Epilepsy, a common disease in Sri Lanka, is a tendency to have seizures (fits). There are several types of epilepsy. In epilepsy there is an abnormal discharge of signals from the brain so the patient will have a continuing tendency to have fits.
Genetics plays a role in developing epilepsy. Brain tumours, injury to the brain and other malformations can also lead to epilepsy.
Some people with epilepsy find that certain ‘triggers’ make a fit more likely. Possible triggers may include:
- Stress or anxiety.
- Heavy drinking.
- Some medicines such as
- anti-depressants, anti-psychot ic medication.
- Lack of sleep or tiredness.
- Irregular meals which cause low blood sugar.
- Flashing lights.
- Menstruation (periods).
- Illnesses which cause fever such as ‘flu' or other infections.
Pathogenesis /Action in
the body -
When the brain sends abnormal signals the patient may develop a fit. During a fit, a large group of brain cells get activated. This abnormal electrical activity can spread throughout the brain, even causing the patient to lose consciousness.
Symptoms and signs -
- Vigorous movements
- Frothing from the mouth
- Eyes rolling upwards
- Loss of consciousness
- Tongue biting, lip smacking
- Abnormal screaming
- Passing of urine or stools
Complications -
The patient can get injured due to vigorous movements that can result in bruises or broken bones
If a child constantly gets long seizures, he or she may have learning difficulties or mental retardation
If fits occur in pregnancy it can be harmful to both mother and baby.
Accidents like drowning can also occur during a fit
Management -
EEG, CT scans will help to diagnose epilepsy. There are several types of anti-epileptic medications. When you develop a fit it is best to go to the nearest government hospital for investigations and treatment. Regular follow-up and medication is needed until your doctor discontinues the medication when you are fit-free and you have no risk factors for future fits. Do not stop or reduce drugs on your own.
Some practical advice for
epilepsy patients
Medication - Take your medication regularly to reduce the risk of having fits. Get into a routine where you have a specific time to take your medicine.
Driving - When you apply for driving licence you should always inform the authorities that you are an epileptic. You should not drive public transport as it is risky. If you are fit free for two or more years you can drive your vehicle but it is better if someone accompanies you.
Work – There are some jobs which are risky such as a pilot’s job, working at heights, driving public transport etc. But there are many safe jobs you can do (office work, teaching etc)
School - If your child has epilepsy, it is better you inform the school / class teacher because in an emergency they will know what to do. Many children with epilepsy do not have any other disability, and the seizures are well controlled with medication. If a child has other disabilities such as learning difficulty it is best to send them to a special school or a normal school which has a special unit for these children.
Sport and leisure activities - People with epilepsy can participate in most sports including swimming, with informed, qualified supervision and relevant safety precautions where appropriate.
Travel - Make sure you have sufficient medication with you for your travels. Long journeys can make you tired and more prone to a fit. But do not limit your travel unnecessarily though it is best to let someone travelling with you know about your condition.
* Try to lead as normal a life as possible
When using the contraceptive pill - Some medicines used to treat epilepsy interfere with the oral contraceptive pill, so there is a possibility of its failure leading to pregnancy. Always inform your doctor about an epileptic condition when selecting a con- traceptive method.
Pregnancy - Being pregnant does not usually affect epilepsy. However, there is a very small chance that the unborn child may be affected by some medicines used to treat epilepsy. It is important to discuss such concerns with a specialist and plan the pregnancy.
It is recommended that you take extra folic acid before and during pregnancy. If you have an unplanned pregnancy, you should not stop epilepsy medication which may risk a fit occurring.
* In other countries epilepsy patients wear bracelets which give a number to be used in an emergency
Safety
- Avoid heights, open fires, sharp furniture because they can be harmful in the event of a fit
- Avoid living alone
Prevention -
Try to avoid trigger factors which can lead to a fit, such as hunger, sleep deprivation, stress, heavy drinking etc.
(The writer is attached to the Health Education Bureau)
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