EPILEPSY

Epilepsy is a family of more than 40 neurological conditions that share a common symptomseizure. Normally, brain cells communicate with each other through electrical impulses that work together to control the bodys movements and keep the bodys organs functioning properly. When thousands to millions of electrical impulses occur at the same time producing abnormal brain electrical activity, the result can be a seizure. There are over thirty types of seizures, some more severe than others. Some people have seizures that last a short time and cause them to stare off into space, giving the appearance that the person is simply daydreaming. Others may experience a more dramatic seizure (tonic-clonic seizure). Where the person loses consciousness and the entire body stiffens and then twitches or jerks uncontrollably. People of all ages, Races, and in all walks of life can develop epilepsy. It is not contagious, and it is not a mental illness. Most forms of epilepsy are not inherited, but it may run in some families. While there is, as yet, no cure for epilepsy, todays treatment options can control most cases. In fact, many people with epilepsy lead normal live and have no symptoms between seizures. The frequency and type of seizure varies from person to person. Thus, it is important that the doctor have experience with and treat people with neurological disorders such as a neurologist. The doctor usually orders an electroencephalogram (EEG) test, a painless recording of the patients brain waves. Another painless test-a magnetic resonance imaging study or MRI-may reveal scar tissue or a structural abnormality within the brain, helping the doctor to make a diagnosis of epilepsy. What causes epilepsy? There is no single cause of epilepsy, and in 70% of cases, no known cause is ever found. Some of the known causes of epilepsy are: Injury to the brain before, during, or after birth. Infections that damage the brain. Injury and lack of oxygen to the brain. Disturbance in blood circulation to the brain (stroke & other vascular problems). Metabolism or nutrition imbalance Tumors of the brain Heredity disease affecting the brain High fever Other degenerative diseases. Most major epileptic seizures (generalized or tonic-clonic) last only a minute or two and demand little of the bystander. All that is necessary is to let seizure run its course and to ensure that the person is in no physical danger and can breathe. The most common treatment of epilepsy is daily use of anti-convulsant drugs, which allow many people with epilepsy to enjoy a healthy life and continue normal activities. The drugs prescribed alone or in combination, are adjusted over time until the best combination is found for each person. Many people with epilepsy must take their anti-convulsant drugs for the rest of their lives to prevent further seizures. However, the doctor may advise a slow withdrawal of the drug if a person has had no seizures for several years. Instructions for the patients: 1. Avoid heights or open roof tops. 2. Avoid diving or swimming in open water like ponds, lakes or river. 3. Avoid handling sharp objects or heavy machineries 4. No driving 5. Avoid open fire places . 6. Avoid any activities harmful for patients or others. First aid during a seizure attack : The goal of first aid is to keep the person safe: 5. Keep calm, help the person to the floor, and loosen clothing around the neck 6. Remove sharp or hot objects that could injure 7. Turn the person on one side so saliva can flow out of the mouth 8. Place a cushion such as a folded coat under the head 9. Do not put anything into the persons mouth 10. After the seizure, allow the person to rest or sleep if necessary 11. Some people will be confused or weak after a seizure. They need help getting home . 12. Contact the parent or guardian if a child had the seizure If seizure activity last more than 3 minutes , Inj . Sedil (diazepam ) 10mg , 1/2 ampoule i/v slowly or per rectum (in case of children ) can be given . It can be repeated after 4-5 minutes if seizure activity not controlled . If seizure last more then 10 minutes patient should be taken in nearby hospital .

DR. ALIM AKHTAR BHUIYAN

MBBS), DTM & H (U.K.), M.D. (NEWYORK, U.S.A), POST- DOCTORAL FELLOWSHIP IN EPILEPSY (NEW YORK, U.S.A) US BOARD CERTIFIED IN NEUROLOGY CONSULTANT NEUROGOLIST, APOLLO HOSPITALS, DHAKA (EX- ASSOCIATE PROFESSOR OF NEUROLOGY, BANGLADESH MEDICAL COLLEGE, DHAKA, EX. - CONSULTANT NEUROLOGIST, VETERANS ADMINISTRATION HOSPITAL SYRACUSE, NEWORK, U.S.A)