Health Committee on Feb. 16th, 2012

[Voices]

Oh, oh!

[Geoff Regan, Liberal, Halifax West, NS]

It's like an auction.

[Sarah Ward]

Seizures are a result of aberrant electrical activity in the brain, and often it arises from a seizure focus. If it's a very small focus, it can stay localized, and you can actually have a seizure—this is also something I didn't know—in only one part of your body. If it's just a small focus in your brain and it doesn't spread, your arm could shake and you might not even be aware.

My supervisors told me stories about a guy who had his arm shake for weeks, and he didn't know why. He was actually having a seizure--for weeks.

It can stay localized, and if it does, that's when surgery is an option. If you can locate that focus, you can remove it and prevent the aberrant electrical activity from starting. However, it's more often the case that it will spread, or the focus isn't localized and is everywhere, it will involve your whole brain, in which case it would be a generalized seizure.

[Geoff Regan, Liberal, Halifax West, NS]

What do you remove?

[Sarah Ward]

That's a good question. I'm not sure. I know that temporal lobe epilepsy is very common, but I'm not sure what the most common part is that's actually removed.

[The Chair, Conservative, Joy Smith]

Thank you very much for that.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Madam Chair, brain surgery is only recommended when drug therapy fails.

[The Chair, Conservative, Joy Smith]

Dr. Fry, this committee is getting out of hand. You have to just wait your turn.

Ms. Quach, you go ahead.

[Hedy Fry, Liberal, Vancouver Centre, BC]

As well, it's only when brain tissue can be removed safely. I just wanted to answer the question. You don't want to go into a part of a brain where removing tissue is going to affect the person's ability later on.

[The Chair, Conservative, Joy Smith]

Well, this is a most interesting committee today. I don't think I've ever had this happen before, but it's very useful.

Thank you, Dr. Fry.

Ms. Quach, I'm going to give you another minute because I think you were robbed by Dr. Fry.

[Voices]

Oh, oh!

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

Thank you, Madam Chair.

Let's go back to the attitudes that we have to change. What are the main attitudes that have to be changed when people see someone having a seizure? What is the worst attitude, the most harmful reaction?

[Aurore Therrien]

I think the best reaction is similar to the one I recently saw from a bus. I saw a young man fall to his knees outside a metro station. A lady came up, knelt down with him and stayed with him. I feel that was the best possible reaction. It's the same thing at work. Sometimes, a person doesn't feel comfortable talking about it to all his co-workers, but he can confide in one person with whom he has a special relationship and talk to them about it. Then, if a seizure occurs, that person is going to be able to be there for him.

In terms of the general public, I think that education is the best thing. I was not expecting to take about that this morning, but it is a very good thing. There is no better place to talk about it than at the Standing Committee on Health. If we can talk to the government about it, and to the media—the people listening to us at the moment—that's significant. Everyone wants to learn and we are continuing to develop good attitudes of compassion, understanding and caring.

So the worst reaction is the one from well-intentioned people that I once saw on another bus. One person had a seizure and everyone wanted to help. Everyone was giving advice on what should be done and that's not always the best thing. Some people were handing the person a bottle of water, and so on. You could see that there was a lot of compassion on the part of the people who wanted to help, but it was not always in the best way. So the most harmful reaction is to jump in and crowd around the person. When the person having the seizure comes to, it can cause them to panic.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Therrien.

Now we'll go to Mr. Gill.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you, Madam Chair.

I don't have any pressing questions, but I do want to thank Mr. Regan and all the witnesses for being here and providing us with very valuable information, and Mr. Regan for taking up this wonderful cause. I really appreciate your efforts.

I will pass the rest of my time to Mrs. Block.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you very much, Mr. Gill.

Thank you, Madam Chair.

I would like to thank our witnesses for being here this morning and my colleague for bringing this very important issue forward through the opportunity that you've had with the private member's bill. I had the privilege of being a junior youth sponsor at my church, and we did have a young lady who had epilepsy. She's grown into a beautiful young woman with two children. She had those pregnancies managed, obviously, with some medication to ensure that those babies were carried safely to term, and as I said, she has a beautiful young family now.

I don't have very many questions, but one of the questions I would have is this: during a person's lifetime with epilepsy, are there periods of time when these seizures happen more often? Is there a time when they maybe subside? What is the impact for elderly people? As well, does epilepsy have an impact on a person's lifespan?

[The Chair, Conservative, Joy Smith]

Go ahead, Ms. Therrien.

[Aurore Therrien]

As I mentioned earlier, epilepsy can occur at any time of life. Though we see it in elementary school children, we also see it in the elderly. I got that information from a neurologist. It is also quite common in the elderly because of different problems. However, it can happen at any age. Unfortunately I do not have exact percentages. But you see it most in elementary school children.

Epilepsy is an entire spectrum of disorders. There are benign epilepsies, like Rolandic epilepsy, that will completely disappear at puberty. These days, a first seizure is not even treated. Seizures must be recurrent before we talk about epilepsy. The acute syndromes on the other end of the spectrum will appear very early in infancy and will be extremely disruptive. Those epilepsies are difficult to treat and can cause the child a great deal of distress.

[The Chair, Conservative, Joy Smith]

The last question Ms. Block asked was about lifespan. Do you know if it affects lifespan in any way? I think, Ms. Block, that was the last question you asked.

[Aurore Therrien]

Right.

There is what is called sudden unexplained death in epilepsy. Because of the losses of life, I think, we have started to talk about it in recent years. It can occur with males and females from a young age to early adulthood. We are hearing about it more and more. It is not common, but it is important to say that, when it occurs, it can end the life of relatively young people, people who have young children themselves. It is important to study it in order to know what we can do to avoid it. Basically, it's a question of properly managing the seizures.

The other aspect to consider is medication. This is important. There have been deaths in the Montreal area. They were people who were not taking their medications properly, either because they had problems with their memory and forgot to take their medications, or because they had associated dependencies that neutralized the effect of the medications, or because they were not taking the medications regularly as directed by their doctor, or because they stopped taking them themselves. We often see that. People do that. Basically, they are hiding the difficulty they have in accepting their epilepsy. It can lead to seizures that do not stop and can lead to death. It is not common, but people have to be aware of it. So we really encourage people to take their medications properly, and, if they have problems, to not hesitate to speak to their physician.

[The Chair, Conservative, Joy Smith]

Thank you so much.

Dr. Morin is next.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you for your excellent bill, Mr. Regan.

I also thank Mr. Carrie very much for telling us what he went through at school.

Thanks also to Ms. Smith for telling us about your experience as a teacher when your students had seizures.

It all got me thinking about when I became familiar with epilepsy for the first time. I had never seen a case personally, but I remember that, 15 years ago, when I was young, I used to watch children's programs on television. Between the programs, there were awareness advertisements about epilepsy. One showed a schoolyard situation where a student had a seizure. We were shown what to do and what not to do. A young girl was in charge of the situation, she got lots of bad advice and replied that that was not what needed to be done.

But if more education is needed, the younger generation, people in their 20s like Anne and myself, are perhaps more aware of what must be done and what must not be done. So I think that the situation will get better. This bill will also help generations to come. As a society, I feel that we are getting better in this regard. That was my little story.

It has been said that epileptic seizures can be set off by an excess of visual stimuli, especially from light. Are there other triggers that we should know about, other risk factors that also cause seizures?

[Aurore Therrien]

Lack of sleep is a major factor. Of course, not following the treatment, not taking the medication properly is another. Stress is yet another factor. There are a number of factors, but lack of sleep is one of the most significant ones. Most people still do well. As organizations, we always recommend that they maintain the lifestyle they want and that they get to know themselves, so that they know what triggers their seizures. The bottom line is that they have to try to avoid all the factors that can cause a seizure.

In terms of the ads, the Canadian Epilepsy Alliance created them, and we are very happy about that. So we are going to continue down that road.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

The fact that I still remember them 15 years later shows it was a good approach and money well invested.

[The Chair, Conservative, Joy Smith]

That was very good.

Have you finished, Dr. Morin?

Thank you for your very good comments.

Go ahead, Dr. Sellah.