How to React If Someone Has a Seizure in Your Presence & Latest Treatment Advances

Epilepsy is the fourth most common neurological disorder in the world, and according to the CDC, as of 2015, 1.2% of the U.S. population had active epilepsy. This is about 3.4 million people with epilepsy nationwide: three million adults and 470,000 children.” In Louisiana, it is estimated that 54,900 people have epilepsy, 7,900 of which are children 17 years old and below. Epilepsy is now defined as a disorder characterized by two or more unprovoked seizures occurring more than 24 hours apart or one or more unprovoked seizures and probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years. Hence, recurrent seizures often lead to a diagnosis of epilepsy.

In late July, I was humbled to be the first in North Louisiana to implant the NeuroPace ® RNS ® medical device designed to reduce epileptic seizures in a patient. The device was implanted in a 23-year-old woman who had been suffering from daily epileptic seizures for the last five years.

The procedure involves creating a small hole in the skull where electrodes are placed in the part of the brain that is causing the seizures. A small pacemaker-type device is also implanted into the skull. When the RNS System device detects an oncoming seizure, it sends an impulse to that part of the brain to stop it.

The patient underwent a series of tests, including a video electroencephalogram (EEG), to determine which area of her brain was causing the seizures. A team of experts, under the guidance of neurologist Dr. Rosario Riel-Romero, pinpointed the area of the patient’s brain that was causing the seizures.

The RNS System typically cuts seizure occurrence in half but can, in some cases, stop all seizures. The NeuroPace RNS System can also transmit brain wave activity reports to doctors via Bluetooth ® - like technology so that they can monitor a patient remotely.

Ochsner LSU Health Shreveport is the only Level 4 Epilepsy Center in the area and was the location for the implantation of the NeuroPace RNS. Previously, patients were traveling to Dallas, New Orleans, Little Rock or Birmingham for this procedure. Other types of state-of-the-art therapies offered at Ochsner LSU Health Shreveport include laser therapy, resection surgery, vagus nerve stimulation, deep brain stimulation, stereotactic electroencephalography and invasive monitoring, and video electroencephalography.

While we are blessed to have an exceptionally strong medical team to address epilepsy in our community, I’m asking our community citizens to familiarize themselves with seizure first aid, so you are prepared should you encounter someone having a seizure. Remember that seizures are traditional symptoms of epilepsy but are also indicators of other neurological conditions.

During a seizure, individuals may be unaware of what is happening or lose consciousness resulting in physical injury. Knowing what to do when someone has a seizure can literally save their life.

The most important thing is to keep the person safe and comfortable. For most seizures, giving basic seizure first aid is all you need to do. Seizure first aid includes:

Always stay with the person until the seizure is over.

Pay attention to how long the seizure lasts.

Stay calm. Most seizures only last a few minutes.

Prevent injury by moving nearby objects out of the way.

Make the person as comfortable as possible.

Keep onlookers away.

Don’t hold the person down.

Don’t put anything in the person’s mouth.

Don’t give water, pills or food by mouth unless the person is fully alert.

Make sure their breathing is OK. Know when to call for emergency medical help.

Be sensitive and supportive and ask others to do the same. Call 911 right away if:

The person can’t cough and clear their airway on their own.

The person is having trouble breathing.

A seizure lasts five minutes or longer.

One seizure happens right after another without the person regaining consciousness (“coming to”) between seizures.

Seizures happen closer together than usual for that person.

The person has trouble breathing.

The person appears to be choking.

The seizure happens in water, like a swimming pool or bathtub.

The person is injured during the seizure.

You believe this is the first seizure the person has had.

The person asks for medical help. For more information on epilepsy, go to www.lsuhs.edu/neurology, https://www.ochsnerlsuhs.org/services-departments/neurology and www.epilepsy.com

Jamie Toms, M.D., is an assistant professor of neurosurgery at LSU Health Shreveport. Areas of specialty include epilepsy, movement disorders, Parkinson’s disease, general/complex cranial and spine diseases.