Epilepsy

by Shayna Bryan, Jaelyn Copeland, Shon Mack, and Senequa Malone | Interns and UAB Community Health and Human Services students

(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])


Epilepsy is a commonly misunderstood illness. Tonight’s conversation explores seizure types, how to recognize seizures, and tips for managing seizure healthWhat is epilepsy?

Epilepsy is a disorder of the brain, also called a neurological disorder, where brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. These recurring seizures are the single symptom of epilepsy.

People are generally diagnosed with epilepsy when they have had at least two or more seizures within a 24-hour window that are not caused by a known and reversible medical condition.

In the US, there are about 3.4 million people with epilepsy; 470,000 of these are children.

What causes seizures and epilepsy?

Seizures can be caused by many things, some of which and known and will resolve on their own. Some of these conditions are:

  • High fever (febrile seizure)
    • Contact doctor if fever is over 102ºF for children, 103ºF adults
  • Head trauma
  • Very low blood sugar (diabetic seizures)
  • Alcohol withdrawal
    • Alcohol withdrawal syndrome can be very dangerous and even deadly, should be overseen by a trained medical professional

These are non-reversible conditions that can cause seizures, such as any conditions that affect a person’s brain. Some of these causes include:

  • Stroke
  • Brain tumor
  • Traumatic brain injury or head injury
  • Central nervous system infection

However, for 60% of people with epilepsy the ultimate cause is unknown.

Triggers or factors that affect the frequency of seizures:

  • Missed medications
  • Lack of sleep
  • Stress
  • Alcohol
  • Drug abuse
  • Menstruation
  • Photosensitivity (Flashing lights)
    • Affects only 3% of people with epilepsy, despite popularity of depiction in media
  • Nutritional deficiencies
  • Over-the-counter medications

How common is epilepsy? Who is affected?

Epilepsy is the fourth most common neurological disorder and affects people of all ages.

About 1 out of 10 people may have a seizure during his or her lifetime and 1 in 26 will develop epilepsy, so they are fairly common. Seizures can last a few second to several minutes. All age, ethnicities, and genders can develop epilepsy, but it is more common in children and older adults and slightly more common in males.

New cases of epilepsy are most common in children till age 10, then decease and then increase again after age 55.

What do you do if you have a seizure? Is there treatment?

What to do: Go to your regular family physician if you have not already been to the hospital or seen by medical professionals. More information about proper first response to a seizure can be found further down.

For the majority of people, epilepsy can be treated or managed with medications or sometimes surgery to control seizures. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.

What do seizures look like? What are the types?

Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. A mild seizure may be difficult to recognize as it can last a few seconds during which you lack awareness. 

There are two types of seizure, depending on how much of the brain is affected: Focal and Generalized. In both, the person may or may not lose consciousness

  • Focal – Affects part of the brain (can be any part), also called partial seizures.
    • Alterations to sense of taste, smell, sight, hearing, or touch
    • Dizziness
    • Tingling and twitching of limbs
    • Staring blankly
    • Unresponsiveness
    • Performing repetitive movements
  • Generalized – Affects both sides of the brain (the whole brain)
    • Repetitive movements like lip smacking or blinking
    • Muscle stiffness
    • Loss of muscle control (you may fall down suddenly)
    • Repeated, jerky muscle movements of the face, neck, and arms.
    • Spontaneous quick twitching of the arms and legs.
    • Tonic-clonic seizures, (which used to be called “grand mal seizures”) are a type of generalized seizure that is what most people probably imagine a seizure to look like. The symptoms are:
      • Stiffening of the body
      • Shaking
      • Loss of bladder or bowel control
      • Biting of the tongue
      • Loss of consciousness

How does epilepsy affect daily life?

Having seizures and epilepsy can impact one’s safety, relationships, work, driving, and more.

Public perception and treatment of people with epilepsy are often bigger problems than actual seizures. Some people have service dogs that can alert them to an oncoming seizure so they can find a safe place to lie down. People with epilepsy are sometimes burdened with unnecessary medical costs by bystanders who call 911 even when emergency medical help is not needed.

What should you do if you see someone seizing?

Most seizures end in a few minutes, and do not usually require emergency medical attention. If you see some seizing, here’s what you should do:

  1. First, keep yourself and other people calm. If you do not know the person, check or call out to see if there is someone around who can attest to the seizing person’s medical history.
  2. Start a timer. You’ll want to keep track of how long the seizure lasts.
  3. Check to see if the person is wearing a medical ID bracelet or other emergency information.
  4. Clear the area of potential hazards so the seizing person doesn’t hurt themselves
  5. Try to gently ease the person on to their side to help them breathe easier
  6. Only call 911 if one or more of these are true:
    • They have never had a seizure before
    • They have a health condition like diabetes, heart disease, or are pregnant.
    • They have difficulty breathing or waking after the seizure
    • The seizure lasts longer than 5 minutes
    • Another seizure follows soon after the first one
    • The person is hurt during the seizure
    • The seizure happens in water
  7. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
  8. Comfort the person and speak calmly.
  9. Offer to call a taxi or another person to make sure the person gets home safely.

ABSOLUTELY DO NOT

  • Hold the person down
  • Try to put anything in their mouth
  • Try to give mouth-to-mouth CPR

Check out these resources to learn more about epilepsy:

Epilepsy Foundation Alabama

(205) 453-8205 / Toll-Free: (800) 626-1582 /  alabama@efa.org
3100 Lorna Road Suite 311
Birmingham, Alabama 35216-5452

Walk to END Epilepsy – Birmingham (November 6, 2021)

Seizure First Aid and Safety Course offered by Epilepsy Foundation (with live webinars hosted in English and Spanish)

Children’s of Alabama – Pediatric Epilepsy Program

UAB Epilepsy Center – Home to Alabama’s only Level IV Epilepsy Center, the highest designation available from the National Association of Epilepsy Centers


Sources:

Centers for Disease Control and Prevention. (2020, September 30). Epilepsy fast facts. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/fast-facts.htm.

Centers for Disease Control and Prevention. (2020, September 30). Seizure first aid. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/first-aid.htm.

Centers for Disease Control and Prevention. (2020, September 30). Types of seizures. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm.

Mayo Foundation for Medical Education and Research. (2021, October 7). Epilepsy. Mayo Clinic. Retrieved November 8, 2021, from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093.

Pietrangelo, A. (2018, September 17). Epilepsy: Causes, symptoms, treatment, and more. Healthline. Retrieved November 8, 2021, from https://www.healthline.com/health/epilepsy.

Schachter, S. C., Shafer, P. O., & Sirven, J. I. (2013, July). Who gets epilepsy? Epilepsy Foundation. Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/who-gets-epilepsy.

What is epilepsy? disease or disorder? Epilepsy Foundation. (2014, January 21). Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy.


Breast Cancer Awareness

by Senequa Malone, Jaelyn Copeland, and Shon Mack, with contributions from Shayna Bryan | Interns and UAB Community Health and Human Services students

Graphic by Jaelyn Copeland

(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])


October is Breast Cancer Awareness month. Breast cancer is one of the most prevalent cancers out there. According to the CDC, it is the second most common cancer in women (after some skin cancers) and the second leading cause of cancer death in women (after lung cancer). About 1 in 8 women will be diagnosed with some kind of breast cancer in her lifetime. No one is exempt from a breast cancer diagnoses. It affects men and women, old and young.

Today we’re going to learn about what breast cancer is, what the risk factors are, how you can reduce your risk, and how it affects Women of Color in our community.

What is Breast Cancer?

Breast cancer is a type of cancer that starts in the breast. Cancer starts when cells begin to grow out of control. There are many different types of breast cancer, these depend on where in the breast the cancer cells are located. The breast is made up of 3 parts:

  • Lobules (glands that produce milk)
  • Ducts (connect glands to nipple)
  • Connective tissue (fat that surround the breast and makes up a large part of the volume)

Most breast cancers begin in the lobules or ducts. When the cancer spreads to other parts of the body, it is said to have metastasized.

How common is Breast Cancer? What about dying from Breast Cancer?

Every person has breast tissue, so everyone one is capable of developing breast cancer. It is most common in women, but men can develop it too. The lifetime risk is of getting breast cancer for a woman is 13% and the risk of dying from breast cancer is 2.6%. The 5-year survival rate post diagnosis is 90%. The number of new cases of breast cancer is going slightly up (0.5% per year), but death is going down (1% per year). This is likely due to early detection and better screening. Men are 100 times less likely to develop breast cancer, but that number is not zero. While rare, men are diagnosed and die from breast cancer every year

What are the risk factors for Breast Cancer?

  • Being born a woman
  • Being older
  • Obesity
  • Family history
    • 15% of women with breast cancer have a family member with it
  • Early menstruation (starting before age 12)
  • Late menopause (starting after age 55)
  • Having dense breast tissue

What are dense breasts?

Breast density is a term that describes the relative amount of different types of breast tissue (glandular, connective, and fat tissue) as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.

Only a mammogram can show if a woman has dense breasts. Dense breast tissue cannot be felt in a clinical breast exam or in a breast self-exam. Nearly half of all women age 40 and older who get mammograms are found to have dense breasts.

Whether your breasts are dense is often due to genetics, but other factors can influence it. Factors associated with lower breast density include increasing age, having children. Factors associated with higher breast density include having a high body-mass index and using postmenopausal hormone replacement therapy.

Is there any way to reduce our risk of Breast Cancer?

Factors we can change include:

  • Maintain a healthy weight
  • Be regularly physically active
    • 150-300 minutes of moderate intensity per week (or about 20-30 minutes a day)
  • Eat a healthy diet
    • Vegetables, whole grains, unsaturated fat
  • Perform monthly breast self-exams
    • 40% of diagnosed breast cancers were detected by women who feel a lump
    • Start at age 20 to become familiar with your “normal”
    • Monitor regularly for changes
  • Consume alcohol moderately, or not at all
    • Women who have 2-3 drinks a day have 20% higher risk than non-drinkers
  • If you have children, breastfeed if you are able

What about Breast Cancer risk among African American women?

African American women have a 31% breast cancer mortality rate – the highest of any U.S. racial or ethnic group. While the reasons behind this disparity are numerous and complicated, the issue is real and there are at least some solutions everyone agrees on: more screening, more self-exams, and more access to treatment for African American women.

New Cases of Breast Cancer per 100,000 People

AreaAll GroupsAfrican American
Women
National121.4124.3
Alabama128.8126.1
Jefferson County130.5128.7
Data pulled from statecancerprofiles.cancer.gov/

Deaths due to Breast Cancer per 100,000 People

AreaAll GroupsAfrican American
Women
National19.927.1
Alabama21.427.5
Jefferson County25.628.4
Data pulled from statecancerprofiles.cancer.gov/

How do I perform a Breast Self-Exam?

Set a schedule and do it regularly. A good time to start is 3-5 days after your period it ends, then continue to perform a BSE every month.

  1. Remove your clothing and take a good look at yourself in the mirror. If you’re never done something like this before, it can feel a little silly and embarrassing at first, but it’s very important to become familiar with your own body and what is normal for you, so you can detect changes.
    • Breasts come in all shapes and sizes (many women have one breast larger than the other), so once you know what is normal for you, when you perform these exams you’re going to be looking for anything that stands out as different or unusual
  2. Look for any distortion of the shape, dimpling, puckering, or odd bulging.
    • How’s the color? Are there any areas of redness, a rash, or parts that look swollen? Is the nipple in its normal positions or has that changed, is it inverted? Is there any discharged? It could look “watery, milky, or yellow fluid or blood”.
  3. Raise your arms, and look for the same things. Does this position aggravate any soreness or pain in your breasts?
  4. Next lie down flat on your back and place one arm behind your head.  With the other hand, use the pad of your fingers to press firmly around your breast tissue. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
    • Use a pattern to make sure you cover your entire breast. Two common patterns are to start in the center and make your way outwards in circles, another is to go top to bottom across the breast like you’re mowing the lawn.
  5. If you do feel a lump, don’t worry, stay calm, and make an appointment with your regular physician.
    • Most lumps are benign (non-cancerous). There are many benign breast conditions that can cause lumps that resolve on their own.

What about Mammograms?

            A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

  • Women ages 40-44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so, particularly if they have family history of breast cancer
  • Women ages 45-54 should get mammograms every year
  • Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.

Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.


Sources and References:

African American women and breast cancer. Breast Cancer Prevention Partners (BCPP). (2021, July 22). Retrieved October 28, 2021, from https://www.bcpp.org/resource/african-american-women-and-breast-cancer/.

Breast cancer information and support. Breastcancer.org. (2021, October 27). Retrieved October 28, 2021, from https://www.breastcancer.org/.

Breast cancer statistics. Susan G. Komen®. (2021, October 6). Retrieved October 28, 2021, from https://www.komen.org/breast-cancer/facts-statistics/breast-cancer-statistics/.

Breast cancer: Breast cancer information & overview. American Cancer Society. (n.d.). Retrieved October 28, 2021, from https://www.cancer.org/cancer/breast-cancer/.

Centers for Disease Control and Prevention. (2021, September 20). Breast cancer. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://www.cdc.gov/cancer/breast/.

Centers for Disease Control and Prevention. (n.d.). USCS data visualizations – CDC. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://gis.cdc.gov/Cancer/USCS/.

Dense breasts: Answers to commonly asked questions. National Cancer Institute. (n.d.). Retrieved October 28, 2021, from https://www.cancer.gov/types/breast/breast-changes/dense-breasts.

Mayo Foundation for Medical Education and Research. (2021, October 14). Swollen lymph nodes. Mayo Clinic. Retrieved October 28, 2021, from https://www.mayoclinic.org/diseases-conditions/swollen-lymph-nodes/symptoms-causes/syc-20353902.

Moore, J. X., Han, Y., Appleton, C., Colditz, G., & Toriola, A. T. (2020). Determinants of mammographic breast density by race among a large screening population. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkaa010

Price, D. (2021, October 7). Black women and the breast cancer disparity explained. The Birmingham Times. Retrieved October 28, 2021, from https://www.birminghamtimes.com/2021/10/black-women-and-the-breast-cancer-disparity-explained/.

State Cancer Profiles. (n.d.). Retrieved October 28, 2021, from https://statecancerprofiles.cancer.gov/.