Seizures do not conform to society's expectations of predictability and self-control in everyday behaviour. Patients, family members, and healthcare professionals may view the concept of control differently. For example, does "good control" mean having no seizures or side effects of therapy, or does it mean that patients are able to live the life they want? Too often, people with epilepsy are prevented from participating in many activities, which can disrupt their emotional well-being and development of social relationships. (Epilepsy: a practical guide)
For people with epilepsy, fear can be huge and is often overlooked. Most people with epilepsy identified that fear and anxiety started from when they were diagnosed. (Sleep and epilepsy: the clinical spectrum). Patients may fear dying during a seizure, suffering brain damage, having a seizure in public, losing control, or losing their friends, their driver's license, or their job. Patients who suffer from epilepsy may fear for their safety during or after a seizure.
Underlying cognitive problems or psychiatric illness may cause or add to poor quality of life. Cognitive impairments maybe because of drug side effects, seizures, or underlying brain dysfunction; the patterns and difficultly of cognitive deficits are different according to seizure type. Increased rates of learning difficulties and behaviour problems have been observed in past research that has been carried out on people with epilepsy. A recent review of behavioural aspects of epilepsy highlights the high prevalence and unusual appeartence of depression in people with epilepsy. (). This is because some people that suffer from the illness find it unfair that they have to suffer ands can not lead a healthy life.
Different people cope with epilepsy in different ways for some people it may be within different life stages and in relation to each person’s experiences. For example, adolescents with uncontrolled epilepsy may struggle with the incapability to drive a car, lack of independence, or social isolation. Adults entering the workforce may be concerned with managing seizures at work, disclosing their epilepsy, or obtaining health and life insurance. The diagnosis of epilepsy may leave some people feeling scared, angry, or disbelieving.
If a patient wants their epilepsy to be under control it would mean that they would have to work together with a team of health care professionals and they would have to find out all of the facts about their illness and understand the situation they are in. A person could do this by starting to educate themselves and they could do this by going to a community support group. Psychosocial issues that some people with epilepsy may have problems like access to health care, management of there epilepsy and identification of there needs personal care and safety.
Socioeconomic differences in health behaviours like smoking, leisure time physical activity, are the determinants of socioeconomic differences in health behaviours. These are poorly understood but are likely to include characteristics of the physical environment (for example, places to walk, availability of healthy foods), social norms (for example, smoking levels in the community, eating habits), and the costs of health protective behaviours. Individual knowledge and motivational factors stem from educational access, and life experiences for example if a person has epilepsy, and the general level of health awareness expressed within the local social environment, are also relevant. The first is perceived control over health, as healthy behaviours have been shown to be associated with stronger beliefs in personal or internal control, and weaker beliefs in chance or external factors. Healthy lifestyles are only likely to benefit health over the longer term, so socioeconomic differences in thinking about the future and expectations about the life span might affect motivation to maintain healthy lifestyle the importance of lifestyle, that wealthy people would think more often about things they could do to stay healthy than would less privileged groups. For example a person from a higher gloss socio economic group who suffers from epilepsy may have a better chance of finding a diagnosis quicker and receiving treatment then what a person from a lower class family might. This could then affect there lifespan and it turn shorting there life.
Epilepsy can leave a person with lots of social and psychological consequences. This can affect the quality of life in adults who suffer from the illness. Quality of life is worse for people who suffer from epilepsy then what it is for a person who does not. It is equivalent or worse in patients with epilepsy then it is with people who have other chronic conditions and it is similar to that of a healthy person when people who have there epilepsy under control. Also if a person who suffers from the illness their quality of life is also worsened because of certain factors like depression and socio economic factors. The impact of surgical treatment on a person quality of life is positive with seizure control. At present the quality of life and psychosocial functioning in people with epilepsy has been looked at my many different studies but it is very difficult to indicate what measures should be used. In trying to have a high quality of life it would seam that a person would not just have to look at the seizures but the other factors involved as well and use all of the factors together to have a good quality of life. Each person who suffers from this illness will be affected in different ways, seizures will affect patients at different stages if the life span in lots of different ways.
There are lots of different causes of seizures in newborn babies. In premature babies, the most common causes are a reduced blood and oxygen flow to the brain, and bleeding into the brain. Parents can become annoyed as they feel that doctors tell them little information about how their baby will develop and if the epilepsy will go away. This frustration is understandable but sometimes this is because the doctors themselves do not always know what will happen. One of the things parents worry about is if their child’s intellectual abilities are going to be affected by the child’s epilepsy. A lot of children with epilepsy can develop with the same range of intellectual abilities as children without the condition. Epilepsy is caused by damage to the brain; this damage could also cause learning disabilities. When a baby is born with epilepsy it is not always possible to foresee what the result for that child will be. It is only when particular development milestones are reached or not reached, that the doctors can try to predict if that child will have epilepsy in the future.
Epilepsy is a common neurological disorder in children. Seizures and epilepsy affect infants and children more than any other age group. Epilepsy is about twice as common in children as in adults (about 700 per 100,000 in children under the age of 16 years compared to 330 per 100,000 in adults). (). A lot of children who suffer from epilepsy go to a mainstream school. There is only a small amount that has epilepsy that has a learning difficulty and need to attend a special school or need extra assistance in class. It is possible that children who do have epilepsy can under achieve at school or easily fall behind. Anti epilepsy drugs can sometimes impair a child to learn. If a child is struggling at school it can lead to poor school attendance and low self esteem. If a child does have epilepsy and it is recognised it is important that the parents and teachers have good communication with the child.
When a child who has epilepsy reaches puberty the body is starting to change from a child into an adolescent this may mean that the amount of medication that they are taking already may have to change so their body can cope with the changes that it is going through. In order to do this correctly doctors may need to carry out more tests to make sure that the seizures are being controlled. Another problem that could affect an adolescent’s lifespan is that in young women during their monthly periods it could make seizures worse because of the change in hormone levels. Adolescence can be a difficult time for any teenager; this is because it is a time when adolescents start thinking about becoming an individual. The development of epilepsy during adolescents can sometimes lead to psycho- social difficulties. When this happens it means that it cans disrupt normal development. Adolescents can also deny that they have a problem which if they do could lead them to ignoring medical advice with could be harmful for them. If the person has had epilepsy all their life it could mean that they have had over protective parents which means that now they are an adolescent they may be less socially skilled which could lead to a low self esteem. This then could mean that they feel like they have no control over their own life and become depressed.
A study investigated 57 adolescents that were aged 12 to 15 years old and compared their idea of what they thought was a normal life span development to their own personal future goals. The study was carried out by using a questionnaire and a follow up interview. The results showed that an overlap of content categories in the life paths supported the relationship between individual goals and normative expectations about life span development, especially when it come to life domains like education, family, and occupation. The respondents showed awareness of the accumulation of social problems. They found out that they are more likely to occur to the average adult then in their personal future. If adolescents rated their future as better than the future of others, they also regarded that future for them is different from the normative life span. Self-evaluation was indirectly related with self-other comparisons. Similarity between the normative life span and personal future correlated with higher probability of problem occurrence and possibility to avoid the problems. (Association for Professionals in Services for Adolescents)
After adolescence is young adulthood, at some point during this stage young women and men may start thinking about marriage and possibly pregnancy. This could affect their lifespan because the changes that her body is going through may caused seizures or increase the amount that they have. This may also put women off having children in fear of their health or fear of losing her baby this could cause women to become depressed. Also they may fear that the medication that she is taking to control her seizures may affect their unborn child so they may feel that she has to discontinue her pregnancy. This could then lead her to feel like she has lost the chance to become a mother because of her illness. They may think about their ability to successfully bear or rear children; unfortunately, many women with epilepsy are still incorrectly told not to have children.
is the most common epilepsy of adults. In a lot of cases, the epileptogenic region is found in the mesial temporal structure. Seizures begin in late childhood and adolescence. There is an association with febrile seizures in childhood, and some studies have shown herpes simplex virus in these regions, suggesting that perhaps this epilepsy has an infectious etiology. Most of these patients have complex partial seizures sometimes preceded by an , and some TLE patients also suffer from secondary generalized seizures.
If a young adult has epilepsy they may fear that they are unable to make relationships with other people because of fear of another seizure. Having epilepsy as a young adult may also means that they could find it difficult to find a job that they want to do but cant because of their illness. This then could affect their social and emotional well being. A diagnosis of epilepsy can mean losing their driving license for at least 12 months. This can be very hard to accept for many people this is because driving is the means to be independent. If driving is important for where they work this could also then lead to unemployment which could make self esteem drop even lower.
It is easy to think that epilepsy is something that a person is born with. This is not true. Epilepsy can begin at anytime in a person’s lifespan this can be from birth to old age. Being diagnosed with epilepsy at any time of life can be a shock and some people can find it difficult to cope with as they become older. There can be lots of different reason who they have developed epilepsy in their old age, but I think what scares them most about the illness is that they will remember epilepsy and how it was perceived and treated years ago and they may fear that little has changed. This is not true but still if the person knows little about the illness it can be very freighting to them. After they have been diagnosed they may feel like their life has been completely turned upside down, this could make them lose self confidence and anxious about having another seizure.
In older adulthood epilepsy can affect women who are going trough the menopause. The menopause is the time in a women’s life when her ovaries stop working, this means that her menstrual periods stop and the level of sex hormones decrease. We know that hormones have an effect on the brain this may mean that seizure patterns may change in some women as they go through menopause just as it may change at other times of hormonal change.
People with epilepsy usually lead a good quality of life that is not affected by their illness and enjoy a full and active life. For some people having epilepsy may bring risks to their health and affect the quality of life that they live. This is because of the risk of having seizures. The fear of having a seizure may cause anxiety, stress, or depression. A lot of people with epilepsy may not have these problems. Not knowing when a seizure may happen may make a person feel isolated and attitudes of other people toward epilepsy may also make people feel anxious and depressed because they are worried about having a seizure in a public place where everybody can see them. This may then cause agoraphobia because a person may feel they don’t want to leave the house in case of a seizure. Successful management of epilepsy involves many factors. These factors are coping with the diagnosis’s, observing and recording seizures, looking at what may trigger the seizure and when they are at most risk of a seizure, and maintaining their own personal safety, and managing their medication and the effects that it has . People who suffer from epilepsy should be taught basic skills like these. Treatment teams may be the best idea for people with seizures or evidence of impaired emotional or psychosocial adjustment. People with well-controlled epilepsy also may benefit from consultation with nurses for epilepsy education or with social workers or other mental health providers for help with adjustment issues. Some patient groups, such as children, women, those with developmental disabilities, and the elderly, may have special needs. Patients and healthcare providers may need to advocate forcefully for access to specialists and complete care.
References
Bazil, C .Malow, B. Sammaritano, M (ed.) [2002] Sleep and epilepsy: the clinical spectrum. Elsevier Science Ltd. New York
Bury, M (1999) health and illness in a changing society. London press. London
Davey, B (ed) (2001) Birth to old age : health in transition . 2nd edition. Buckinham. Open University press.
Rayner, E, Joyce, J R, Twyman, M, Clulow, C (2005), 4th edition . Human development, an introduction to the psychodynamics of growth, maturity and ageing. Routledge. Hove
Rapoport R, Rapoport, R, (1980) Growing through life. Multimedia productions. Holland .
Stanley, H, Hayne, W, (1994) Lifespan developmental psychology. Lawrence Erlbaum Associates. Hillsdale publishers New Jersey.
Schachter, S. Schomer , D (1997) Epilepsy: a practical guide. Academic Press. San Diego
NHS direct: Epilepsy an introduction, [internet] 14th January, available at :
Malmberg L-E.; Norrgard S. February 1999: Adolescents' ideas of normative life span development and personal future goals. Association for Professionals in Services for Adolescents. [Internet], available at:
http://www.ingentaconnect.com/content/ap/ad/1999/00000022/00000001/art00199
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Sonja Orridge 052729504
Life span
Case study: Epilepsy
Health Studies
Unit Tutor: Paul Linsey
4 February 2008
