The International Day Against Epilepsy is being celebrated in the world today, an opportunity to draw attention to a disease that is still perhaps too little talked about, but which is estimated to affect one in a hundred people in Italy. In Sardinia, the incidence follows the national figure, with 10-12 thousand people who find themselves facing the disorders of this pathology every day.
On the occasion of the International Day, many initiatives and activities have been launched in collaboration with the specialized structures. And the Italian League against Epilepsy (Lice) Sardinia launches an important event to be held in Oristano on 7 May (hotel Mistral, from 9 to 19), a conference aimed primarily at women and with particular focus on the theme of epilepsy in pregnancy.
"Epilepsy - explains the Cagliari neurologist Walter Merella , regional coordinator of Lice for Sardinia to L'Unione Sarda - is a brain disease whose diagnosis generates anxieties and fears in patients that are often disproportionate to the actual severity in terms of ability to condition the life of those affected. And it is above all women who are conditioned: many for fear of the social stigma they may encounter conceal the pathology even from their partner or husband, often avoiding treatment and with consequences that can be very serious ".
How is the disease characterized?
“Epilepsy manifests itself in the repetition of short-term events, crises, which unfortunately are unpredictable. They can appear during the day or during sleep. But they compromise the person's autonomy only for a few minutes. Yet, perhaps due to the lack of precise information on the disease, over the centuries a series of prejudices and inaccuracies have built up around epilepsy which often leads as a consequence to the marginalization or even the self-marginalization of the people who suffer from it ”.
How, then, can we reduce the perception of epilepsy?
“First of all, epilepsy is not a life sentence. Most patients can be cured and even cured, also thanks to the fact that in the last 30 years the drugs have gone from less than 10 to about 30 and specific surgery therapy is taking hold, especially for children and young people. Secondly, epilepsy does not cause cognitive disturbances and if these are present it is the cause and not the effect ".
What are the indications that children, young people and adults can follow to lead a life free from the consequences of the disease?
"Sports and physical activity are first of all possible, and if anything very useful. Of course, extreme sports or physical contact should be avoided, but the majority of individual sports are practicable. A driving license can be obtained if you are free from crisis by at least one year. The recent legislation also provides that those who have seizures only in the course of sleep may be eligible to drive even if they have more seizures in the same year. There is, then, no contraindication to the use of a computer. photosensitivity is a prevalent finding in some forms of childhood epilepsy; in this case the child neuropsychiatrist will give precise indications on the use of TV or computer screens ".
Let's go back to the topic of women affected by epilepsy, and in particular those who wish to become pregnant. How much does the disease interfere with the chances of carrying on a motherhood?
“Epilepsy does not interfere with sexual life and fertility. The woman with epilepsy can face a pregnancy also because usually in that period the crises tend to reduce in frequency if not even to disappear. The only delicate aspect is related to the teratogenic effect of antiepileptic drugs. The risk of malformations is 3-4 times higher than the generic risk that any woman runs, which is around 1% ".
Explain to us better ...
“This aspect has been investigated and studied also thanks to national or international registers, the richest of which has been promoted by our scientific society and is based in Milan at the Besta Neurological Institute: it is called eurap. This archive has collected a prospective evaluation of over 30,000 pregnancies of women taking antiepileptic drugs. Thanks to the processing of these data, it is now possible to reassure affected women on malformation risks in an objective way, confirming that they have a good chance of giving birth to healthy children ".
In view of the birth, are there any aspects to be investigated with your gynecologist?
"Childbirth can be dealt with naturally with the possible support of epidural analgesia, unless there are gynecological contraindications or there have been crises during pregnancy".
What about while breastfeeding?
"The woman can breastfeed under the supervision of the neonatologist who will advise against this practice of high biological and psychological value only if the newborn should show symptoms of an effect of the drugs taken".
What is the likelihood of passing the disease on to children?
“In reality it is now established that in a country like Italy almost 90% of women with epilepsy give birth to healthy children. Certainly it is important a correct assistance of the woman from an interdisciplinary point of view. In everyday life the Neurologist, the Gynecologist and the Neonatologist (the three figures who help the woman to deal with pregnancy, childbirth and unborn child) rarely or only in conjunction with complex or risky cases. On the other hand, constant dialogue and discussion is important in the months of gestation and in the first months of a child's life ".