Mediscene

Epilepsy : The do's and don’ts

Continuing our series on epilepsy in association with the Epilepsy Association of Sri Lanka
By Dr. Pyara Ratnayake

As you already know, epilepsy like most other illnesses is amenable to treatment. The medications are usually given in an oral ( tablet/syrup) form. You usually do not need to stay in hospital and medication can be commenced as an outpatient. This needs to be taken for a long period (usually two or more years) and it is important that medication doses are not missed or altered without medical advice. A rebound seizure is possible in this situation. The effect of medication can be maximized by spacing them out evenly through the day and not changing your regular time of intake.

Anti-epileptic medications could have side effects but most can be avoided or treated if identified early. If you are to commence medications, be sure to ask your doctor what you should be looking out for.
Healthy life habits such as regular balanced meals and adequate sleep are helpful in achieving lasting seizure control.

A person with epilepsy can participate in most of the usual activities. School, sports, travel, hobbies etc. do not have to be given up due to epilepsy. It is a common practice to overprotect individuals, especially children with epilepsy in our culture. Misplaced concern by others, lack of self-confidence and social stigma cause many people with epilepsy to become withdrawn from society and prevents them from achieving their full potential as individuals. This social discrimination and lack of feeling of self-worth is seen time and again as the cause of most of the burden of misery suffered unnecessarily by people with epilepsy.

Special precautions are needed in few instances only. Activities that can harm an individual in case of sudden unconsciousness should be avoided. Examples are swimming, driving, cycling, work involving heights or dangerous machinery. Most children with epilepsy have normal intelligence and are able to do well in school. Admittedly the incidence of learning difficulty and behaviour problems including hyperactivity, conduct disorders, depression etc. are more common in the segment of population with epilepsy. These could even be secondary to circumstances such as medication side- effects, missing school, poor self-confidence and social stigma. These issues need to be identified and treated for optimal outcome.

Epilepsy is not contagious. It is usually not inherited. Individuals with epilepsy are capable of marriage and successful child bearing. Although there is a slight risk to the foetus and the mother, prior planning and discussion before conception of pregnancy can minimize this risk. Folic acid taken before conception is a known protection against some expected foetal problems.

The writer is a Consultant Paediatric Neurologist

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