EULALEE THOMPSON
SILAS MARNER, the protagonist in George Eliot's celebrated 19th century novel, Silas Marner, lived in a sleepy, rural town, Raveloe, (set in Britain) inhabited by barely educated and superstitious folk. Silas lived an isolated life and was ostracised because of his "glaring face" which the townspeople connected with the devil, demons and the setting of curses.
Silas' strange habit of glaring into space at odd times - his "glaring face" it is now believed was really an "unconscious fit", a less dramatic type of epilepsy (seizure disorder) with a sudden 10 to 15 seconds loss of consciousness. The condition, epilepsy was little understood then in that rural, late 19th century setting and people living with the condition now still struggle with similar myths and misconceptions.
REDUCING PREJUDICE
It is in an effort to reduce prejudice and misinformation about epilepsy that the Jamaican Epilepsy Association was convened about three years ago, with Nora Perez as its president. Working closely with the medical group, the Jamaican League Against Epilepsy, the Association last year established a Video-EEG Centre at the Andrews Memorial Hospital in St. Andrew.
"It may seem like a small step but it is actually a big step ... we are able to diagnose the patients accurately, classify them ... and then those patients who do have the realistic chance of benefiting from surgery we are able to deal with them ... without this facility, we would not be able to make this decision," said Dr. Amza Ali, consultant neurologist.
The EEG (electroencephalography) is not, of course, new technology but the establishment of this private unit here could not be too soon. According to Dr. Ali, prior to the equipment' s installation, diagnosing epilepsy was guess work.
"We have the capacity to document, so we can know for sure what the patient has," he said.
In normal brain function, electrical impulses in the brain are discharged in an orderly and organised way but in cases of seizures the electrical discharge are abnormal and there is an acceleration of the brain's electrical activity, affecting how the person feels and behaves. The EEG equipment records the electrical activity of the patients brain by placing small electrodes on the scalp.
The brain waves when printed on paper varies in appearance depending on whether brain activity is normal or abnormal. Different types of seizures produce different wave patterns which are helpful in the diagnosis of specific types of seizure.
"A lot of people who are referred to us do not have epilepsy. They have a lot of other kinds of neurological disorders which produce movements and strange behaviours and so on , and this technology allows us to sift out those patients and to offer them the right line of treatment be it psychiatric or treatment of movement disorders," Dr. Ali said.
DIAGNOSES
About 48 patients have been seen so far at the two-bed Video-EEG unit; 30 diagnoses of epilepsy have been made. Each room has affixed to its ceiling, a digital video camera, networked to a computer in another room, allowing for the continuous monitoring of patients. Patients are usually monitored on a 24-hour basis.
The prevalence rate of epilepsy, based on data collected in other countries, is between 1 and two per cent and the incidence (that is, new cases) is about one per 1,000.
In terms of management of the condition, Dr. Ali said that 80 per cent of patients with epilepsy will do well on medication; and the EEG equipment will improve patient management.
"Without the capacity to accurately diagnose patients, they weren't given medication appropriately, so we were successful way less, " he said.
You can send your comments to eulalee.thompson@gleanerjm.com.
