National Epilepsy Week

Epilepsy is one of the most common neurological conditions, yet it remains widely misunderstood. This National Epilepsy Week, the Council for Medical Schemes (CMS) joins the global call to raise awareness and break the stigma around epilepsy. Through education and clear information, we are here to empower medical scheme members with knowledge about the condition and guaranteed cover under Prescribed Minimum Benefits (PMBs).

What is epilepsy?

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing convulsions or seizures or periods of unusual behaviour, sensations, and at times loss of awareness. However, it is important to note that having a seizure does not necessarily mean a person has epilepsy.

Epilepsy can affect anyone, regardless of age or gender, and many people living with epilepsy lead full, active lives with the right care and support.

Signs and symptoms

Seizures can look different from person to person. Symptoms may include:

• Temporary confusion or staring spells.
• Uncontrolled jerking movements of the arms or legs.
• Loss of consciousness or awareness.
• Sudden feelings of fear, anxiety or déjà vu.

Medical help should be sought after a first seizure or if a seizure lasts longer than five minutes. Further medical attention is needed if seizures become more frequent or change, or if there is difficulty breathing, injury, or prolonged confusion.

Causes and risk factors

Epilepsy often has no identifiable cause, but it can be linked to several triggers and underlying factors, including:

• Age, as it is more commonly diagnosed in children and older adults.
• Genetic influence or family history of epilepsy.
• Head injuries or trauma (including prenatal injuries).
• Brain conditions such as tumours or strokes.
• Brain infections such as meningitis, which cause inflammation of the brain or spinal cord.
• Childhood seizures associated with high fevers.

What is covered as PMB level of care?

The PMB regulations include epilepsy under the Diagnostic Treatment Pairs (DTP) and the Chronic Diseases (CDL). This means medical schemes are required to cover:

• Clinical assessment and diagnosis, such as:
  • Detailed medical history (including family, social, past medical history and eyewitness accounts of seizures).
  • Neurological examination (e.g. strength and reflex testing).
  • Various blood (e.g. glucose, sodium, potassium, calcium, phosphorus, magnesium, blood urea nitrogen, ammonia, anticonvulsant medicine levels (if already on treatment) and complete blood count (to assess possible infection).

• Treatment including:
  • Medical management and hospital care where required.
  • Anticonvulsant medication, prescribed according to an approved stepped medicine algorithm.
  • Ventilation and neurosurgery, where clinically indicated.
  • Neurosurgery (subject to strict clinical criteria, as not all patients qualify).

Stigma and misinformation can be more limiting than epilepsy itself. This National Epilepsy Week, let’s replace myths with facts and stand in support of those living with the condition.

Read the full CMScript here.