Overcoming Epilepsy

Dr. S.K. Gupta
Today is the World Epilepsy Day and there are some facts which are to be known regarding epilepsy. Epilepsy is a treatable disease and not caused by Evil Spirits or Super natural factors which is still believed in the rural areas. It is the second most common neurological disorder but is poorly understood even today Historically, epilepsy has received little public health attention despite poor health outcome and potentially devastating social consequences from untreated disease.
It affects more than 5/1000 people and there are approximately 50 million persons with epilepsy worldwide and 80% of them are in developing countries.
In India the incidence of epilepsy is 0.5 to 1.7% in the general population and there are approximately 10-15 million epileptics in our country. Epilepsy can occur in any age group but it is more common in children and young adults.
Epilepsy is not a disease but a sign or symptom of underlying neurological disorder. Epilepsy means the tendency to have “seizures” Epilepsy is the oldest known brain disorder. On the other hand seizures are short episode of symptoms caused by a burst of abnormal electrical activity in the brain. When the electrical activity involves a small area of brain it produces minor seizure (Partial) and if large area is involved a major seizure results (Generalized). Typically a seizure lasts from a few seconds to a few minutes.
CAUSES OF EPILEPSY.
There is no single cause of Epilepsy. Many factors can injure the nerve cell in the brain.
The following are some of the most frequently identifiable causes:-
* Head injury that causes damage to the brain tissue.
* Trauma at birth, or high fever.
* Certain drugs or toxic substances when administered in large, doses.
* Interruption of blood flow to the brain caused by stroke or certain cardiovascular problems.
* Diseases which alter the balance of blood or its chemical structure, or diseases that damage the nerve cells in the brain.
* Infections, Viral, N.C.C, Tuberculosis, Bacterial etc.
However in some cases Epilepsy could also be due to some unidentified disorders and in 75% of cases there is no known cause & this is known as idiopathic epilepsy.
There are certain factors which trigger seizures like lack of sleep, high fever, loud noise, stressful conditions, increased excitement, flashing lights, drug withdrawal etc.
SOME MISCONCEPTION ABOUT EPILEPSY
The failures in understanding and treating properly epilepsy, has resulted in resistant chronic seizures, which is due to socio-economic problems and prejudices, since majority of people in our country wants to hide the disease.
Some DO’s about Epilepsy which general public should understand.
* Have normal interaction with family and friends and keep self confidence and be optimistic.
* Never hide the disease.
* Always consult nearest primary care physician and if he feels then consult Neurologist.
* Avoid stressful conditions.
* Take drugs regularly.
* Have proper sleep and good diet and a healthy life style may assist in the maintenance of optimum seizure control.
* See your doctor regularly.
* Keep stock of medicines and don’t change brand of drugs if seizures are controlled.
DON’TS
Do not jump to conclusions regarding your epilepsy. Discuss your doubts with your doctor.
* Do not withdraw socially or become isolated.
* Do not indulge in alcohol or drug abuse.
* Do not let epilepsy stand in your way of achieving your goals in life.
* Do not stop medicines of your own.
* Do not hesitate to report any side effect or drug intolerance to your doctor.
* Avoid very bright light and loud noise.
* Do not discontinue or reduce drugs during some concurrent illness or pregnancy or otherwise. These are the common causes of uncontrolled epilepsy.
PRECAUTIONS.
Keep calm, you cannot stop a seizure once it has started. Let the seizure run its own course. Do not try to overpower the person.
* Ease the person to the floor and loosen clothing.
* Try to remove any hard, sharp, or hot objects that might injure the person. It may be necessary to place a cushion or soft item under their head.
* Turn the patient to one side to drain saliva from the mouth.
* Let the patient rest or sleep for sometime after the convulsion.
* In case of a child having seizure, contact his/her parents or guardian.
* If the person undergoes a series of convulsions, with each successive one occurring before he or she has fully recovered consciousness, or a single seizure lasting longer than 10 minutes, you should immediately consult a neurologist.
* Do not force or insert anything in the mouth of the patient.
* Do not restrain the convulsive movements while holding or protecting the patents from injury.
* Do not crowd around the patient, allow free air circulation.
* Do not offer anything to eat or drink till he/she is fully conscious.
REMEMBER:-    People with epilepsy can marry and women can produce children and breast feed their new borns under the guidance of the Neurologist and Gynaecologist.
With the advancement in the treatment,epilepsy can be treated easily in almost 80percent of the patients.With the discovery of new medicines for epilepsy it is very safe to use them even for a longer period.
Duration of treatment is for a period of three to five years. though some may get relief with in 6 months to one year & in some cases the treatment may last for a very long period. Most of patients requires a single medicine though some may require more than one medicine also.
There are about 20-30 percent people with a history of poorly controlled epilepsy despite multiple medications & this is known as uncontrolled or resistant seizures . These cases can be considered for Epilepsy surgery.
The management of a person with epilepsy just seizure control is not enough. To dispel the myths, misconception and stigma attached to epilepsy, and to integrate the people with epilepsy into society, patient education, public education is need of hour which is the message of today’s world epilepsy day.
To conclude epilepsy is a treatable disease and people should come forward for treatment and beware of quacks and never believe in evil spirits or supernatural powers.
(The author is a Neurologist)

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