World Purple Day: Epileptic patients can lead a normal life

The 26th of March every year is observed as ‘purple day’ or World Epilepsy Awareness day. It was first started by a fourteen-year-old girl Cassidy Megan, a Canadian who was herself an epilepsy patient. According to the World Health Organization, 50 million people suffer from this problem globally. About 80% of these reside in developing countries and more than 50% of these do not have access to appropriate treatment. India has around 10 million epilepsy patients. In the past, it was thought to be due to spiritual possession, insanity and a bad omen. In many parts of the world, it is thought to be contagious. Epilepsy patients face social discrimination, emotional distress, and discrimination in the workplace, schools, and organizations.

An epileptic attack occurs due to a sudden onset of excessive electrical activity in the brain, usually lasting for 1-3 minutes. The tendency for recurrent seizures with/without a secondary cause is called epilepsy. There can be an alteration of sensation, behavior, or level of consciousness during this few minutes

Epilepsy is a disorder of the brain, however, it is not a mental illness. It is common, chronic, and has neurological roots. An epileptic attack is called fits, convulsion, seizure, etc. however it is important to differentiate epilepsy from these for predicting the prognosis, to determine the duration of treatment and to decide the type of treatment. Epilepsy is also called by different terms like ‘fits’, convulsion, seizure, etc. In India, it is called Apasmara.

Common triggers for epileptic seizures are:

1. Lack of sleep
2. Emotional stress
3. Watching visual flickers
4. Irregular medication

In developing and resource-poor countries a few of the important and preventable causes of epilepsy are – infections, birth injuries, stroke, and head trauma. In a significant number of people, it is hereditary.

Epilepsy can be seen in all age groups but it is most commonly observed at childhood and old ages. Few investigations required to correctly diagnose epilepsy are MRI/CT scan of the brain, EEG(electroencephalogram) and few blood tests.

In nearly 70% of these sufferers, no definitive cause can be demonstrated. However, 70% of all epilepsies respond to drugs and it is completely possible for patients to lead a seizure-free life. There are different types of treatments available:

1. Medications (more than 20-25 different medications)
2. Surgical
3. Nonpharmacological ( ketogenic diet, vagal nerve stimulation, etc)

The medications are usually needed for a long time. In about 30% of affected people, drugs will not benefit well. In these patients, brain surgery and vagus nerve stimulation therapy is considered

WHAT TO DO WHEN SOMEONE GETS AN EPILEPTIC ATTACK?

1. Don’t try to stop it, roll the patient to one side
2. Protect the person from injuries
3. Don’t put anything in the mouth
4. Allow ventilation and loosen the cloths
5. Take to the doctor immediately if there is the frequent recurrence of seizures

 GENERAL ADVICE TO PATIENTS AND THEIR CAREGIVERS  

1. Get examined qualified doctors and required investigations
2. Regularity in medications
3. Regular sleep and eating timing
4. Never stop medications abruptly
5. Always keep medications in excess.
6. Do not overprotect the patients but support and encourage when required.
7. Discourage driving, swimming alone, or handling of machines while on medication
8. If required/frequent seizures, inform the teacher, friends about the seizure and medications
9. Avoid night swifts in works
10. Mothers who are epileptics can breastfeed their babies while taking medication

Authored by Dr. Sreekanta Swamy, Lead – Senior Consultant, Neurology, Aster RV Hospital, J.P Nagar, Bangalore