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Epilepsy is a condition that affects the brain and causes repeated seizures, which were sometimes previously referred to as "fits".The severity of seizures can differ from person to person. Some people simply experience an odd feeling with no loss of awareness, or may have a "trance-like" state for a few seconds or minutes, while others lose consciousness and have convulsions (uncontrollable shaking of the body).Some people may only have a single seizure at some point during their life. If they do not have a high risk of having further seizures, they would not be regarded as having epilepsy.
The main symptoms of epilepsy are repeated seizures (fits). There are many different types of seizure, depending on the area of the brain affected.
Doctors classify seizures by how much of the brain is affected. There are:
Partial (or focal) seizures : Where only a small part of the brain is affected
Generalized seizures : Where most or all of the brain is affected
For more details you can watch:
Following are some myths and facts about EPILEPSY:
These patients are possessed by God. They should be worshipped.
This is rubbish, scientifically proved to be a disease of the brain causing excessive electrical signals producing abnormal behavior / movement and should be given medical treatment.
Never touch a patient having seizure. The disease will be passed on to you.
The patient having seizure needs your help and should be given appropriate care. Epilepsy cannot be passed on by touching the patient.
Having a person in the family with epilepsy is a stigma, so this fact should be concealed.
It is not a stigma and every effort should be made to remove this stigma through education.
Epilepsy is a form of madness, so it should be treated in a lunatic asylum.
Epilepsy is a disease of the brain, so it should be treated by physicians or neurologists.
Children with epilepsy are dull and cannot learn, so they should not be sent to school.
Children with epilepsy can be extremely intelligent. There are many examples of high achievers in history who have had epilepsy. Usually it is the stigma against epilepsy which prevents parents from sending their children to school, to learn and achieve their full potential.
Women with epilepsy can never have children. So they should not get married.
Epileptics can safely get married and they can safely have children under specialist supervision.
A seizure can be terminated by putting a key in the patient's hand or by making the patient smell onions or a leather shoe.
Use of shoes so frequently seen to terminate seizures. It is most unscientific. Never do that. One may lose precious moments in saving the patients.
Seizures can take on many different forms, and seizures affect different people in different ways.
Seizures have a beginning, middle, and end.
Some people are aware of the beginning of a seizure, possibly as much as hours or a day before it happens.
Some people may experience feelings, sensations or changes in behavior hours or days before a seizure. These feelings are generally not part of the seizure, but may warn a person that a seizure may come.
An aura or warning is the first symptom of a seizure.
Considered as a part of the seizure.
An indescribable feeling.
Change in feeling, sensation, thought, or behavior that is similar each time a seizure occurs.
The aura can also occur alone and may be called a simple partial seizure or partial seizure without change in awareness.
An aura can occur before a change in awareness or consciousness.
Yet, many people have no aura or warning; the seizure starts with a loss of consciousness or awareness.
Common symptoms before a seizure:
Awareness, Sensory, Emotional or Thought Changes:
Feelings of being there before but never have.
Feeling that something is very familiar but it isn't.
Different types Smell, Sounds& Tastes.
Visual loss or blurring
Fear/panic (often negative or scary feelings)
Headache, Dizzy or lightheaded
Nausea or other stomach feelings (often a rising feeling from the stomach to the throat)
Numbness or tingling in part of the body
It's the period of time from the first symptoms (including an aura) to the end of the seizure activity, This correlates with the electrical seizure activity in the brain.
Common symptoms during a seizure:
Awareness, Sensory, Emotional or Thought Changes:
Loss of awareness (often called "black out")
Confused, feeling spacey
Periods of forgetfulness or memory lapses
Loss of consciousness, unconscious, or "pass out"
Unable to hear
Sounds may be strange or different
Unusual smells (often bad smells like burning rubber)
Loss of vision or unable to see
Formed visual hallucinations (objects or things are seen thataren't really there)
Numbness, tingling, or electric shock like feeling in body, arm or leg
Out of body sensations
Body parts feels or looks different
Feeling of panic, fear (intense feeling that something bad is going to happen)
Difficulty talking (may stop talking, make nonsense or garbled sounds, keep talking or speech may not make sense)
Unable to swallow, drooling
Repeated blinking of eyes, eyes may move to one side or look upward, or staring
Lack of movement or muscle tone (unable to move, loss of tone in neck and head may drop forward, loss of muscle tone in body and person may slump or fall forward)
Tremors, twitching or jerking movements (may occur on one or both sides of face, arms, legs or whole body; may start in one area then spread to other areas or stay in one place)
Rigid or tense muscles (part of the body or whole body may feel very tight or tense and if standing, may fall "like a tree trunk")
Repeated non-purposeful movements, called automatisms, involve the face, arms or legs, such as
- lip-smacking or chewing movements
- repeated movements of hands, like wringing, playing with buttons or objects in hands, waving
- dressing or undressing
- walking or running
Repeated purposeful movements (person may continue activity that was going on before the seizure)
Convulsion (person loses consciousness, body becomes rigid or tense, then fast jerking movements occur)
Losing control of urine or stool unexpectedly
Change in skin color (looks pale or flushed)
Pupils may dilate or appear larger than normal
Biting of tongue (from teeth clenching when muscles tighten)
As the seizure ends, there is the recovery period after the seizure. Some people recover immediately while others may take minutes to hours to feel like their usual self.
Common symptoms after a seizure:
Awareness, Sensory, Emotional or Thought Changes:
Slow to respond or not able to respond right away
Difficulty talking or writing
Feeling fuzzy, light-headed or dizzy
Feeling depressed, sad, upset
Frustrated, embarrassed, ashamed
May have injuries, such as bruising, cuts, broken bones or head injury if fell during seizure
May feel tired, exhausted or sleep for minutes or hours
Headache or other pain
Nausea or upset stomach
General weakness or weak in one part or side of the body
Urge to go to the bathroom or lose control of bowel or bladder.
Because there is no obvious sign a person has epilepsy, unless they are having a seizure, it can make diagnosing epilepsy difficult. A diagnosis is usually made after a person has had more than one epileptic seizure.
The stiffening and jerking phase of a tonic-clonic seizure lasts longer than 5 minutes.
One major seizure follows another without full recovery in between.
The person hits their head during the seizure and there is no sign of consciousness being regained within 10 minutes of the convulsions ceasing. Unconsciousness could be due to concussion. (Remember that some people sleep after a seizure. A sleeping person responds when gently shaken; an unconscious person does not).
There is an injury you cannot deal with (e.g. if you cannot stop bleeding).
The person is very confused and disorientated for a long period after the seizure.
The seizure has occurred in water and it is suspected that water has been inhaled.
It is the first seizure the person has ever had.
What are the Risk factors for EPILEPSY ?
A risk factor is
something that makes a person more likely to develop seizures and epilepsy.
Sometimes a risk factor can cause scarring of the brain or lead to areas
of the brain not developing or working right.
Babies who are born small for their age
Babies who have seizures in the first month
Babies who are born with abnormal areas in
Bleeding into the brain
Abnormal blood vessels in the brain
Serious brain injury or lack of oxygen to
Infections of the brain: abscess, meningitis,
Stroke resulting from blockage of arteries
Conditions with intellectual and
Seizures occurring within days after head
injury ("early posttraumatic seizures")
Family history of epilepsy or fever-related
Alzheimer's disease (late in the illness)
Autism spectrum disorder
Fever-related (febrile) seizures that are
Long episodes of seizures or repeated
seizures called status epilepticus
Use of illegal drugs such as cocaine
Mild head injuries, such as a concussion
with just a very brief loss of consciousness, do not cause epilepsy. Yet
the effects of repeated mild head injuries and epilepsy are unknown.
Having a seizure at certain times can lead to circumstances that are dangerous to yourself or others.
Falling. If you fall during a seizure, you can injure your head or break a bone.
Drowning. If you have epilepsy, you're 15 to 19 times more likely to drown while swimming or bathing than the rest of the population because of the possibility of having a seizure while in the water.
Car accidents. A seizure that causes either loss of awareness or control can be dangerous if you're driving a car or operating other equipment.
Pregnancy complications. Seizures during pregnancy pose dangers to both mother and baby, and certain anti-epileptic medications increase the risk of birth defects. If you have epilepsy and you're considering becoming pregnant, talk to your doctor as you plan your pregnancy. Most women with epilepsy can become pregnant and have a healthy baby. You'll need to be carefully monitored throughout pregnancy, and medications may need to be adjusted. It's very important that you work with your doctor to plan your pregnancy.
Emotional health issues. People with epilepsy are more likely to have psychological problems, especially depression, anxiety and, in extreme cases, suicide.
Be guided by your doctor, but general safety considerations include:
Before starting any new exercise program, consult with your doctor or specialist.
Pre-exercise screening is used to identify people with medical conditions that may put them at a higher risk of a experiencing a health problem during physical activity. It is a filter or 'safety net' to help decide if the potential benefits of exercise outweigh the risks for you. Print a copy of the pre-exercise screening tool and discuss it with your doctor or exercise professional.
Avoid known seizure triggers.
Always take your medication as prescribed and have an adequate supply available.
Stay well-hydrated and drink or snack on something with sugar in it.
Don't continue exercising if you feel faint, lightheaded, nauseous or dehydrated.
Don't overexert yourself : know your limits.
Make sure your coach and possibly teammates are aware of your condition and know what to do if you have a seizure.
If involved in solo exercise, consider wearing a medical alert bracelet or pendant, so people can easily identify you have epilepsy.
Wear protective gear appropriate to your sport, such as a helmet or knee pads.Always wear a life jacket when involved in water sports.
Let family or friends know your walking, jogging or exercise route before you leave and how long you will be out.
Consider carrying a mobile phone with an ICE (in case of emergency) telephone number listed.Swim with companions who are aware of your condition and who are physically strong enough to support you and know what to do if you have a seizure.
Swim in supervised areas, such as in a public pool with an attendant or at the beach between the flags, where lifeguards are on patrol.
Tell the pool attendant or lifeguard that you have epilepsy and the type of seizures you experience. You may need to brief them on how best to help you, if they don't already know.
People with epilepsy, even if well controlled, should never swim alone.
Anti-epileptic medications and exercise:
Anti-epileptic medications are the most common treatment for epilepsy and seizures, but some of the side effects may influence your performance, including:
Fatigue and tiredness : which can be a problem for active people
Other problems : such as blurred vision or problems with concentration, impaired coordination and slower response times
Exercise : can alter the levels of anti-epileptic medications in the blood. People taking anti-epileptic medications who exercise regularly should discuss with their doctor the need to have their blood levels monitored (especially in the first few months of training)
Anabolic steroids : don't take anabolic steroids, as they interfere with anti-epileptic medication levels in the blood
Anti-epileptic medications may lead to bone loss (osteopaenia and osteoporosis) : large studies suggest a doubling of fracture risk in people with epilepsy. Weight-bearing exercise can help prevent these conditions. Discuss appropriate activities with your doctor.
Understanding your condition can help you control it.
Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor.
Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night.
Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly.
Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water and rest if you get tired during exercise.
The home is the most common place for seizure-related accidents. Activities such as bathing and cooking place the person with seizures at risk for injury. Making simple changes in household activities or your environment may create a safer home.
Bathrooms, which have mirrors, sinks, shower doors, bathtubs, and hard floors, can be risky for people with uncontrolled seizures. Bathroom activities are generally private matters and balancing the need for both privacy and safety is important for people with seizures. Also be careful in rooms with fireplaces and on stairs.
A few safety tips:
To give some privacy, place an occupied sign on the bathroom door instead of locking it.
Sing in the shower so people know you're okay.
Take showers instead of baths.
Make sure shower and bath drains work properly so water doesn't build up.
Use nonskid strips in tub or shower - everyone should use these!
Use tub rails or grab bars.
For people who fall during a seizure or have frequent seizures:
Use a shower chair or sit on bottom of tub and use hand held shower nozzle.
Take showers when someone else is in the house.
General Home Safety Tips:
Use an electric razor to avoid cuts
Avoid glass tables.
Avoid scatter rugs. Wall-to-wall carpeting or soft flooring may reduce injuries for individuals who fall.
Use protective or padded covers on faucet handles, nozzles, or the edges of countertops to help cushion falls and reduce injuries.
Electrical equipment such as hair dryers or razors should be used away from any water source.
Secure televisions, computers or other things that could fall off tables.
Have a way to call for help if you are alone. Look into alarm systems, medic alerts and other safety devices!
Ways of preventing injury from seizures during sleep include:
Remove sharp or potentially dangerous objects from near the bed.
If there's a danger of falling out of bed, try sleeping on a futon, other low bed, or put a mattress on the floor. Pads can also be placed on the floor next to the bed.
Limit the number of pillows used so they don't get in the way at night.
Avoid sleeping on your stomach.
Share a bedroom or have someone nearby who can help if a seizure occurs.
Some people place a monitor in the room so a person can hear if a seizure occurs at night.
Look into seizure alert or detection devices. They may be able to detect when a seizure occurs and alert someone, or call for help.
Smart Monitor is one that can detect repeated shaking during a seizure and may help people with tonic clonic seizures.
Others are being developed so stay tuned.
Epilepsy & Workplace:
When looking at safety in the workplace, a number of factors should be considered such as:
The type of job - Some jobs may pose greater risks or not be right for a person with seizures. Does it involve driving, working around dangerous machinery, flying?
Risks in the environment- Does the work require climbing? Is the area safe if a person were to have a seizure?
Work hours - Some work schedules may increase the likelihood of someone having a seizure, such as frequently changing shifts or night hours resulting in sleep deprivation.
Availability of seizure first aid - Are people available to help if the person needs it or does he work alone? Do people know how to provide appropriate help?
Employer and employee attitudes and behaviors - What are the attitudes and reactions of people in the workplace? Are they supportive and understanding?
Need for disclosure about seizures - Does the employer need to know about your seizures? If seizures are well-controlled and don't affect the ability to do the work, people should think carefully about disclosing information about epilepsy or any health condition.
Diet for Epilepsy Treatment: When a child with epilepsy hasn't responded to two anti-seizure medications and isn't a candidate for epilepsy surgery, there's a third option to consider - a ketogenic diet.
It's based on a ratio of fat to carbohydrates and proteins.
A normal diet contains a 0.3:1 fat-to-carb and protein ratio, but the classical ketogenic diet is based on a 3 or 4:1 ratio.
The diet maintains a stable, low-normal level of glucose and higher levels of ketones (derived from fat metabolism) in the body, forcing the brain to draw its energy from fat instead of sugar.
1. Don't try it on your own. Children who may benefit from this diet need to be carefully chosen. The ketogenic diet may not be safe in children with certain rare metabolic disorders. Children beginning the ketogenic diet are admitted to the hospital and frequently undergo a period of fasting. The child's glucose levels are closely monitored as the diet is gradually introduced.
2. Implementing the diet: not easy, but doable. Strict compliance is needed for best results.
3. Have realistic expectations. The ketogenic diet is not a cure for epilepsy.Though reduction in seizures is common, sustained complete freedom from seizures occurs only rarely.
4. Other benefits may occur. Many parents will observe that their child is more alert and active while on the diet. They may continue with the diet for that reason even if there's no reduction in seizures.
Ketogenic Diet Plan Indian Version - Phases
Phase I: The pre-counseling period & investigations:
Patient's history about the type and frequency of seizures is recorded, previous treatments and ongoing medications are evaluated clinically. Depending on these, the patient is selected to be a candidate for the ketogenic diet.After this, patient is kept on a carbohydrate wash-out diet for a period of 2-3 days as against the standard method of fasting. The patient is advised with a diet very low in carbohydrates with normal proteins and fats are increased gradually in the diet.
Phase II: Initiating the Diet
Normally, ketogenic diet is initiated with fasting. The aim of the fasting is to bring patient into 4 ketosis level. This usually takes 24-48 hrs. It is the most crucial period.
Phase III: Fine-tuning
This is the most important phase of the diet treatment. This varies with patients with an average period of 4-6 weeks. Patients come for a regular follow-up with the physician and dietician. During this period, calories and ratio of the diet are adjusted in order to maintain 4 level of ketones throughout the day.
Changes in medicine are made as per the progress of the patient and seizure control. Following successful implementation of the diet and seizure control, the patient is slowly weaned off medication.