Wednesday, November 17, 2021

National Epilepsy Day: All you want to know about managing epilepsy

National Epilepsy Day: Epilepsy is a neurological disorder in which brain activity becomes abnormal and leads to seizures. If you notice anyone who suddenly feels disoriented, lose focus for a few minutes and then feel tired post that, it could be an epileptic attack and urgent medical attention is needed for that person.

While 50 million people worldwide are affected by epilepsy, India accounts for nearly 10-20 percent (5-10 million) of the global burden of epilepsy.

On the occasion of National Epilepsy Day (November 17), Dr Rima Chaudhari, Consultant-Neurology, Fortis Hospital, Mulund, shares facts about this noncommunicable disease of the brain and ways to manage it.

"In an epileptic condition, the abnormal and excessive electrical activity of the brain causes seizures, unusual behavior, sensations, and sometimes loss of awareness. Some people simply stare blankly for a few seconds during a seizure, while some get repeated twitching of arms or legs. Having a single seizure doesn't necessarily mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis, says Dr Chaudhari.

During a seizure, awareness and responsiveness are impaired and people who have them usually don't realize what's happening to them. There is no warning before a seizure, and the person is completely alert immediately afterward, according to Dr Chaudhari.

A common condition in children

Epilepsy is commonly diagnosed in children and can be confused with other conditions. An accurate diagnosis is essential. Seizures usually respond well to medication and most children with epilepsy will enjoy a normal and active childhood.

"Get proper sleep, avoid triggers and take medicines on time to avoid seizures. The impact of epilepsy will vary for every person. Remember to keep a balance between protecting your loved one and encouraging their independence," says Dr Chaudhari.

Difference between focal and generalized seizures

Epileptic seizures can be either be focal or generalized depending on where the abormal brain activity begins. When the seizure occurs only in one area of your brain, it is called focal seizure. Focal seizures without loss of consciousness may alter emotions or sensations transiently, lead to involuntary jerking or tingling in a body part, dizziness, or flashing lights. In another type of focal seizures there is impaired awareness and the affected person may stare into space or not respond normally or perform repetitive movements such as hand rubbing, chewing, swallowing, or walking in circles

Generalized seizures on the other hand involve all areas of the brain.

* Absence seizures are characterized by transient staring into space or subtle body movements such as eye blinking or lip-smacking while tonic seizures cause stiffening of muscles and may cause fall to the ground

* Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause a fall.

* Clonic seizures are associated with repeated or rhythmic, jerking muscle movements of the neck, face, and arms.

* Myoclonic seizures usually appear as sudden brief jerks or twitches of arms and legs.

* Tonic-Clonic seizures are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening, shaking, and sometimes loss of bladder control or biting of the tongue

Epilepsy management: Things to remember

* Epilepsy is a controllable condition

* Epilepsy is not a mental illness

* If you witness an attack, note the details as an accurate description prevents the wrong diagnosis.

* Early treatment is key

* The drugs prescribed have to be taken regularly. Do not miss any dose.

* The duration of treatment generally is 2 to 5 years after the last attack

* Restrictions for a person with epilepsy are very few. Make sure to sleep adequately. Patients can study, work and enjoy life

* Women with epilepsy can marry and bear children

* Treat epilepsy as you would treat asthma, headaches. Do not overprotect nor ostracise.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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Friday, July 12, 2019

What all one needs to know about Epileptic seizure

According to a recent study, this is the most common neurological emergency in children and seizures are potentially fatal. In fact, up to 5 percent of affected children succumb to it and a third suffer brain damage. The longer the seizure, the greater the chance of long-term complications.
Epilepsy is a neurological disorder where abnormal brain activity induces unprovoked seizures. It can affect anyone regardless of sex, race, age and cultural background. Though uncommon, this condition can sometimes cause fatal epileptic seizures.

Medications can control the seizures to a certain extent. However, surgical intervention may be needed in some cases. Most people, however, have to be on medication throughout their lives to control seizures but, for others, it becomes infrequent and then stops completely as they age. One peculiarity about this disease is that it is more common in young children and the older generation.

WHAT CAN AN EPILEPTIC SEIZURE DO?

It can cause temporary confusion, uncontrollable jerking movements of the arms and legs, loss of consciousness or awareness and psychic symptoms like fear, anxiety or déjà vu. It can also make a person stare at the same spot for the duration of seizure. Though symptoms vary from person to person, it usually remains the same for each person.

WHEN DOES AN EPILEPTIC SEIZURE BECOME FATAL?

Epileptic seizures are usually not fatal and only 1 in 1000 patients die because of it, suggests some estimate. However, sometimes, it can cause death. Let us look at a few conditions that can cause fatal epileptic seizures.

Lafora disease

According to researchers  Lafora disease, an inherited form of epilepsy that results in death by the age of 30, can be caused by mutations in a gene that regulates the concentration of the protein laforin.  In Lafora disease, a person has normal development for the first decade of life, followed by an initial seizure in the second decade. These seizures become progressively worse and eventually it causes early dementia and death within 10 years of onset. Medications can help contain the initial symptoms, but there is no long-term treatment or cure yet.

Status epilepticus

This condition increases the risk of permanent brain damage and death.Usually, a seizure will stop by itself. But, at times, you may experience a long seizure or a series of seizures without recovering in between. If this carries on for 5 minutes or more, it is called status epilepticus.

What you can do: If this happens in a tonic-clonic seizure where people fall down and shake, you need to get medical help immediately. If a convulsive seizure carries on for more than 30 minutes,it can cause brain damage and even death. Call an ambulance if the patient has trouble breathing after the seizure or if one seizure immediately follows another with no recovery in between. You also need to act fast if the seizure lasts two minutes longer than usual for that person and if the seizure lasts for five minutes or more.

Sudden unexpected death in epilepsy (SUDEP)

This is rare, but the risk is there. Only about 1 per cent or 1 in 1000 epilepsy patients die of SUDEP. Death usually occurs suddenly when the patient is sleeping, either during or after a seizure and the cause is often inconclusive. Most experts are of the view that this could be due to heart or respiratory health.The risk is greater in patients who have frequent tonic-clonic seizures or those whose seizures are not controlled by medications. This is more common in people with poorly controlled epilepsy and is rarely seen in children.

Though the exact cause of SUDEP is not known, experts suspect that it could be due to pauses in breathing during a seizure, which can cause death if they go on too long. A convulsive seizure may also result in an obstructed airway, which leads to suffocation. Though it is rare, a seizure may sometimes induce a cardiac arrest and this can result in sudden death.

What you can do: SUDEP is related to seizures. To reduce the risk of death, it is important to control seizures and especially tonic-clonic seizures. You can also reduce the risk of SUDEP by listening to your doctor and taking the prescribed anti-epileptic drug on time. Also, if there is any change in medication, see that it is gradual. Talk to your doctor about controlling seizures at night and use a seizure alarm if you have to. Keep yourself healthy.

A few other complications

Having a seizure at an inconvenient time can be dangerous to yourself as well as others. This is especially true if you drive. If you have a seizure in the middle of traffic, you may cause an accident and injure yourself and others. Such accidents, at times, can be fatal. In fact, many countries have very strict rules regarding issuance of driver’s license to a patient of epilepsy. You may also hurt yourself seriously if you suffer a fall during a seizure. Drowning is also a real possibility if you suffer one while swimming or even in a bathtub.

People with epilepsy can also die from problems that can happen during or after a seizure. One can inhale vomit, and this can be fatal. If you see anybody having a seizure, turn them onto one side immediately. This will allow saliva, vomit or other fluids to drain out of the mouth and not enter the lungs.

WHEN SHOULD YOU CONTACT A DOCTOR?

Consult a doctor immediately if you experience or see somebody experiencing the following symptoms:
  • An  epileptic seizure that continues for 5 minutes or more.
  • Breathing becomes slow and consciousness doesn’t return even after seizure stops.
  • Recurrent seizures with no recovery time in between.
  • Temperature is high.
  • There is any injury due to seizures.
  • A pregnant or diabetic person undergoing seizure          
     
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