27 Dec Know everything about Epilepsy
What is Epilepsy?
Epilepsy is a disorder of brain , it is commonly known as ‘seizure’ or ‘fits’.
What happens in epileptic fits ?
During epileptic episodes, person commonly looses consciousness , his body may become stiff / rigid , jerky movements can occur in body , eyes may roll up , jaws get tightened , head may turn to one side, frothy saliva with blood may come out from mouth. There can be grunting noise from throat . This thing typically lasts from 1-2 minutes , many a times this entire thing may not be witnessed by anyone as it can happen at anytime and place . It may occur during sleep. Person may pass urine in clothes . Person tends to gain consciousness in few minutes , but does not recollect any thing , he appears confused ,may complain of headache and bodyache, may have difficulty in speaking because of tongue bite , tends to sleep more following the attack.
What are the warning symptoms?
Some patients get warning symptoms prior to fits. They may complain of fatigue , weakness, heavy headedness, confusion , forgetfulness 1-2 days prior fits ,this is called as premonition.
Apart from this patient can also get certain stereotype symptoms just few minutes to seconds prior to episode , this is called as ‘Aura’. They can be in form of funny sensations in stomach, something rising from stomach upwards, abnormal sensations over hands or feet or face. Some may get complex visual sensations in form of bright colourful lights , zigzag lines etc or may get visual hallucinations . They may hear sounds in form of words , musical sounds etc , good or bad smells can also be perceived.
There are certain other kinds of epilepsies in which different symptoms can occur – for example person may appear dazed , confused , facial expressions may change, chewing movements may occur, may utter unknown words , sounds etc . List of symptoms is long , basically one should know that during such episodes person loses awareness of surroundings , he doesn’t remember what he is doing and what is happening around him. Mostly this lasts for less than a minute to upto 1-2 minutes. Uncommonly abnormal jerking of hands/face/ and foot can occur with loss of consciousness.
What to do when person gets epileptic fit ?
- Try to secure patient , make him turn to one side(preferably left side) , so that saliva from mouth flows out. Also gently pat his upper back.
- Loosen any tight clothing (tie, shirt buttons etc) around his/her neck.
- Make sure his/her nose and mouth are not obstructed by any surrounding pillows, bed-sheets, blankets etc or any other object so that he can breathe freely.
- Remove any sharp objects from nearby as it can potentially injure the patient.
- Try to make video of the event with help of mobile phone if possible.
- Can consult neurologist for SOS medication which can be given at home.
- Don’t insert any thing in patients mouth to prevent jaw from tightening as this will injure patients teeth and oral cavity.
- Don’t try to restrain patient’s body forcefully if it is jerking.
- Don’t try to transfer patient from one place to another unless there is risk of getting injury from nearby objects
- Don’t make patient smell shoe or slipper.
How does a neurologist proceed with treatment of Epilepsy?
In case of ongoing fits or recent fits in last few hours patient will need to be hospitalized for control of seizure. if the patient is drowsy , confused or violent. If he has not had seizure in last 48 hours , he can be managed on clinic basis. Neurologist will like to ask detailed symptoms during episode , and all past medical details related to the illness . He may like to do MRI Brain , EEG and blood investigation depending on patient’s requirements.
Why do fits occur?
Fits occur because of excessive electrical discharge from the brain. Epilepsy can start after head injury, brain infections , stroke, any scar in brain because of any reason , it can be hereditary also .
It can affect any age group of patients.
What are the treatments available.?
Patients need to take regular medication if he/she has had more than one seizure and if advised by his neurologist. Taking medicines regularly is very important, as skipping medicines may precipitate seizure. With advancements in medical science , now a days many new medicines are available which are more effective and have good safety profile. Epilepsy surgery is a option in selected few cases where neurologist thinks seizure control can be better achieved with brain surgery.
What precautions should person having epilepsy take ?
- One should not drive .
- Avoid swimming , fasting, late nights and alcohol.
- Avoid skipping medicines.
How is long term outcome in cases of epilepsy?
Long term seizure control depends upon factors like extent and cause of underlying brain damage.
On compliance to treatment nearly 2/3 rd of all epilepsy patients ultimately develop good control, out of this 50% are ultimately seizure free without long-term medication , and remaining 50% remain seizure free on medication. 1/3 rd of the remaining patients have poor seizure control for whom other options like epilepsy surgery have to be explored.