Epilepsy

Causes

In majority of patients epilepsy does not have any cause. It may occur due to imbalance in in brain electrical activity. Some patients may have structural brain defect like stroke or brain tumor but in majority of patients there is no cause.

Symptoms

Patients develop seizures that can occur at any time of the day and even during sleep. During seizure, patient may fall on ground and sustain injury. Patient can have jerky movements of the body. Sometimes patients can utter a loud cry and pass urine or stool during seizure. Seizures are of different types. Sometimes patients may lose consciousness while others remain alert. Some patients may become blank for few seconds.

Recovery

Patients usually take medicines for or many years. 60 percent patients can discontinue medicines after couple of years while remaining patients need to take medicines indefinitely.

Diet

There are no specific dietary advices for epileptic patients. In general patients should not skip meals. Minority of patients need special diet like ketogenic diet as advised by treating doctor. Patients are advised not to take alcohol for any other substance of abuse.

General advice for all epileptic patients

  • Stick to medicine prescribed by physician. There should be no exceptions. Skipping medicine mean a breakthrough seizure.
  • Generally epilepsy is not life threatening. However skipping the medicine can take life of patient.
  • If patient of epilepsy develops fever then he or she should immediately take paracetamol or other fever medication and and see nearest doctor as soon as possible. Fever can result in fit in previously well controlled patient.
  • Lack of sleep can result in breakthrough seizures. Patients should have proper night time sleep of six to eight hours. Patients should avoid functions at night time like wedding events or other parties.
  • In female patients with epilepsy, breakthrough fits can occur during certain phases of their menstrual cycle. They need to discuss this with their treating doctor.
  • Pregnancy in epileptic patients needs special care. Epileptic patients should discuss this with their treating doctor.
  • Patients suffering from epilepsy should stay away from heights and they should not do swimming. They should not operate heavy machinery.
  • Driving needs extreme caution as it can put the the life of patient and others at risk. Patients who are well controlled on drugs and are fit free since last 2 years can drive private vehicles. Under no circumstances, epileptic patients should drive public transport vehicles.
  • Epileptic patient can live normal life and professional career. It is disease, not stigma.
  • Epilepsy is a disease. It is not an evil eye or some supernatural phenomena. It is treatable disease and patients can live successful life.

Frequently Asked Questions

If epileptic patients gets pregnant, does she need to take drugs regularly?

Yes of course. It is extremely important for pregnant epileptic female to take anti-epileptic drugs during the pregnancy.  She should also continue the drugs after delivery. Non-compliance with doctors’ advice can put the life of patient and fetus at risk. It is advisable that female patients who are planning their marriage or baby, should see the treating doctor couple of months in advance.

Can epileptic patients breastfeed their infants? Is there any risk of passing drugs via breastfeeding?

Yes it is 100% safe to breastfeed infants if the mother is taking antiepileptic drugs. There are no risks to the babies. Only a very small amount of drugs pass on in breast milk and it is not dangerous to baby.

What kind of precautions should an epileptic mother observe regarding her newborn?

First of all epileptic mothers should take their medicines faithfully. They should not bath the baby alone. Also the baby needs to be changed on floor. Breastfeeding is encouraged as always.

What if epileptic patient gets sore throat or some other medical problem?

Epileptic patients who develop other medical conditions like sore throat etc. should see qualified medical practitioner. It is because antiepileptic drugs have number of serious interactions with other drugs that are commonly used. Some drugs can lower the levels of antiepileptic drugs while other drugs can raise their levels and vice versa.

What to do when the patient is having fit or seizure?

First of all you should remain calm. Turn the patient to the left side if possible. You should remove any sharp item near patient like knife etc. Preferably patient should be put on the floor to prevent any fall. Please do not try to hold the patient or restraint his jerking movements. Do not try to put anything in his mouth. Do not try to give him water as it may go in his lungs and can cause death.

Should I take the patient to hospital after every fit or seizure?

Usually the fit lasts less than a minute and afterwards the patient falls asleep or is drowsy. You only need to take the patient to the hospital if the fit lasts more than 5 minutes or if the patient has repeated fits. In this case you may call 1122 and take the patients to hospital immediately.

Is epilepsy treatable disease?

Epilepsy is cured in 60% patients with appropriate drug treatment and they remain fit free off medications afterwards. Remaining patients have to take treatment for longer period of time.

What kind of professions epileptic patients should choose?

Epileptic patients can work in all professions with exception of few. They should avoid field work, jobs that require them to stay on heights or depths. They should not be doing night shifts. Also they should not operate heavy machinery. They should also avoid driving heavy, public and transport vehicles.

Can epilepsy patients marry?

Definitely epileptic patients can marry and can have children. They can have successful life like others.

After marriage, is there any risk of passing epilepsy to children?

There is a small chance that children of epileptic patients may inherit epilepsy. Majority of children do not inherit epilepsy.

Is there any specific diet that epileptic patient should take?

No there are no diet restrictions for epileptic patients. However they should not indulge in alcohol. Minority of patients are advised ketogenic diet by the treating doctor.

Can epileptic patient drive?

Patients who are well controlled on drugs and are fit free since last 2 years can drive private vehicles. Under no circumstances, epileptic patients should be allowed to drive public transport vehicles even if their fits are very well controlled.

What are the conditions that can provoke seizures in in well controlled epileptic patient?

Fever can increase the the chances of seizures even in patients who are taking antiepileptic drugs regularly. So fever should be treated as soon as it appears. Also staying up late at night it and inadequate sleep can bring seizures. Anxiety and depression can also provokes seizures. Some female patients, can have seizures in certain phases of their menstrual cycle; they need to discuss it with the their doctor. Alcohol can also provoke seizures.

Disclaimer:
The information given here is intended for use of general public . It should not be taken as standard medical reference.

About the Author:

One of the most well known neurologists in Lahore, he is serving as Assistant Professor of Neurology at Lahore General Hospital. He is a graduate of King Edward Medical College and did residency in general medicine & neurology at Mayo Hospital Lahore. He did FCPS in neurology and moved to Lahore General Hospital, and has been working there since.

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