Epilepsy &

management

What is Epilepsy?

Disorder of the brain

characterized by

recurrent fits which occur

without provocation

May have loss of

consciousness, state of

confusion for few

seconds, muscle spasm

Above mentioned

symptoms do not

necessarily happen for all

What is a fit?

Abnormal electrical activity in brain

Sudden (abnormal) change in the physical behavior with Jerking of limbs

Muscular spasm

Froth coming out from mouth

Stare

Minor spells

Astonishing range of feelings and actions

Different types of seizures

Major type of fit: Readily recognizable

Falling unconscious

Shaking movements

Tightening of body

Minor type of fit: Not loosing conscious

Very brief interval of time

Recovers rapidly

Cause of Epilepsy

Problem in brain area due

to:

Head Injury

Infections

Birth injuries

Brain scan helps in

identifying the problem

In case of normal brain

scan, cause can be

chemical and electrical

imbalances in brain

Treatment

Several effective treatments are available

Medications Majority of patients

respond to it

May provide seizure freedom

Surgery Medications does not work

Risk benefit ratio is more for patient’s quality of life

Diet (ketogenic) Less evident, under studies

Difficult to follow

Duration of treatment

Till the time doctors does not tell you stop

Depends upon the type of epilepsy and patients factors

Generally 2-5 years of time period for becoming seizure free

Few patients may need to take it lifelong

Dietary restrictions to follow

Normal well balanced diet

Certain supplements may be required for

medicines used for treatment

Avoid alcohol completely

Avoid skip of meals, have regular meals

Over-indulgence and fasting should be

avoided

Precautions for patients

Comply to the prescribed medicines

Do not switch in brands without the intimation to your doctor

Avoid swimming, driving, cooking

Perform in supervision only if seizure free for last 6 months

Have confidence in your coworkers/ close relatives and caregivers & share about seizures situation

Consult a doctor in case of emergency

Carry your ID Card which should mention do’s and don’ts

Side effects of antiepileptic drugs

Now-a-days medicines are available that

are comparatively effective and well

tolerated

Few drugs can cause sleepiness when

introduce for first time or increased the

dose

Skin rashes, jaundice, low appetite should

be sought out immediately if observed

Epilepsy with other illness

While consulting the neurologist one should share all the possible illness and its treatment

Neuro-physician need to consider the treatment for other illness while prescribing treatment for epilepsy

This holds true for other way out as well

If oral medicines are not possible to take then hospitalization is indicated

Is epilepsy hereditary?

Very few patients may have

epilepsy due to heritable

cause

These types can easily be

controlled

Majority of people with

epilepsy can have normal

children

Marriage? Normal life?

Marriage is possible

Do not stop medicines after marriage

Epilepsy is just another condition

Try to share this condition with partner and

family of the partner

“Epilepsy can be controlled”

Pregnancy? Normal children?

Pregnancy is possible

Children can be normal

Few precautions need to take while pregnancy

Frequent monitoring of maternal and foetal

health

Early hospitalization, Labor & delivery need to

be supervised

Do not stop medicine or change medicine during

pregnancy until doctor advice to do so

Holiday travel

With the help of good medicines travel can be easier

Avoid stress

Have complete sleep/ rest

Have proper food (carry with you once sitting in plane/ train etc.)

Carry your personal details and details of epilepsy

Carry your doctors’ prescription

Carry appropriate medicines stock

Avoid going to hot places as epilepsy can be aggravated due to high temperature

Prevention of epilepsy

Simple measure are needed to take prevention

Wear helmet while driving

Eat healthy food, wash vegetables, fruits, salads well before cooking or eating

Wash hands before eating

Safe disposal of human waste

Good antenatal care can prevent birth injuries

THANK’S

Dr. Gourav Goyal

MD, DM (Neurology)

Fellowship in stroke & Neuro-intervention

Assistant Professor, Department of Neurology,

MGMCH JAIPUR