Specialised diagnosis and treatment of epilepsy at dedicated unit in Alberton
Drickus Maartens • February 24, 2020
Epilepsy monitoring unit aims to improve quality of life for people with epilepsy
Epilepsy, in its various forms, is believed to affect as many as 55 million people worldwide, and approximately one percent of South Africans. There are many different types of epilepsy, and in some cases this complex condition can be difficult to accurately diagnose.
A specialised epilepsy monitoring unit (EMU) established at Netcare Mulbarton Hospital in Alberton, not only assists patients with an accurate diagnosis but also in identifying the most appropriate treatment plan for managing their condition.
Dr Vanmala Naidoo, a neurologist who practises at the Netcare Mulbarton Hospital EMU, says: “Epilepsy is a complex set of conditions, and in some cases may be due to secondary causes such as meningitis or a head injury. Diagnosis is not always simple, as there are other conditions that may present similarly to certain types of epilepsy, or vice versa. Observation and assessment at the EMU provides important information that we use to make a diagnosis and treat the patient effectively.”
“While some epileptics experience convulsive, or grand mal seizures, characterised by the body stiffening accompanied by uncontrolled muscle jerking, other types of epilepsy may involve atonic seizures where the person briefly loses control of their muscles and collapses, or absence seizures where the person may be perceived to be ‘staring’ into the middle distance for up to 10 seconds. Certain types of seizures can be extremely subtle, and the person experiencing them may not necessarily even be aware of the seizure.”
A seizure is defined as a surge in the electrical impulses of the brain, causing a number of possible symptoms depending on which area of the brain is affected. Dr Naidoo points out that, contrary to common belief, seizures are not necessarily only attributable to epilepsy but may be attributable to other factors including stress and certain infections.
“In some cases people are unaware that they are having seizures, and may experience symptoms that they wouldn’t associate with epilepsy, such as chronic headaches or migraines, memory loss, sleep disturbances and fatigue,” she says.
She explains that some patients may initially be investigated for conditions including mood or behavioural disorders or certain kinds of cognitive impairment including dementia, when in fact they are living with undiagnosed – and therefore untreated and uncontrolled – epilepsy.
“Untreated or inadequately managed epilepsy not only impacts the person’s quality of life, in extreme cases it may be detrimental as it can lead to brain injury, disability and in rare cases may even be fatal. Sudden Unexpected Death in Epilepsy (SUDEP) is far less likely to occur in people who have been properly diagnosed and are professionally assisted to manage their condition through appropriate treatment.
“As seizures often occur at night while people are sleeping, this is an important time to monitor brain activity and physical responses in order to discover signs of epilepsy and to identify what type of seizures the patient may be experiencing and where in the brain the seizures originate.
“We make use of electroencephalogram [EEG] to monitor and record electrical impulses in the brain, and this information indicates where there are any abnormalities and, in the case of diagnosed epileptics for example, the EEG assists us in tailoring their treatment accordingly. EEG monitoring assists us to identify how often the person has seizures, even those types of seizures that might otherwise be difficult to notice,” Dr Naidoo notes.
The unit is operated by a team that includes three neurologists, neurophysiologists, a European-certified sleep therapist, technicians, trained nursing staff, as well as other healthcare practitioners.
“The multi-disciplinary expertise within our team means that we are able to assess individuals holistically and provide each of them with comprehensive and personalised treatment. Our specially trained nursing staff are experienced in the care of neurological patients and are kind and compassionate,” Dr Naidoo says.
The EMU at Netcare Mulbarton Hospital is equipped to comfortably accommodate patients, who typically spend 24 to 72 hours in the unit. Patients may bring laptops, books or craft materials to help them pass the time.
“Each patient is provided with detailed feedback after the monitoring, where we explain the findings from the EEG and our analysis of their sleep cycle. We discuss the proposed treatment plan to ensure there is no uncertainty, and then after a few weeks we follow-up with the patient to see how they are responding to the treatment.”
The general manager of Netcare Mulbarton Hospital, Nellie Koen, says that the EMU is proving an important addition to the healthcare services available at the hospital. “The epilepsy monitoring unit is helping to improve quality of life for many patients. In some cases, the individuals are able to get a definitive diagnosis for the first time, thanks to the expertise of the EMU team. We hope that with greater public awareness about epilepsy, more people in need will be assisted to safely manage their condition and improve their quality of life,” Koen concludes.
What to do if you see someone having a grand mal seizure
“There are a number of misperceptions about the neurological condition of epilepsy, some of which are potentially harmful. As we mark National Epilepsy Week, we wish to raise awareness about what to do if you witness someone having a convulsive seizure because well-meaning but misinformed seizure interventions may actually cause injury to the person having a seizure,” says neurologist Dr Vanmala Naidoo of the epilepsy monitoring unit at Netcare Mulbarton Hospital.
DO:
- Loosen constrictive clothing around the person’s throat
- Remove any sharp or hard objects including furniture near the person that might cause them injury
- Remove spectacles, if the person is wearing them
- Reassure any bystanders that may have gathered and who are upset by what they’re witnessing, and ask them to give the person space while you keep an eye on them
- Position the person so that they lie on their side in the recovery position if possible, so that any vomit or excess saliva can drain from their mouth
- Call an emergency medical services provider, such as Netcare 911 on 082 911, if the person having a seizure is pregnant
- Call an emergency medical services provider if the seizure lasts longer than three minutes
WHAT NOT TO DO:
- Do not panic
- Do not try to put your fingers or any object into the person’s mouth during the seizure
- Do not hold the person down or restrain them
ONCE THE SEIZURE IS OVER:
- Check that the person is breathing normally. At this stage you may need to clear any obstruction from the mouth with your finger, and put the person in the recovery position (i.e. laying the person on their side, with their mouth angled downwards so that any fluid or vomit will drain out of the mouth instead of blocking the airway).
- Allow the person to rest
- People are frequently confused or drowsy after a seizure or have a severe headache. Reassure them and stay with them until they are fully alert and recovered
- Do not offer them food or drink until they are fully alert
- Check the person has not sustained any injuries during the seizure

Colorectal cancer, one of the most prevalent yet preventable cancers, can develop in the colon or rectum, often starting as small polyps that can quietly become malignant if left unchecked. Dr Mpho Ramabulana, a colorectal surgeon and gastroenterologist at Netcare Akasia Hospital, underscores the life-saving power of vigilance and the importance of early detection.

The lives of millions of South Africans with a litany of rare diseases can be vastly improved, and even saved, by addressing challenges in identifying, studying and treating their conditions. With Rare Disease Day on the 28th of February 2025, the Rare Diseases Access Initiative (RDAI) is driving an evolution of the country’s healthcare, through innovative strategies to better care for over 4.2million people living with an estimated 7000 rare diseases. “As our healthcare system faces significant changes in the years ahead, it is vital that we also advocate for people living with rare diseases in South Africa, especially those with limited healthcare access,” said Kelly du Plessis, CEO of Rare Diseases South Africa (RDSA), a member of RDAI. “As part of our ongoing research and awareness efforts, RDAI has conducted an initial analysis of the incidence and prevalence of rare diseases within the country.” This research will assist in improving access to healthcare, policy development, and patient advocacy, while giving critical insight into the challenges faced by patients. “According to research, some rare diseases affect fewer than 1 in a million people, while others, such as Down syndrome, cystic fibrosis, and haemophilia, have a more recognisable prevalence,” says Dr. Helen Malherbe, RDAI lead researcher on rare disease prevalence data. “Many conditions are undetected, underdiagnosed or misdiagnosed, with too many having no information available about them at all.” The RDAI was formed in 2019 to promote a more favourable environment for those impacted by rare diseases in South Africa. Participants include Ampath, the Board of Healthcare Funders (BHF), Discovery Health, Genetic Counsellors South Africa (SASHG), the Government Employees Medical Scheme (GEMS), Health Funders Association (HFA), Medihelp, Medscheme, North-West University (NWU), Rare Diseases South Africa (RDSA), the South African Medical Association (SAMA) and The South African Medical Technology Industry Association (SAMED). The Council for Medical Schemes (CMS) participates as an observer. In the same year, Rare Disease International signed a memorandum of understanding with the World Health Organisation leading to an international rare disease policy framework. In 2021, the United Nations General Assembly moved to adopt a resolution recognising 300 million people living with rare diseases worldwide. “A general lack of awareness and delayed diagnosis remain major hurdles for those affected by rare diseases. Policymakers and healthcare stakeholders need to prioritise access to treatment, diagnosis, and support for rare disease patients,” says Bada Pharasi, CEO of IPASA, “Through this initiative, working collaboratively with stakeholders at every level of the healthcare supply chain, we can bring real and meaningful change to those affected, including family members and care givers, through smart and efficient strategies.” The globally agreed definition of a rare disease is any medical condition with a specific pattern of clinical signs, symptoms, and findings that affects fewer than or equal to 1 in 2000 persons in a population. “Most are genetic, and some are inherited and passed down in families,” Malherbe says. “Some affect only the patient’s genetic recipe, while others may be acquired during life due to infection, trauma, or environmental effects. For many, the cause is still unknown. “These conditions mainly affect children, as they are largely incurable and many are life-threatening. Some require specialised and co-ordinated care, some have limited and expensive treatment options, while others have no information or effective treatments at all,” she adds. The RDAI is calling for a patient-centred care model built on equitable access, transparency and efficiency. Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government. “The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.” The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring. Thoneshan Naidoo, Chief Executive Officer of the Health Funders Association noted that, “We appreciate the unique opportunity provided by RDAI which enables stakeholders across the industry to work together and identify strategies that improve equitable access to the appropriate diagnosis, treatment and healthcare services for rare disease patients, in an affordable and sustainable manner, taking account of the other pressing needs across the healthcare system.” “True innovation in healthcare is only possible through partnerships and joint advocacy efforts that raise awareness and improve access to treatment. Our long-term goal is the development of a rare diseases policy framework and guidelines for coordinated care,” says Pharasi. “Our members are united in the commitment to unlocking improved patient outcomes and improving access to services and robust health needs assessment facilities.” he concludes. About RDAI The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change. About RDSA Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life. Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa. About IPASA The Innovative Pharmaceutical Association South Africa (IPASA) is a voluntary trade association representing 24 leading pharmaceutical companies committed to research, development, and innovation. Our mission is to drive healthcare advancement by advocating for policies that improve patient access to safe, high-quality, and affordable medicines.