a general convulsion - a sudden fall, complete loss of consciousness, foaming at the mouth and rolling of the eyes - to events that to the unprofessional eye will not look like a convulsion at all.
"There are many other situations of convulsions in which the electrical activity is not in the entire brain, but only in a certain area, and depending on where the abnormal electricity comes from - that will be the clinical expression of the convulsion," explained Dr. Oliel.
So, for example, a convulsion can also be staring, A stoppage of activity, for a few seconds. "Many times we receive children who are sent to us for an assessment with a question of attention and concentration, because the child hovers or stares a lot in class, and when we get a little more information, the question arises as to whether this is a child who finds it difficult to concentrate or is it a child who has a lot of disconnections short as a result of convulsions."
Epilepsy can also be a condition of uncontrolled jumping of an arm or leg, but consciousness is completely preserved. "The child or adult in whom the convulsion occurs is fully aware of the uncontrolled movement, and reports it," said Dr. Oliel, "and a convulsion can to also be in a state where consciousness is in the middle - there is no falling or fainting, but a state in which there is a disconnection accompanied by certain motor movements, for an allotted period of time, usually very short, and then there is a gradual return to consciousness. When the same person is not aware of the event, but those who are next to them see a change in awareness , in the ability to respond".
A simple and non-invasive test, EEG/ShutterStock
How is it diagnosed and treated?
Since epilepsy can appear in all kinds of forms, explained Dr. Oliel, one of the things that helps doctors diagnose is that the parents document an event that is suspected to be an epileptic event. "In the age of cell phones, the thing that really helps us is that parents document an event.
In most cases, just by looking at the event itself we can tell if it's a seizure or not," she said, with this documentation, along with the questioning and medical history, the family history and the neurological examination, and an EEG test, a diagnosis can be made.
Dr. Oliel clarified that " Usually you don't go your whole life without being diagnosed with epilepsy, because the more time goes by, and it goes undiagnosed, the frequency of events increases, and at some point you can't help but understand that."
Sometimes later it also reaches a general convulsion, and "sometimes it is not diagnosed until the general convulsion comes, and then you get this diagnosis".
How to help a patient during an epileptic attack?
Dr. Oliel has, of course, come across this question a lot, and therefore clarified that the most important thing is to know what not to do. Bad - they try to forcefully open the mouth to stick the tongue out so that it doesn't get swallowed," she said, "So no, the tongue doesn't get swallowed and we don't choke on the tongue, and we don't have to pour water or hold hands and feet, or do massages or CPR."
What is that? "Most of all, what needs to be done is to lay the person or child on their side, so that if there are secretions, they can be removed gently without forcefully opening the mouth," explained Dr. Oliel, "in most cases, the jaws are tightly closed, and in trying to open them, teeth break Or fingers are bitten, and I've already had kindergarteners who lost nails in children's mouths, so don't do that. Remove the secretions from the outside."
In addition, it is important to pad the area around the head with something soft, so that there are no bumps against a hard surface.
At the same time, the duration of the convulsion must be timed, and the MDA must be called.
Most convulsions, 90-95 percent, end within a minute or two, without intervention, simply wait for it to end. But it is important to know that "many times a convulsion ends when the motor expression ends, but afterwards, because The intense electrical activity of the brain cells - the brain rests.
This is what we call the post-convulsive period, and then it is very difficult to wake up the person or the child, because the brain undergoes a slow recovery process, and many make a mistake and include this part in the convulsion," explained Dr. Oliel, "the convulsion itself is very short, one to two minutes, and the period The post-convulsion can last from 10 minutes to an hour, and then it will look like fainting or a deep sleep that is difficult to wake up from."
How is epilepsy treated?
"Medicine has a large variety of treatments, and the treatment is usually adapted to the type of epilepsy, the age and many times also to the character of the person or the character of the child," explained Dr. Oliel, "today we have at least 30 different types of anticonvulsant drugs, and every year there is the development of A new drug with a new mechanism.
The drugs treat the symptoms, they prevent the abnormal electrical activity from causing convulsions.
The treatment does not cure epilepsy, but nevertheless a significant part of the types of epilepsy pass after a certain period of time.
More on the same topic:
epilepsy
brain
nerves
Omer Detz