Legal Implications

Some of the legal implications involved with patients with epilepsy:

Most people diagnosed with epilepsy are forbidden by their local laws from operating vehicles. However, there are usually exceptions for those who can prove that they have stabilized their condition. Those few whose seizures do not cause impairment of consciousness, or whose seizures only arise from sleep, may be exempt from such restrictions, depending on local laws. There is an ongoing debate in bioethics over who should bear the burden of ensuring that an epilepsy patient does not drive a car or fly an airplane.

G. Yi Hui

rEpLy

To address yong hui's question, we found the following information:

Things You’ll Need:
Handkerchiefs
Pillows

Step 1:Ease the person to the floor, if you see that she is about to have a seizure. She could get hurt if she falls. AND REMEMBER, CALL THE AMBULANCE!

Step 2:Insert a handkerchief between her teeth if she knows she's going to have a seizure. It will help her avoid biting her tongue.

Step 3:Loosen constrictive clothing (unless the seizure has come on and the person is jerking too much).

Step 4:Protect the head with a pillow, or any soft object, if possible. During a grand mal seizure, the head has a tendency to strike the floor repeatedly.

Step 5:Shoo away onlookers and close the door to provide privacy.

Step 6:Move furniture out of the way.

Step 7:Avoid trying to restrain the person having a seizure. You will never be strong enough to fight against the powerful seizing muscles, but you may get hurt.

Step 8:Make sure not to jam anything between the seizing person's clenched teeth. If her jaw is clenched, you could break her teeth or injure her lips.

Step 9:Turn her onto her side if you can, to prevent choking or aspiration of vomit that may occur during seizure.

Step 10:Reorient the person after she begins to regain consciousness following her seizure. Sometimes awareness is regained soon after a seizure, sometimes it can take several minutes or more.

Hope this piece of information helped :)

G. Yi Hui

treatment for epilepsy

Epilepsy is a condition in which a person has a tendency to have recurring seizures. Medication can provide seizure control for approximately 70 per cent of people with epilepsy. For some people, surgery is successful if medication fails. Avoiding known triggers and attention to lifestyle can sometimes improve seizure control.Treatment aims to prevent seizures and maximise quality of life.
Antiepileptic medications
Medication can be given to prevent seizures. When deciding whether or not to start medication, or which type of medication is to be prescribed, various issues will be taken into account.It may include the type of seizure,age or gender of the person etc.Medication does not ‘cure’ epilepsy; its role is to stop you having seizures. To prevent seizures, the prescribed doses must be taken regularly to maintain an effective level of the drug in your body.
Surgery
Epilepsy is sometimes caused by an area of abnormal brain tissue, frequently located in the temporal lobe of the brain. If surgery can remove this tissue, seizures can often be prevented. The chance of successful surgery and the risks of complications differ for each person.
Surgery is usually only used where medication fails. It is not intended to be a substitute for medication. If surgery is considered to be a possible treatment for your epilepsy, extensive tests will first be carried out.
Ketogenic diet
The ketogenic diet has been reported to reduce seizures in a very small number of children. Low in carbohydrate, the diet forces the body to break down muscle to make glucose. This state, known as ketosis, causes changes in body chemistry that may help to control seizures. The diet is extremely severe and must be carried out under medical supervision. It is not usually considered for adults and usually only suggested when other treatments fail.

By xuxn

Diagnosis of Epilepsy

Usually when diagnosis of patients that are said to have epilepsy, the patient’s medical history, including any family history of seizures, associated medical conditions and current medications are being taken into consideration. A complete physical and neurological examination of muscle strength, reflexes, eyesight, hearing and ability to detect various sensations are tested so that the cause of seizure of the patients can be determine.

Some of the tests used in evaluation of epilepsy:

a. Electroencephalography (EEG)
- Recording and measuring of electrical impulses in the brain
- Only test that directly detects electrical activity in brain
- Seizures are defined by abnormal activity in the brain, hence can be detected by EEG
- Diagnose seizure type by the different pattern of brain-wave activity- Localize the area of seizure onset
- During an EEG, a series of 32 electrodes are placed on the patient's scalp to record the electrical activity of the brain

b. Inpatient Video-EEG Monitoring
- Used to localize seizure onset in patients undergoing evaluation for epilepsy surgery.
- Used to confirm epilepsy when the diagnosis is uncertain

c. Magnetic Resonance Imaging (MRI)
- Allows detailed imaging of the brain
- Able to detect certain lesions in the brain that cause seizures
- Use special techniques, may detect very subtle asymmetries in the brain that may help determine on which side of the brain the seizures start

d. Neuropsychological Testing
- A patient's memory and cognition are measured
- E.g. IQ test
- Help identify areas of the brain that are not functioning normally, which provide clue as to the area of seizure onset
- Important component in pre-surgical evaluation as one risk of epilepsy surgery relates to the effects of surgery on memory and cognition

Sharon C.

some FACTS about EPILEPSY

Here are some fun facts on the origin and stigma on epilepsy :)

The word epilepsy is derived from the Greek epilepsia, which in turn can be broken in to epi- (upon) and lepsis (to take hold of, or seizure). In the past, epilepsy was associated with religious experiences and even demonic possession. In ancient times, epilepsy was known as the "Sacred Disease" because people thought that epileptic seizures were a form of attack by demons, or that the visions experienced by persons with epilepsy were sent by the gods. Among animist Hmong families, for example, epilepsy was understood as an attack by an evil spirit, but the affected person could become revered as a shaman through these otherworldly experiences.

However, in most cultures, persons with epilepsy have been stigmatized, shunned, or even imprisoned; in the Salpêtrière, the birthplace of modern neurology, Jean-Martin Charcot found people with epilepsy side-by-side with the mentally retarded, those with chronic syphilis, and the criminally insane. In Tanzania to this day, as with other parts of Africa, epilepsy is associated with possession by evil spirits, witchcraft, or poisoning and is believed by many to be contagious. In ancient Rome, epilepsy was known as the Morbus Comitialis ('disease of the assembly hall') and was seen as a curse from the gods.Stigma continues to this day, in both the public and private spheres, but polls suggest it is generally decreasing with time, at least in the developed world.

G. Yi Hui

Epilepsy Syndromes

There are many different types of epilepsy syndromes, due to abnormal brain activity resulting in wide variety of seizure types and syndromes.

Epilepsy syndromes are often classified into two classes: benign and catastrophic. Seizures associated with benign syndromes are typically well controlled with medications and are often outgrown. In contrast, seizures associated with catastrophic syndromes often persist despite medication or the age of the child, and typically result in more extensive developmental problems.
Here are some of the common seizure syndromes:

1. Benign Epilepsy Syndromes

a. Childhood absence epilepsy (CAE)
- Characterized by recurrence of absence seizures that can occur up to hundred times per day
- Affects children between the ages of 4 – 12 years old
- Most children with CAE outgrow the propensity for seizures by adolescence

b. Benign Rolandic Epilepsy (BRE)
- Affects children between 3 to 16 years old
- Seizures are infrequent and in some cases do not require medication
- Begins with a sensation at the corner of the mouth and drooling, followed by jerking of the mouth that can progress to the rest of that side of the face, and sometimes to that entire side of the body
- Patients are unable to speak for a period of time during and after the seizure.
- Seizures usually occur at night, and usually affecting the facial and pharyngeal muscles

c. Juvenile Myoclonic Epilepsy (JME)
- Begins in late childhood or early adolescence from 8 to 20 years old
- Characterized by mild myoclonic jerks as the individual is going to sleep or waking
- Absence seizures are usually less common in this syndrome
- Patients are often diagnosed when they have the first generalized tonic-clonic seizure later in life when they experience sleep deprivation.
- Alcohol is a contributing factor
- Usually lifelong
- Severity of JME varies from person to person – some will experience full blown tonic-clonic seizures regularly, others will suffer only under sufficient stress from lack of sleep and intoxication

2. Catastrophic Epilepsy Syndromes

a. Infantile Spasms (west syndrome)
- Affects infants from 1 month to 1 year old and very young children
- Typical seizures are characterized by repetitive muscle contractions, sudden flexor and extensor spasms of head, trunk, and extremities
- Spasms occur in clusters, in which one spasm follows another after a brief period of time
- Clusters of infantile spasms typically occur as the child is going to sleep, or soon after waking

b. Doose Syndrome (Myoclonic-Astatic Epilepsy – MAE)
- Affects children between the ages of 1 to 5 years old
- Children with Doose syndrome typically experience mixed seizure types.
- There is no known cause for this syndrome

c. Lennox-Gastaut Syndrome
- Affects children between the ages of 2 to 6 years old.
- Common among children who experienced infantile spasms
- Has no single cause but typically results from some developmental brain disorder or brain injury
- Mixed seizure disorder
- Can have two or more seizure types, one of which is the atonic type of seizure, which causes loss of muscle tone and a sudden collapse to the ground

d. Landau-Kleffner Syndrome
- Rare syndrome characterized by loss of speech due to abnormal electrical activity in the child's brain during sleep
- Child experiences mild seizures and slowly loses ability to understand language and to speak, as well as their interest in communicating
- Causes lifelong language deficits

Sharon C.

Causes for Epilepsy

There is a fine balance in the brain between factors that begin electrical activity and factors that restrict it, and there are also systems that limit the spread of electrical activity. During a seizure, these limits break down, and abnormal electrical discharges can occur and spread to whole groups of neighboring cells at once. This linkage of electrical discharges creates a "storm" of electrical activity in the brain. This is a seizure. When a person has had at least two of these seizures, that's called epilepsy.

The reasons why epilepsy begins are different for people of different ages. But what's true for every age is that the cause is unknown for about half of everyone with epilepsy.
Children may be born with a defect in the structure of their brain, or they may suffer a head injury or infection that causes their epilepsy. Severe head injury is the most common known cause in young adults. In middle age, strokes, tumors, and injuries are more frequent. In people over 65, stroke is the most common known cause, followed by degenerative conditions such as Alzheimer's disease.
Often seizures do not begin immediately after a person has an injury to the brain. Instead, a seizure may happen many months later. We do not have a good explanation for this common observation, but scientists are actively researching this subject.

Chiu Hsin Yao