Preface

Epilepsy continues to be a major health problem throughout the planet affecting millions of people, mainly in developing countries where parasitic zoonoses are more common and cysticercosis as a leading cause, is endemic.

We decided to edit this book because we found another way to approach this problem, covering novel aspects of epilepsy without ignoring its foundation and therefore, apart from the classic issues that cannot be missing in any book about epilepsy, we introduced novel aspects related with epilepsy and neurocysticercosis as a leading cause of epilepsy in developing countries. Of course, the publication of this book could not have been possible but for the ungrudging efforts put in by a large number of individuals working in the field of epilepsy and many people from many countries, ethnic, religious and socioeconomic groups that coincidentally confluence in Epilepsy.

As can be seen in other books on epilepsy, we also cover those topics related to history, classification of seizure and epileptic syndromes, associated sleep disorders and novel aspects on epileptic channelopathies. Social aspects related to epilepsy in three different chapters are included as well.

We are looking forward with confidence and pride in the vital role that this book has to play for a new vision and mission. Therefore, we introduce novel aspects of epilepsy related to its impact on reproductive functions, oral health and epilepsy secondary to tuberous sclerosis, mithocondrial disorders and lisosomal storage disorders.

It was a great sense of delight to include in this book two chapters about combined neuro-cardiogenic epilepsy syndromes and sudden unexpected death in epilepsy, and other three chapters about epilepsy and neglected parasitic zoonotic diseases, including a description of epileptic seizures not reported in the medical literature before and the role of the pig industry. It will push this book to a higher level of acceptance because the most common cause of epilepsy in developing countries is linked to the parasitic infections of the brain and in this regard, new knowledge is delivered in this book.

#### X Preface

Some chapters and the edition job were entirely made in a rural setting and this edition is aimed at health care professionals including general practitioners, family doctors, internists, neurologists, epileptologists, neurosurgeons, psychiatrists, medical students, nursing students, and students of the professions allied to medicine among others.

Preface XI

community, mainly to those working for millions of epileptic patients in rural and

Furthrmore, I'd like to extend my gratitude to Dr. Roberto Gonzalez Martin Vice-Minister of the Cuban Ministry of Health (CMH), Dra Luisa Maria Diaz National Director of Postgraduate (CMH) and Dr. Jorge Delgado Bustillo Deputy Head of National Unit of International Collaboration (CMH), Prof. PhD Nereyda Cantelar del Castillo, Dr. PhD Reinaldo Menendez and Lic Maribel Chao from the National Institute of Tropical Medicine "Pedro Kouri", Prof. MM Balintulo Vice-Chancellor and Principal of Walter Sisulu University (WSU) in Mthatha, South Africa, Prof CL Obi Deputy Vice Chancellor, Academic Affairs and Research, Prof. G Buijs Deputy Chancellor, Planning, quality Assurance and Development, Prof. KJ Mammen Director, Directorate of Post Graduate Studies, Prof. GE Ekosse Director: Research Development (WSU); Prof K Mfenyana Executive Dean of Faculty of Health Sciences (WSU), Prof JE Iputo Director of the School of Medicine (WSU), Prof. A Awotedu Chairman of the Department of Medicine (WSU) , Dr. Xamlashe CEO and Dr. TM Madiba Head: Clinical Governance of Mthatha Hospital Complex and all my friends,

Finally, I'd like to thank to my first daughter Zayra Susana (died in 1979), who is my inspiration in life, to my wife Lourdes de Fátima, for her unconditional support and active participation in this book, to my second daughter, Lic. Lorna María (Who is also an excellent lawyer), my little daughter Fatima Susana Adolfina (2 years old) and my little son Thabo Humberto Jorge (3 years old) because writing chapters and editing a book takes a lot of time, and they were very understanding when I needed to work. They also understood when I was writing a chapter during our holidays at home and I had to move from one hotel to another looking for Internet access trying to download more than 150 abstracts. To my lovely father and my sister Lilia Teresa, Mayra Alejandra and Lorna Irene who always supported me, and the rest of my family:

Many thanks also to family, relatives, and friends of all collaborators for their patience

**Prof. Humberto Foyaca- Sibat**  Walter Sisulu University, Mthatha

South Africa

and acceptance of the lost evenings, nights, weekends, and holidays.

colleagues and collaborators my deepest sense appreciation.

sub-urban areas.

thanks very much indeed.

More than 150 abstracts were submitted for review from all over the world, about 50 % were selected during the first phase of this editorial process. All materials for this edition has been thoroughly revised, and updated. Many specialists have provided expert advice on changes in their field and their help has been invaluable to us in our efforts to keep the relevance of the book for our readership community. All chapters were reviewed by each author twice after submission, the final version was peerreviewed by two experts and recommendations were made. Nevertheless, some advices of contributors may differ from the approach of the editors or even the neurologic community. However, we kept and supported it as part of our policy of respect to all scientific criteria, mainly those that still remain controversial. The future will decide who was wrong. On the other hand, we also encourage other authors who are experts in the field, to report their personal experience, expertise, and obtained results.

Knowing that authors from many countries may have different experience and scientific results, in order to achieve a high degree of scientific content with a standard level of acceptance, we took a detailed overview of all important novel information. We all tried to keep the high prestige of our Editorial Company as a main priority and we declare our happiness in writing this book in the electronic era with a full-text website allowing us to display our scientific messages to an even larger global readership apart from all benefits of print format.

Our aim has been to produce a reference book in which this information is presented in an integrated and rapidly accessible format.

We all attempted to bring in valuable updated information about novel aspects of epilepsy, some of which has not been previously reported in the medical literature, as well as other new knowledge in epilepsy to our readership.

#### **Akcnowledgements**

Many people helped support the writing of this book. First, I'd like to thank all of technical reviewers. These folks check to make sure the examples work, look for technical errors, and make many suggestions on writing quality. It's not possible to write a quality medical book without quality scientific reviewers.

We are extremely grateful for the skill and support of our Publishing Process Managers Natalia Reinic and Dragana Manestar who have meticulously co-ordinated the whole project with unfailing good mood and patience and to the INTECH Open Access Publisher for giving us the opportunity to address this book to our medical community, mainly to those working for millions of epileptic patients in rural and sub-urban areas.

X Preface

others.

results.

Some chapters and the edition job were entirely made in a rural setting and this edition is aimed at health care professionals including general practitioners, family doctors, internists, neurologists, epileptologists, neurosurgeons, psychiatrists, medical students, nursing students, and students of the professions allied to medicine among

More than 150 abstracts were submitted for review from all over the world, about 50 % were selected during the first phase of this editorial process. All materials for this edition has been thoroughly revised, and updated. Many specialists have provided expert advice on changes in their field and their help has been invaluable to us in our efforts to keep the relevance of the book for our readership community. All chapters were reviewed by each author twice after submission, the final version was peerreviewed by two experts and recommendations were made. Nevertheless, some advices of contributors may differ from the approach of the editors or even the neurologic community. However, we kept and supported it as part of our policy of respect to all scientific criteria, mainly those that still remain controversial. The future will decide who was wrong. On the other hand, we also encourage other authors who are experts in the field, to report their personal experience, expertise, and obtained

Knowing that authors from many countries may have different experience and scientific results, in order to achieve a high degree of scientific content with a standard level of acceptance, we took a detailed overview of all important novel information. We all tried to keep the high prestige of our Editorial Company as a main priority and we declare our happiness in writing this book in the electronic era with a full-text website allowing us to display our scientific messages to an even larger global

Our aim has been to produce a reference book in which this information is presented

We all attempted to bring in valuable updated information about novel aspects of epilepsy, some of which has not been previously reported in the medical literature, as

Many people helped support the writing of this book. First, I'd like to thank all of technical reviewers. These folks check to make sure the examples work, look for technical errors, and make many suggestions on writing quality. It's not possible to

We are extremely grateful for the skill and support of our Publishing Process Managers Natalia Reinic and Dragana Manestar who have meticulously co-ordinated the whole project with unfailing good mood and patience and to the INTECH Open Access Publisher for giving us the opportunity to address this book to our medical

readership apart from all benefits of print format.

in an integrated and rapidly accessible format.

**Akcnowledgements** 

well as other new knowledge in epilepsy to our readership.

write a quality medical book without quality scientific reviewers.

Furthrmore, I'd like to extend my gratitude to Dr. Roberto Gonzalez Martin Vice-Minister of the Cuban Ministry of Health (CMH), Dra Luisa Maria Diaz National Director of Postgraduate (CMH) and Dr. Jorge Delgado Bustillo Deputy Head of National Unit of International Collaboration (CMH), Prof. PhD Nereyda Cantelar del Castillo, Dr. PhD Reinaldo Menendez and Lic Maribel Chao from the National Institute of Tropical Medicine "Pedro Kouri", Prof. MM Balintulo Vice-Chancellor and Principal of Walter Sisulu University (WSU) in Mthatha, South Africa, Prof CL Obi Deputy Vice Chancellor, Academic Affairs and Research, Prof. G Buijs Deputy Chancellor, Planning, quality Assurance and Development, Prof. KJ Mammen Director, Directorate of Post Graduate Studies, Prof. GE Ekosse Director: Research Development (WSU); Prof K Mfenyana Executive Dean of Faculty of Health Sciences (WSU), Prof JE Iputo Director of the School of Medicine (WSU), Prof. A Awotedu Chairman of the Department of Medicine (WSU) , Dr. Xamlashe CEO and Dr. TM Madiba Head: Clinical Governance of Mthatha Hospital Complex and all my friends, colleagues and collaborators my deepest sense appreciation.

Finally, I'd like to thank to my first daughter Zayra Susana (died in 1979), who is my inspiration in life, to my wife Lourdes de Fátima, for her unconditional support and active participation in this book, to my second daughter, Lic. Lorna María (Who is also an excellent lawyer), my little daughter Fatima Susana Adolfina (2 years old) and my little son Thabo Humberto Jorge (3 years old) because writing chapters and editing a book takes a lot of time, and they were very understanding when I needed to work. They also understood when I was writing a chapter during our holidays at home and I had to move from one hotel to another looking for Internet access trying to download more than 150 abstracts. To my lovely father and my sister Lilia Teresa, Mayra Alejandra and Lorna Irene who always supported me, and the rest of my family: thanks very much indeed.

Many thanks also to family, relatives, and friends of all collaborators for their patience and acceptance of the lost evenings, nights, weekends, and holidays.

> **Prof. Humberto Foyaca- Sibat**  Walter Sisulu University, Mthatha South Africa

**1** 

Hamdy Fouad Moselhy

*United Arab Emirates* 

*Faculty of Medicine and Health Sciences, UAE University,* 

**Psychosocial and Cultural Aspects of Epilepsy** 

Epileptic activity within the brain has an effect on the behavior, mood, and cognitive functions of the epileptic patient. Additionally, his/her behavior and mood may be affected by the attitude of others to his/her disability. Furthermore, the patient's social and psychological adaptations may modify his/her epileptic experiences. As a consequence of the interaction between these aspects patients with epilepsy face many cultural and psychosocial problems (Betts et al., 1976). The definition of the term psycho-social in dictionaries is "pertaining to or concerning the mental factors or activities which determine the social relations of an individual" (Webster, 2011). Meanwhile, the definition of culture is all the knowledge and values shared by a society (Webster, 2011). As many as possible previously published studies on the psychosocial and cultural aspects of epilepsy were identified from various parts of the world by using multiple search strategies. Published literatures cover varieties of areas, including: psychiatric problems (e.g. mood disorders, anxiety, psychotic disorders); feeling of shame, fear, and worry; low self-esteem; problems related to education, employment, dating, marriage, child-bearing, poor quality of life, and stigma (Lai, 2007). Publications on the link between culture and epilepsy show the believed etiology of epilepsy, public awareness, understanding and attitude toward epilepsy (Fong & Hung, 2002). Although some of these aspects have been considered in earlier chapters, at the risk of some repetition, we aim in this chapter to introduce an overview of different psychosocial areas related to epilepsy and examining the public awareness, understanding

To be epileptic is to be stressed and stress can influence the incidence of fits. Under stress many people develop anxiety symptoms which may be seen as a fight or flight reaction, some become depressed, and others show obsessive ritualistic behavior. There are those who develop temporary psychotic states or acute conversion (hysterical) reactions which effectively isolate them from the stressful situation (Betts et al., 1976). Beside the significance of the stress to the epileptic, the reaction of individual depends on several factors. Firstly, the support which a person has from family and friends affects his ability to cope. Secondly, the genetic constitution of the individual and the responsiveness of his autonomic nervous system to stress may play an important part (Slater & Shields, 1969, as cited in Betts et al., 1976). Thirdly, stress responses are influenced by educational and cultural background. Finally, reactions are

**1. Introduction** 

and attitudes of different cultures to epilepsy.

**2. Psychological effects of being epileptic** 
