Epilepsy is a disease that manifests in attacks, also known as seizures. One of the most common neurological disorders, affecting 0.5% to 1% of the population. Epilepsy can occur at any age but is most common in childhood and old age. It is a disease that occurs under different symptoms with causes, treatments and prognoses.

Not all epileptic seizures are necessary. Sometimes, alcohol or some medications prescribed for other diseases can cause seizures in some circumstances.

Currently, most physicians do not interpret the isolated seizure and epilepsy. The prognosis of epilepsy is a clinical condition consisting of recurrent seizures in a patient.

The brain is composed of a large number of nerve cells called neurons that communicate with each other through electrical signals. For normal operation of the brain must be careful regulation of power flows that integrate the activity of these neurons.

An abnormal electrical discharge in the brain disrupts the normal functioning of neurons and can produce, among other things, an epileptic seizure. The type of seizure depends on the origin and extent in the brain of the shock in question. During an attack, these discharges can cause:

- Contraction of the muscles.

- Abnormal sensations (perception of odors or flavors, tingling or itching, burning on a side of the body).

- Emotional symptoms such as fear, perception of having lived before an event, a symptom known by the name of déjà vu, or the opposite sign, known by the name of jamais vu.

- Loss of consciousness.

Epileptic seizures are usually brief, it lasts a few seconds to few minutes. Once past the seizure, brain electrical activity to normal.

credit to: Dr. Jimmy Alfonso Schiemann Delgado

Remember, it was Tuesday, December 16, 1997. More than half of Japanese youth awaiting episode 37 of their favorite series: the Pokemon. After 20 minutes, the scene of the cartoon unfolds: Pikachu deck his opponent with a succession of flashes red and blue. And there is drama: 11 000 Japanese teenagers are victims of ailments, 618 must be hospitalized due to seizures of convulsions.

Flashes of light

Immediately after the Pokemon incident, a battery of experts (pediatricians, psychiatrists, neurologists …) gather to understand. Their explanation was soon all these children were suffering from a form of epilepsy called photosensitive. This particular form of epilepsy for a 20. About 0.5 to 0.8% of children aged 4 to 14 years would be involved. The mechanisms triggering seizures are still poorly understood. According to Italian scientists, this problem can be explained by an inability of the brain to control his reactions when the eye is subjected to flashing lights or alternating high-contrast images. These researchers have also highlighted the fact that crises are triggered when the frequency of flashes is between 4 and 14 Hertz.

Risk Warning

Thus, these crises can occur only among people with existing predispositions. In children with epilepsy, the photosensitive character can be assessed by electroencephalogram (EEG). But sometimes this form escapes detection. However, many people are unaware they are suffering from photosensitive epilepsy and may discover it during a game or a television. Regarding video games, in fact, manufacturers are now obliged to include a warning about the risk of occurrence of seizures. But what precautions are taken to television programs, including those for youth?

Nintendo exonerated?

Asked about this, Nintendo, inventor of Pokemon, denies any responsibility in cases of epilepsy that hit Japan. In this case, the company said it has not participated in the design of the cartoon. If there is fault, it relates to both the producer, who would have control of the cartoon made, and the chain (Tokyo Channel), which would verify the program before broadcast. At Nintendo, we are assured that we take all precautions necessary. The company said it was the first to include warnings to prevent epilepsy in his videogames.

All episodes verified by TF1

It is thus the broadcaster to control himself its programs. It seems indeed, since the accident in Japan, all channels verify their content. This is confirmed Poussier, Program Director of Youth TF1 channel which broadcasts the Pokemon cartoon: “As soon as we receive a new series, we undergoes a series of tests designed to protect spectators. First Several people from the Youth team will view every episode. Then, three psychologists also watch the series. These two checks to detect any problem with editorial content. Finally, our technical services also check the episodes they are capable of detecting sequences likely to trigger photosensitive seizures. We are particularly vigilant with regard to the Japanese series. For the Pokemon cartoon, I personally asked the distributor to send us all the tapes to verify, before taking the decision to buy. Anyway, the series had already been vetted by the Japanese and American scientists. Moreover, the episode had been a problem had been removed.”

Stop watching TV?

For a child who suffers from photosensitive epilepsy, so there is no a priori risk facing a cartoon. Of course the risk to zero would not turn on the television, which advises Jacqueline Beaussart, president Aispace (Acting, inform and educate the public to improve understanding of epilepsy): “You can not prevent a child watching television. This would put in a situation of exclusion vis-à-vis its peers that they have access. It should just be vigilant and follow a few rules of precautions such as minimum distance to the position and adequate lighting.”

Clearly it is easier to set up some rules rather than proscribe television, especially if they forbid him to watch Pokemon: parents are no match for Pikachu …

Children main victims

When discussing epilepsy, we should rather talk about epilepsy, both the diseases are different, both the prognosis and treatment modalities are different. If children are affected first, most are fortunately benign epilepsy in children. The maximum rate of the disease is between 0 and 1 year and remains very important to 10 years. It then gradually decreases to remain at low levels between 30 and 50 years and back dramatically after age 75.

It is estimated that the average lifespan of epilepsy is 12 to 15 years. Some minor forms always recover while others never experience spontaneous remission.

It is actually four different types of epilepsy:

• The spontaneous benign epilepsy (20 to 30% of cases). Patients respond well to medical treatment that can stop after a few years;
• Epilepsy pharmacosensible (30 to 40% of cases). The remission under treatment is permanent and it is possible to consider stopping the medication;
• Epilepsy addicted (10 to 20% of cases). Stopping treatment leads to relapse systematic;
• Epilepsy drug (20% of cases). This severe form of epilepsy resistant to all drug treatments. At the individual level, this form of epilepsy is a major handicap to the socio-professional often major.

While neurological examination does not stress any peculiarity in the first three forms of the disease, it is mostly unusual for drug-resistant patients. It was then that surgery can sometimes be considered.

Advances in surgery

The severe epilepsy resistant to medication is a real handicap for patients. Over 80 000 people in France are concerned. For many, surgery may be synonymous with healing. Lack of equipment, lack of resources, the operation is to perform an ablation zone of the brain known as the “seizure” is still practiced by a limited number of teams. However, it should be able to act quickly. From childhood, even when brain plasticity is still important. “But now 200 to 300 patients are operated every year”, said Dr. Dominique Broglin, while about 50 000 people are potential candidates for intervention.