The UCI Department of Informatics organized a virtual research seminar entitled “Was it a crisis? Diagnosis in Lived Experience and Medical Practice” in January. The seminar, which was presented by the President’s Postdoctoral Fellow Dr Megh Marathefocused on the importance of individualized health care for people with epilepsy.
Symptoms of seizures are generally thought of as times when a person falls to the ground, convulses, and loses consciousness. While this can sometimes be true, seizures can manifest in different ways depending on the person. According to Marathe, seizures do not necessarily correlate with these behaviors and can often go undiagnosed for a long time.
“Epilepsy disrupts our notions of normal and abnormal because it’s one of the few conditions where a person seems perfectly normal for the most part, except for short seizures,” Marathe said.
Marathe defined epilepsy as “a disability and chronic disease classified by recurrent and unpredictable seizures”. They also pointed out that epilepsy is an incurable disease and that 30-40% of epileptic patients continue to have seizures despite medical treatment.
During the seminar, Marathe discussed the partnership between physicians and patients to use a “rapid approach” when classifying epileptic and non-epileptic events. The expeditious approach is defined as choosing a treatment course that puts the patient’s personal interests and health first. This approach attempts to best maintain a patient’s independence, social relationships, and career, all of which could be disrupted by a diagnosis of epilepsy or disruptive side effects caused by various medications.
The distinction between seizure and non-seizure events made between patients and their physicians can have serious effects on all aspects of a patient’s life, including well-being, health care, source of income and independence. For example, the Department of Motor Vehicles (DMV) may revoke or suspend the driver’s license of a person with epilepsy if they believe it is causing a security risk. Additionally, frequent outbursts can lead to impractical career changes or the inability to hold specific jobs for a long time, depending on the employer and the nature of the job.
Because one patient’s seizure symptoms can be very different from another’s, the quick approach focuses on the individual and environmental factors that contribute to seizure classification. Marathe said independent factors must be considered when considering the individual’s age, comorbidities and medications because seizures manifest differently in different people.
One of Marathe’s main goals in his research on seizure classification is “to prevent difference from turning into discrimination.”
People with epilepsy have a history of abuse, including involuntary isolation and sterilization. Additionally, there have been a number of laws that deny people with epilepsy the right to marry or mark a diagnosis of epilepsy as grounds for annulling a marriage. marriage.
Marathe thinks it is important to distinguish between ‘usual’ and ‘unusual’ epileptic seizures instead of ‘normal’ and ‘abnormal’.
“The very act of calling an event, process, or person normal or abnormal creates the broader categories of normal and abnormal entities and [leads] to the division between [the two groups]“, said Marathe.
According to Marathe, the classification of seizure events should depend on individual aspects of the patient, including age, mobility, medications and environment. Therefore, Marathe research focuses on creating a computational intervention that uses the opportune approach and revises its interpretation as new information is acquired. Ideally, an algorithm would be able to individually classify the severity of epileptic events, similar to how doctors revise their interpretations based on multiple aspects of a patient’s life.
An essential diagnostic test for epilepsy is electroencephalography, more commonly known as EEG. According to Epilepsy Foundationan EEG scan is administered by placing electrodes on a patient’s scalp where electrical activity in the brain is interpreted as normal or abnormal seizure activity.
When reviewing EEG scans, a physician can take the quick approach and determine if a particular case is considered a seizure based on the best interests of the patient, such as reducing possible seizure events to avoid pathways aggressive treatment.
The number of seizures that occur during the EEG examination often determines the level of care provided to a patient – more frequent seizures provide a more intense pathway to treatment. Marathe said some drugs used to treat epilepsy can cause side effects that are more detrimental to a patient’s health than if they avoided the drug altogether.
Another of Marathe’s main goals in their research is to promote the inclusion of people with epilepsy within marginalized groups, such as women, BIPOC and the LGBTQ+ community. This research axis is working on a computerized seizure detection system that would implement a rapid approach when interpreting EEG scans and recommending treatment.
Shakira Noriega is a STEM Contributing Writer for the Winter 2022 term. She can be reached at [email protected].