Combating epilepsy: Professor Mofou Belo, specialist in neurology and neurophysiology

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Extract from the article: A neurological disease characterised by abnormally high excitation of brain cells, epilepsy can be a very violent phenomenon that mobilises all the patient's muscles, leaving them physically tired. Find out all about this disease from Professor Mofou

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« Epilepsy requires regular and appropriate follow-up for each patient. Treatment is often multidisciplinary... Epilepsy is nothing to be afraid or ashamed of... »

 

A neurological disease characterised by abnormally high excitation of brain cells, epilepsy can be a very violent phenomenon that mobilises all the patient's muscles, leaving them physically tired. Find out all about this disease from Professor Mofou Belo, Head of the Non-Communicable Diseases Surveillance Division at the Togolese Ministry of Health.

Health-Education: What is epilepsy?

Pr Mofou Belo: Epilepsy is a chronic neurological disease characterised by repeated epileptic seizures. An epileptic seizure is due to paroxysmal hyperactivity of a group of cerebral neurons. The term paroxysmal means that the signs begin and end abruptly. There are several types of manifestation. The most common is a generalised seizure affecting the whole body. A loss of consciousness may follow an epileptic seizure.

What causes this disease in children?

There are many causes. When we talk about epilepsy in children, there are what are known as structural or lesional causes. This means that the epilepsy is due to a brain lesion. Complications during pregnancy and childbirth can lead to foetal suffering causing brain damage. Infections of the nervous system such as meningoencephalitis and brain abscesses can leave sequelae in the brain.  Congenital cerebral malformations, brain tumours and cranial trauma are also causes of epilepsy.  Increasingly, with the development of science, certain genetic anomalies are predisposing to the onset of epileptic seizures.

What are the symptoms of epilepsy?

There are several types of epileptic seizure.There are generalised seizures and focal seizures.Generalised seizures can be tonic, clonic or tonic-clonic. Tonic seizures are sustained muscle contractures, and parents describe their children as stiff.Clonic seizures are brief muscular jerks. Tonic-clonic seizures have a tonic phase and a clonic phase. Generalised seizures are often accompanied by loss of consciousness, and sometimes by the emission of urine. Absence seizures can also occur in children, for example when a child suddenly stops playing. You get the impression that they are absent, but then they come to in a matter of seconds and resume their game. In the case of school-age children, the teacher may notice that the child stops writing at a given moment and resumes writing after the seizure, all within a few seconds. Seizures can also manifest as unexplained falls.

Focal seizures depend on the area of the brain responsible for the epilepsy. For example, if the neurons responsible for vision are involved, the patient may experience visual hallucinations. The person perceives the same image each time, even though the image does not exist.

How would you describe the extent of this disease in your day-to-day experience of caring for patients suffering from it?

It's a common disease, affecting many children.  Around 5,000 of them are regularly monitored in health departments and centres, and new cases continue to be diagnosed by paediatricians and neurologists.

Can epilepsy be cured?

Epilepsy can be treated.Depending on the type of epilepsy, we prescribe anti-epileptic drugs.Regular monitoring of each patient's condition is essential.Treatment can be multidisciplinary, involving paediatricians, psychiatrists, neurologists, family doctors and neurosurgeons, etc.

What are the complications of epilepsy?

Untreated epileptic seizures can be complicated by status epilepticus, with repeated or closely spaced seizures that can lead to prolonged loss of consciousness. This being the case, I would not systematically speak of complications but rather of consequences. Trauma such as burns or fractures can occur during seizures. Epilepsy often has negative consequences for the quality of life of our patients, with an impact on social life (marginalisation, social exclusion, etc.) and on children's schooling.Are there any age groups affected by epilepsy when it comes to children?

If I look at the children being treated, the majority are between a few days and 20 years old.These are school-age children.  To a lesser extent, newborn babies, infants and adults may be affected.Can epilepsy be prevented?Epilepsy can be prevented by, for example, urging women to follow pregnancy and childbirth carefully and to give birth in a specialist care setting.Compliance with the vaccination calendar is also advisable.

What are the main difficulties facing patients?

I'd mainly like to talk about access to anti-epileptic drugs.Medicines are expensive. We often have to adapt the treatment of our patients to the income of the patient or their parents.

Your final words

We need to fight prejudice about epilepsy. Epilepsy can strike at any age.Even older people can be affected by epilepsy. There is no need to be afraid or ashamed of epilepsy.  A child who has a seizure at school is shunned by his classmates who think he is not normal; teachers are often afraid of such pupils. In the same way, it's important to have the reflex to consult a doctor when there are signs of epilepsy and to seek treatment.  I also ask patients to adhere to the treatment.

Interview by Abel OZIH