Epilepsie, tu nous fais peur!

Posté le 13/11/2013 | Auteur: L.M.

L’épilepsie est un sujet tabou en Afrique. Entre sorcellerie et malédiction, l’épilepsie porte souvent plusieurs facettes et la population atteinte est le plus souvent exclue. Comment lutter contre ce phénomène en Afrique?

Epilepsie Afrique Epilepsie

L’épilepsie est un sujet tabou en Afrique. Il existe très peu d’études réalisées sur le sujet à l’échelle continentale alors qu’il touche bien plus de monde que les 3 à 4 millions de personnes dépistées. Entre sorcellerie et malédiction, l’épilepsie en Afrique porte souvent plusieurs facettes et la population atteinte est le plus souvent exclue.


Qu’est-ce que l’épilepsie?


De manière historique, la notion de crise d’épilepsie (peu importe ces appellations antérieures) est évoquée depuis l’antiquité et varie selon les populations. Ainsi certaines d’entre elles retiennent le côté surnaturel, chaque type de crise étant associé à un nom de dieu ou esprit, le plus souvent malfaisant et le traitement relevant du spirituel. Les malades suscitent ainsi la crainte, l’incompréhension, la suspicion et sont donc rejetés par la société.

 

Il faut attendre les XVIII-XIXème siècles pour que l’idée d’épilepsie comme dérèglement cérébral et nécessitant vivement un traitement commence à s’intégrer dans la société, ceci pouvant être complémentaire de l’instauration de la discipline de neurologie (qui faisait partie intégrante de la psychiatrie) dans le monde médical.

 

L’épilepsie se définit médicalement parlant par des décharges électriques neuronales brutales, anormales et asynchrones (imaginer un « court-circuit » d’un appareil électrique) et dont les signes varient selon la zone cérébrale concernée. Les symptômes pouvant évoluer du simple enraidissement à des convulsions brutales voire perte de connaissance, coma et décès.

 

Les causes ?

 

Les causes d’épilepsie sont nombreuses et parfois non identifiables dans le cas des épilepsies dites cryptogéniques qui représentent tout de même 60% des cas d’épilepsie. Ce qui est important, c’est de savoir qu’il existe des traitements qui permettent de soulager 70 à 80 % des patients traités. Encore faut-il qu’ils soient pris en charge à temps, c’est-à-dire avant que les séquelles soient définitives.


Parmi ces causes, on peut citer les infections telles le paludisme, la méningite et autres. Des causes vasculaires telles les AVC congénitales (i.e. dès la naissance, ndlr), le mode de vie tel que le manque de sommeil, la consommation abusive d’alcool, le stress et les émotions violentes. Les facteurs génétiques sont aussi évoqués.


L’épilepsie en Afrique

 

En Afrique, l’épilepsie a toujours fait peur. Elle est très souvent assimilée à la manifestation du mal ou à une malédiction. Il est commun d’observer dans certaines cultures des scènes de fuite ou d’exorcisme lors d’une crise. Les patients sont exclus de leur cercle familial, amical, perdent leur emploi et dans certaines situations sont rejetés même par le personnel médical très souvent mal informé sur cette maladie neurologique. Les plus courageux se rabattent sur des guérisseurs professionnels mais dans la majorité des cas ne sont pas traités. Parmi les nombreux exemples évocateurs de cette situation:

  • Au Congo, la crise épileptique est surnommée la « maladie de l’oiseau » du fait des convulsions.
  • Les hallucinations ou les yeux qui révulsent sont perçus comme des signes de présence démoniaque par les populations.
  • Au Cameroun, les épileptiques sont « possédés ». Ils ne sont pas eux-mêmes mis en cause ; ils sont simplement habités par le diable qui provoque ces convulsions de temps en temps.
  • Au Liberia et dans d’autres parties de l'Afrique, l'épilepsie est aussi associée à la sorcellerie ou à l'esprit du mal. La plupart des guérisseurs au Swaziland attribuent l'épilepsie à la sorcellerie : un ennemi envoie des esprits occuper le corps et provoquer des convulsions.

 

L’OMS considère que le principal frein du traitement en Afrique n’est pas principalement le coût du traitement mais surtout les superstitions qui entourent cette maladie. En 2012, elle dénombre 50millions de personnes souffrant d’épilepsie dans le monde dont 80% issus de pays en développement. Et en Afrique 80% des personnes atteintes d’épilepsie ne sont pas traitées. En cas de crise il est tout de même important de retenir quelques gestes :

  • Ne pas essayer d’arrêter les convulsions/ Ne pas donner à boire
  • Desserrer tout ce qui peut comprimer le larynx( cravate, col, …)
  • Ne pas essayer d’ouvrir la bouche pendant la crise
  • Ecarter tout objet qui pourrait blesser le patient
  • Appeler les secours/ penser toujours à consulter après la crise surtout si le patient n’est pas un épileptique connu et sous traitement

 

En conclusion, l’Epilepsie n’est pas une maladie contagieuse, elle peut même être traitée dans bien des cas. Ajoutons que les personnes atteintes d’épilepsie peuvent mener une vie normale si elles sont traitées. L’absence de traitement en Afrique est souvent le résultat d’une non-information voire d’une désinformation des populations. Cette maladie est considérée comme urgence médicale qui peut avoir des conséquences graves dont des séquelles au niveau du langage, de la mobilité, une démence, un coma voire décès. Et si les traitements sont assez accessibles dans les pays développés, on ne peut pas s’empêcher de mettre le doigt sur le fait qu’ils restent très coûteux pour les populations des pays en développement. De plus ils doivent être pris sur le long terme (2-5 ans), ce qui constitue un frein à la prise en charge médicale dans les pays en voie de développement. Une maladie qui s’ajoute donc à une longue liste de maladie sous traitée dont le paludisme, la méningite, les AVC, etc.


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