Dr. Sreekanta Swamy, Lead – Senior Consultant, Neurology, Aster RV Hospital, J.P Nagar, Bangalore
The 26th of March every year is observed as ‘purple day’ or World Epilepsy Awareness day. It was first started by a fourteen year old girl Cassidy Megan, a Canadian who was herself an epilepsy patient. According to the World Health Organization, 50 million people suffer from this problem globally. About 80% of these reside in developing countries and more than 50% of these do not have access to appropriate treatment. India has around 10 million epilepsy patients. In the past it was thought to be due to spiritual possession, insanity and a bad omen. In many parts of the world it is thought to be contagious. Epilepsy patients face social discrimination, emotional distress, and discrimination at the work place, schools and organizations.
A epileptic attack occurs due to a sudden onset of excessive electrical activity in the brain, usually lasting for 1-3 minutes. Tendency for recurrent seizures with/without a secondary cause is called epilepsy. There can be an alteration of sensation, behavior, or level of consciousness during these few minutes
Epilepsy is a disorder of the brain, however it is not a mental illness. It is common, chronic, and has neurological roots. An epileptic attack is called fits, convulsions, seizure etc. however it is important to differentiate epilepsy from these for predicting the prognosis, to determine the duration of treatment and to decide the type of treatment. Epilepsy is also called by different terms like ‘fits’, convulsion, seizure etc. In India, it is called Apasmara.
Common triggers for epileptic seizures are:
- Lack of sleep
- Emotional stress
- Watching visual flickers
- Irregular medication
In developing and resource poor countries a few of the important and preventable causes of epilepsy are – infections, birth injuries, stroke and head trauma. In a significant number of people it is hereditary.
Epilepsy can be seen in all age groups but it is most commonly observed at the childhood and old age. Few investigations required to correctly diagnose epilepsy are MRI/CT scan of the brain, EEG(electroencephalogram) and few blood tests.
In nearly 70% of these sufferers no definitive cause can be demonstrated. However 70% of all epilepsies respond to drugs and it is completely possible for patients to lead a seizure free life. There are different types of treatments available:
- Medications (more than 20-25 different medications)
- Nonpharmacological ( ketogenic diet, vagal nerve stimulation etc)
The medications are usually needed for a long time. In about 30% of affected people, drugs will not benefit well. In these patients, brain surgery and vagus nerve stimulation therapy is considered
WHAT TO DO WHEN SOMEONE GETS AN EPILEPTIC ATTACK?
- Don’t try to stop it, roll the patient to one side
- Protect person from injuries
- Don’t put anything in the mouth
- Allow ventilation and loosen the cloths
- Take to doctor immediately if there is frequent recurrence of seizures
GENERAL ADVICE TO PATIENTS AND THEIR CAREGIVERS
- Get examined qualified doctors and required investigations
- Regularity in medications
- Regular sleep and eating timing
- Never stop medications abruptly
- Always keep medications in excess.
- Do not over protect the patients but support and encourage when required.
- Discourage driving, swimming alone, or handling of machines while on medication
- If required/frequent seizures, inform the teacher, friends about the seizure and medications
- Avoid night swifts in works
- Mothers who are epileptics can breast feed their babies while taking medication