Hesperian Health Guides
Chapter 9: Preventing violence can prevent epilepsy and seizures
HealthWiki > Epilepsy and Seizures > Chapter 9: Preventing violence can prevent epilepsy and seizures
Contents
Links between violence and epilepsy
Injuries that harm the brain are some of the most common causes of epilepsy. Head injuries may be caused by falls, vehicle crashes, dangerous work, playing sports, or the effects of alcohol or other drugs.
Head injuries can also result from physical violence, including the use of weapons and the destruction in conflict zones, criminal assault, and police violence. At home, violence from a partner or family member may cause serious head injury. Severe head injuries can cause brain damage that may lead to seizures and epilepsy.
Other forms of violence that can cause epilepsy and seizures may be less easy to see. The way societies and communities are set up affects how and where we live, what educational opportunities and jobs are available to us, and how we are treated by government programs and institutions. When harm, threats, and unfair limits on our choices or opportunities are caused by an economy, social system, or government, this is structural violence. Structural violence results from systems of racism, sexism, class division, and homophobia. These unfair systems affect everyoneâs ability to enjoy life and have equal access to opportunity, and they harm some people more than others.
Structural violence can lead to epilepsy and seizures. For example, poverty may force a woman to marry at a young age and prevent her from being able to access help during a difficult birth. If her labor goes on for too long, the baby may not get enough oxygen or their head may repeatedly push against the motherâs pelvic bones.
These situations can injure the babyâs head and brain and cause epilepsy. Another example is when poverty prevents a family from treating their childâs malaria or meningitis. If a child does not receive treatment for these illnesses or if treatment is delayed, the child can have seizures that might develop into epilepsy.
But when girls are allowed more access to education, they often wait until they are older to marry or bear children. And when healthcare is made available to all who need it, people will not be prevented from getting treatment.
Who is most at risk for violence?
Physical and structural violence can affect anyone, but they cause more harm to people who have less power over their lives. To prevent people from being harmed in ways that can cause epilepsy and seizures, it is helpful to ask: Who is more likely to be injured by physical violence? Who is more likely to be involved in accidents? Who is more likely to be harmed by structural violence and discrimination?
People living in poverty. Poverty is structural violence. Substandard housing, unsafe transportation, dangerous jobs, poor nutrition, unaffordable health care, and lack of clean water may seem different than physical violence, but they cause physical harm just the same. For example, poor living conditions can lead to having tapeworms, which can cause brain infections and seizures (see Chapter 3). And when poverty causes health problems, it often also denies treatment.
Women. Women are more likely than men to be physically injured by intimate partners, including by sexual violence, and to be discriminated against in jobs and educational opportunities. When a woman is beaten during pregnancy, injuries to her or the baby can cause epilepsy.
Children. Poverty, debt, or the loss of parents may force children to leave school and work, often in unsafe environments and for lower wages. Physical and emotional abuse of children is often considered acceptable, putting children at risk of violence from family members and others. Because their bodies are smaller and less developed, children have a limited ability to defend themselves and get help when needed.
LGBTQ communities. People whose gender identity or intimate relationships are not socially accepted are often targets of hate violence and police violence. LGBTQ people often face discrimination in health care and other areas of community life. Sadly, they are sometimes even rejected by their own families. In some countries, same-sex relationships are against the law, and employment and housing discrimination against LGBTQ people is common.
Migrants, immigrants, and refugees. Often forced by poverty and political violence to leave their homes or countries, migrants may be threatened with deportation or removal, forced to survive by working in dangerous and low-paying jobs, and crowded into unhealthy living spaces, often without access to health care, social supports, or personal safety.
People in prisons. In many prisons, people are locked in cages and controlled with violence. They are harmed by overcrowding, poor nutrition, lack of exercise, and poor health care. People in prisons who have epilepsy are regularly denied antiseizure medicines, which can lead to more frequent and worsening seizures.
Activity
Structural violence in your community
This activity helps show that people with less power over their lives may be more vulnerable to violence. It works best with at least 5 or more people. To prepare: Make 2 listsâone with words or characteristics that describe a person with more or less power (see below), and one that describes challenging things that may happen in a community. (see next page). Add or delete from the lists so they reflect your community.
Adult
Rich
Light skin
Boss
Majority
ethnicity
Citizen
Dominant religion
High caste
No disability
Heterosexual
Child
Poor
Dark skin
Worker
Minority
ethnicity
field worker
Other religion
Low caste
With disability
LGBTQ
- Ask each participant to choose 5 characteristics from the list and write them on a sheet of paper. Some of their choices will overlap but try to make sure that all the characteristics show up at least once among the choices made by the group.
- After they choose characteristics, ask each participant to make up a person they will ârole playâ with the characteristics they have chosen. Have them give a name to the person they make up and invent a few other details. One by one, have each participant introduce themself to the group.
- Then ask the participants to line up side by side, holding the paper that shows their characteristics. Tell them that you will say out loud things that may happen in the community. If they think their character or their characterâs family would be affected by it, they should take a step forward. If not, they stay where they are. If they are not sure, they should say so and the group can discuss and decide.
- Read the âthings that may happenâ (examples below) out loud one at a time. Remind people to take a step forward if they think their character would be harmed in the situation
 - School fees doubled for each child - Principal decides schools will not accept or teach students with disabilities - Local health clinic closes so nearest is now 10km/6 miles away - Armed conflict breaks out; people must show identity papers to get a job, rent a house, get health care, etc. - Politicians blame immigrants for crime - Religious leaders say women should stay home and care for children - Bus fares and fuel costs increase |
 - Agricultural chemicals pollute river where people get water - Unemployment increases; men drink in the street - Abortion is made illegal - Groups protecting rights of women, minorities, LGBTQ people are shut down - Police violence increases - Sales tax/VAT increases - Partner drinks, is abusive, but you feel you cannot leave - Boss demands sexual favors - Factory explosion injures many workers |
- Reflection: Ask these and other questions for group discussion:
- Which of our characters have moved a lot or been harmed the most?
- What characteristics do they share?
- What does this say about how inequality affects our society?
- Which of the harmful situations might cause or worsen a personâs epilepsy and seizures?
- Conclusion: Lead a group discussion on the kinds of actions that might reduce or prevent physical and structural violence in your community, especially as they relate to conditions that can cause seizures. Emphasize the importance of people working together to help each other deal with the challenges they face.
affordable bus fares
less dangerous roads
safe drinking water
Harriet Tubman
Slavery is one of the most violent institutions imaginable. An enslaved person has had almost all control over the conditions of their life taken away from them.
Harriet Tubman, one of the great heroes of the United States, was born into slavery in 1820. When she was 12 years old, a white overseer attacked an escaping slave with a large iron weight. He missed his target but hit Harriet in the head, nearly killing her. As a slave, she got no medical treatment for her injury, but her mother nursed her back to life.
The violent blow to her head injured her brain and caused her lifelong pain, including headaches and seizures. Because people did not understand much about epilepsy 200 years ago, and any testing and treatment that did exist was denied to people in slavery, we cannot know for sure if Harriet Tubman developed epilepsy. But what Harriet describes in her biographyâher brain shutting down in the middle of an activityâappears to be epilepsy, likely absence seizures.
After escaping slavery, Harriet returned to slave areas at least 13 times to lead over 70 people to freedom on the âUnderground Railroad.â During the US Civil War, fought between people wanting slavery to continue and people wanting to end it, Harriet commanded troops fighting slavery and directed a spy network to attack large plantations and free hundreds of slaves. Newspapers praised her patriotism, wisdom, energy, and ability, and called her âGeneral Tubman.â This well-deserved praise was unheard of in that era for an enslaved person, for an African-American, for a woman, or for a person with epilepsy, much less for someone with all 4 characteristics.
Seizures from stress and trauma
Violence in any form can lead not only to physical injuries but also to stress, anxiety, and trauma. In some people, especially those who have been affected by war, rape, and childhood abuse, these psychological injuries can trigger seizures.
Seizures with psychological causesâoften referred to as âpsychogenic nonepileptic seizuresâ (PNES) or âconversion disorderââare frequently mistaken for epilepsy. However, unlike seizures from epilepsy, which are caused by abnormal electrical activity in the brain, these seizures are a response to psychological distress. Because they are not due to a physical brain condition, psychologically-caused seizures do not respond to antiseizure medications. Instead, they are managed as a mental health issue. To learn how to recognize and treat these types of seizures, see Chapter 3.
Seizures from psychological causes can be prevented in the same way that structural violence can be preventedâby improving living conditions, replacing stigma with acceptance, and making services and opportunities available to all.