EPILEPSY
·
Epilepsy is a group of neurological diseases characterized by unpredictable
seizures and can cause other health problems.
Epileptic seizures are episodes that can vary from brief and nearly undetectable to long
periods of vigorous shaking.
·
Epilepsy is the fourth most common neurological disorder and affects people
of all ages.
·
Epilepsy means the same thing as "seizure disorders"
SEIZURE Vs EPILEPSY
A single epileptic attack is described as seizure.
The term epilepsy is coined when seizures are recurrent and long standing.
CAUSES
·
The cause of most cases of epilepsy is unknown.
·
Brain injury, Stroke, Brain tumor.
·
Birth trauma, Prolonged and difficult labor.
·
Meningitis, Encephalitis.
·
Cysticercosis.
·
Hereditary - a small percentage of cases.
DIAGNOSIS
A person is diagnosed with epilepsy if they have had at least two seizures occurring greater than 24 hours
apart that were not caused by some known and reversible medical
condition like alcohol withdrawal or extremely low blood sugar.
CLASSIFICATION
Based on manifestations,
1. Grand mal
2. Petit mal
3. Complex Partial
4. special verities like Reflex Epilepsy
The layman is aware of Grand mal seizure which is
characterized by generalized convulsive
movements with rolling up of eyes, heralded
by the epileptic cry along with falling and later frothing
from the mouth. This
lasts for 3-4 minutes during which the patient is unconscious. He may injure
himself during the episode and at times may bite his tongue.
Petit mal affects young children between 5-10 years and is noticed as brief spells of
unconsciousness
during which the child does not fall but may blink or stare
vacantly. He will not respond if he is
called by name at the time of the
episode. The whole episode may lasts less than a count of ten.
Many such episodes 25-100, can occur daily. It may be the teacher in the class who
notices this first,
through inattentiveness shown by the student.
Complex Partial Seizure as the name itself suggests has complex symptomatology. It may manifest
as
repetitive motor acts like opening and shutting the door, crushing of whatever
the person see by
hand, inappropriate uttering of meaningless words etc for
short periods during which he is unaware of the surroundings.
Unlike petit mal, this can occur during any age groups but the number of
attacks per day is one or two
only. The complex seizure may be followed by
grand mal seizure at times.
Reflex Epilepsy is a rare type precipitated by extraneous
stimuli like sunlight, some music etc. A
type of reflex epilepsy called Hot
Water Epilepsy is seen in south India. It occurs when a person takes hot water
bath.
WHAT A BYSTANDER SHOULD DO WHEN A PERSON DEVELOPS
SEIZURE?
Remove all the hard objects that can harm himself around the patient.
People should not crowd around as it will affect the oxygenation.
Put the patient on his side to avoid aspiration.
Do not feed the patient, as he may vomit.
Admit the patient if more than one seizure occurs.
INSTRUCTIONS TO PATIENT
Take medicine regularly. A doctor may attempt to reduce the dose if the
person doesn’t develop for a minimum of 2 years or more.
Avoid sleep deprivation as well as not take alcohol.
Occupation involving tackling of machinery is best avoided, except for
these guides he can lead a normal life.
Driving is possible on specific instructions of the doctor only.
Care of epileptic patient during dental treatment
Expert opinion from doctor treating him is needed.
He should not stop or miss the anti-epileptic drug
Should be accompanied by a bystander.
Future developments in epilepsy
Research is in the offing for the development of the software to be
implanted in the brain that can detect the excitation stimulus as it originates
which can lead to production of seizure and to nullify it, before it spreads in
the brain.
Brain stimulation in particular parts of brain by putting a permanent
electrode may help in abolishing the epileptic attacks.
Thus, the future prospects for an epileptic holds good.
BY,
DR.RENJU T GEORGE,
INDIA.
