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Epilepsy &
management
What is Epilepsy?
 Disorder of the brain
characterized by
recurrent fits which occur
without provocation
 May have loss of
consciousness, state of
confusion for few
seconds, muscle spasm
 Above mentioned
symptoms do not
necessarily happen for all
What is a fit?
 Abnormal electrical
activity in brain
 Sudden (abnormal)
change in the physical
behavior with
 Jerking of limbs
 Muscular spasm
 Froth coming out from
mouth
 Stare
 Minor spells
 Astonishing range of
feelings and actions
Different types of seizures
 Major type of fit:
 Readily recognizable
 Falling unconscious
 Shaking movements
 Tightening of body
 Minor type of fit:
 Not loosing conscious
 Very brief interval of
time
 Recovers rapidly
Cause of Epilepsy
 Problem in brain area due
to:
 Head Injury
 Infections
 Birth injuries
 Brain scan helps in
identifying the problem
 In case of normal brain
scan, cause can be
chemical and electrical
imbalances in brain
Treatment
 Several effective
treatments are available
 Medications
 Majority of patients
respond to it
 May provide seizure
freedom
 Surgery
 Medications does not work
 Risk benefit ratio is more
for patient’s quality of life
 Diet (ketogenic)
 Less evident, under studies
 Difficult to follow
Duration of treatment
 Till the time doctors does not tell you stop
 Depends upon the type of epilepsy and patients factors
 Generally 2-5 years of time period for becoming seizure
free
 Few patients may need to take it lifelong
Dietary restrictions to follow
 Normal well balanced diet
 Certain supplements may be required for
medicines used for treatment
 Avoid alcohol completely
 Avoid skip of meals, have regular meals
 Over-indulgence and fasting should be
avoided
Precautions for patients
 Comply to the prescribed medicines
 Do not switch in brands without the intimation to your
doctor
 Avoid swimming, driving, cooking
 Perform in supervision only if seizure free for last 6
months
 Have confidence in your coworkers/ close relatives and
caregivers & share about seizures situation
 Consult a doctor in case of emergency
 Carry your ID Card which should mention do’s and
don’ts
Side effects of antiepileptic drugs
 Now-a-days medicines are available that
are comparatively effective and well
tolerated
 Few drugs can cause sleepiness when
introduce for first time or increased the
dose
 Skin rashes, jaundice, low appetite should
be sought out immediately if observed
Epilepsy with other illness
 While consulting the neurologist one
should share all the possible illness and its
treatment
 Neuro-physician need to consider the
treatment for other illness while
prescribing treatment for epilepsy
 This holds true for other way out as well
 If oral medicines are not possible to take
then hospitalization is indicated
Is epilepsy hereditary?
 Very few patients may have
epilepsy due to heritable
cause
 These types can easily be
controlled
 Majority of people with
epilepsy can have normal
children
Marriage? Normal life?
 Marriage is possible
 Do not stop medicines after marriage
 Epilepsy is just another condition
 Try to share this condition with partner and
family of the partner
 “Epilepsy can be controlled”
Pregnancy? Normal children?
 Pregnancy is possible
 Children can be normal
 Few precautions need to take while pregnancy
 Frequent monitoring of maternal and foetal
health
 Early hospitalization, Labor & delivery need to
be supervised
 Do not stop medicine or change medicine during
pregnancy until doctor advice to do so
Holiday travel
 With the help of good medicines travel
can be easier
 Avoid stress
 Have complete sleep/ rest
 Have proper food (carry with you once
sitting in plane/ train etc.)
 Carry your personal details and details
of epilepsy
 Carry your doctors’ prescription
 Carry appropriate medicines stock
 Avoid going to hot places as epilepsy
can be aggravated due to high
temperature
Prevention of epilepsy
 Simple measure are needed to take
prevention
 Wear helmet while driving
 Eat healthy food, wash vegetables, fruits,
salads well before cooking or eating
 Wash hands before eating
 Safe disposal of human waste
 Good antenatal care can prevent birth
injuries
THANK’S
Dr. Gourav Goyal
MD, DM (Neurology)
Fellowship in stroke & Neuro-intervention
Assistant Professor, Department of Neurology,
MGMCH JAIPUR

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Epilepsy Management Guide

  • 2. What is Epilepsy?  Disorder of the brain characterized by recurrent fits which occur without provocation  May have loss of consciousness, state of confusion for few seconds, muscle spasm  Above mentioned symptoms do not necessarily happen for all
  • 3. What is a fit?  Abnormal electrical activity in brain  Sudden (abnormal) change in the physical behavior with  Jerking of limbs  Muscular spasm  Froth coming out from mouth  Stare  Minor spells  Astonishing range of feelings and actions
  • 4. Different types of seizures  Major type of fit:  Readily recognizable  Falling unconscious  Shaking movements  Tightening of body  Minor type of fit:  Not loosing conscious  Very brief interval of time  Recovers rapidly
  • 5. Cause of Epilepsy  Problem in brain area due to:  Head Injury  Infections  Birth injuries  Brain scan helps in identifying the problem  In case of normal brain scan, cause can be chemical and electrical imbalances in brain
  • 6.
  • 7. Treatment  Several effective treatments are available  Medications  Majority of patients respond to it  May provide seizure freedom  Surgery  Medications does not work  Risk benefit ratio is more for patient’s quality of life  Diet (ketogenic)  Less evident, under studies  Difficult to follow
  • 8. Duration of treatment  Till the time doctors does not tell you stop  Depends upon the type of epilepsy and patients factors  Generally 2-5 years of time period for becoming seizure free  Few patients may need to take it lifelong
  • 9. Dietary restrictions to follow  Normal well balanced diet  Certain supplements may be required for medicines used for treatment  Avoid alcohol completely  Avoid skip of meals, have regular meals  Over-indulgence and fasting should be avoided
  • 10. Precautions for patients  Comply to the prescribed medicines  Do not switch in brands without the intimation to your doctor  Avoid swimming, driving, cooking  Perform in supervision only if seizure free for last 6 months  Have confidence in your coworkers/ close relatives and caregivers & share about seizures situation  Consult a doctor in case of emergency  Carry your ID Card which should mention do’s and don’ts
  • 11. Side effects of antiepileptic drugs  Now-a-days medicines are available that are comparatively effective and well tolerated  Few drugs can cause sleepiness when introduce for first time or increased the dose  Skin rashes, jaundice, low appetite should be sought out immediately if observed
  • 12. Epilepsy with other illness  While consulting the neurologist one should share all the possible illness and its treatment  Neuro-physician need to consider the treatment for other illness while prescribing treatment for epilepsy  This holds true for other way out as well  If oral medicines are not possible to take then hospitalization is indicated
  • 13. Is epilepsy hereditary?  Very few patients may have epilepsy due to heritable cause  These types can easily be controlled  Majority of people with epilepsy can have normal children
  • 14. Marriage? Normal life?  Marriage is possible  Do not stop medicines after marriage  Epilepsy is just another condition  Try to share this condition with partner and family of the partner  “Epilepsy can be controlled”
  • 15. Pregnancy? Normal children?  Pregnancy is possible  Children can be normal  Few precautions need to take while pregnancy  Frequent monitoring of maternal and foetal health  Early hospitalization, Labor & delivery need to be supervised  Do not stop medicine or change medicine during pregnancy until doctor advice to do so
  • 16. Holiday travel  With the help of good medicines travel can be easier  Avoid stress  Have complete sleep/ rest  Have proper food (carry with you once sitting in plane/ train etc.)  Carry your personal details and details of epilepsy  Carry your doctors’ prescription  Carry appropriate medicines stock  Avoid going to hot places as epilepsy can be aggravated due to high temperature
  • 17. Prevention of epilepsy  Simple measure are needed to take prevention  Wear helmet while driving  Eat healthy food, wash vegetables, fruits, salads well before cooking or eating  Wash hands before eating  Safe disposal of human waste  Good antenatal care can prevent birth injuries
  • 18. THANK’S Dr. Gourav Goyal MD, DM (Neurology) Fellowship in stroke & Neuro-intervention Assistant Professor, Department of Neurology, MGMCH JAIPUR