What is epilepsy Why should we learn about epilepsy Medical aspects of epilepsy Common myths and misconceptions about epilepsy What can you do to mitigate the problem Summary 2 Dr R P Joshi ID: 779901
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Epilepsy
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Dr R P Joshi
Slide2Epilepsy overviewWhat is epilepsy?Why should we learn about epilepsy?Medical aspects of epilepsyCommon myths and misconceptions about epilepsyWhat can you do to mitigate the problem?Summary
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Slide3Introduction Epilepsy is one of the most common brain disorders. It is also one of the oldest recorded medical conditionsEminently treatable 3
Dr R P Joshi
Slide4What is epilepsy (fits)?Common neurological conditionCaused by abnormal electrical discharges in the brainManifested by sudden brief episodes of altered or diminished consciousness, involuntary movements, or convulsions
Dr R P Joshi
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Slide5Epilepsy Origin of the word- ep·i·lep·sy from Greek - from epi-
+ lambanein ”to take”, “seize” or "to be overwhelmed by surprise".
Epilepsy is known as
Apasmara
in India and Sri Lanka , as
Mirgee
/
Lata
/
Laran
in northern India,
ª
ÀÄÆbÉðgÉÆÃUÀ
(ಕನ್ನಡ)
, Khichuni in Bangladesh, as Ayan in Indonesia, while Rake Lom Ba Mu or Roke Lom Chak are the lay terms in ThailandMerriam-Webster
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Dr R P Joshi
Slide6Is epilepsy a new disease?Dr R P Joshi6
Ancient disease1046 BC - Babylonian tablet has description of epilepsy400 BC –
Charaka
Samhita
has detailed description on
apasmara
Babylonian Tablet - 1046 BC
Slide7Wrong beliefs in the societyPossessed by demon Industrialization -Lunatics/ violent/ insaneDevil incarnationAsia – poorva janma karma phala, bhhota
cheste
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Dr R P Joshi
Slide8Colonies for the ‘outcast’A hospital for the "paralyzed and epileptic" was established in London in 1857. Establishment of epilepsy 'colonies‘ in many countries in nineteenth centuryDianalund in Denmark, Chalfont in England, Bielefeld-Bethel in Germany,
Heemstede in Holland, Sandviakain in Norway Zurich in Switzerland.
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Dr R P Joshi
Slide9Patients Paring Vegetables, Craig Colony For Epileptics 18989
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Slide10Even today...Dr R P Joshi10
branding
chaining
Slide11Issues in management of epilepsy 1850 AD – first AED discovered (bromide)
Current treatment results >70% controlBUTEven today, there are many myths and misconceptions about epilepsy even in the educated
Leads to wrong treatment and stigma
The Person With Epilepsy suffers less from a seizure disorder and more from social prejudices.
MAKING EPILEPSY A SOCIAL ILLNESS
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Dr R P Joshi
Slide12Common myths(ALL ARE WRONG)Curse Mental illnessIntelligence is affectedSpreads to others by touchingAffects studies, career
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Dr R P Joshi
Slide13Common myths(ALL ARE WRONG)Can not play gamesCan not marry/have childrenCan not be curedLife long medication
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Dr R P Joshi
Slide14Common mythsCannot watch TVCannot work with computersCannot eat non-veg foodNo bananas/cold food/hot food!Attack aborted by iron objects
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Dr R P Joshi
Slide15Why should we learn about epilepsy?Dr R P Joshi15
Epilepsy is a common condition ~1% of population
The
PWE
suffers
less
from a seizure disorder and
more
from social prejudices. This is all because of lack of adequate
knowledge
of epilepsy even in the educated public
Epilepsy is more than Seizures
Slide16Dr R P Joshi16
Countries affected - ALL
Age group –ALL
Economic status – ALL
Educational status – ALL
Religion - ALL
Epilepsy can affect anybody
Slide17What causes a seizure?The seizures are caused by sudden, usually brief, excessive electrical discharges in a group of neurones -World Health Organization
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Dr R P Joshi
Slide18Types of epilepsy18
Generalized Epilepsy
Generalized Tonic
Clonic
Epilepsy
Absence
Myoclonic
Epilepsy
Partial Epilepsy
Simple Partial Epilepsy
Complex Partial epilepsy
Dr R P Joshi
Slide19All siezure is not epilepsyDr R P Joshi19
Other causes of seizuresFebrile convulsionsSyncope attacks
Panic attacks
Ecclampsia
in pregnancy
Hypoglycemia,
hypocalcemia
Heart arrhythmias
Sick sinus syndrome
Slide20What causes epilepsy?20Dr R P Joshi
Slide21Causes of EpilepsyDr R P Joshi21
Causes of epilepsy
Slide22Can we prevent epilepsy?Care during pregnancy and delivery prevents birth injury- prevents epilepsy in the child Wear a helmet - Prevent head injury prevent epilepsyPractice Good Hygiene- Prevent Tapeworm InfestationControl of blood pressure and sugar prevents stroke – a common cause of epilepsy in the elderly
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Dr R P Joshi
Slide23Secondary prevention – avoid triggers of epilepsy• Forgetting to take prescribed seizure medication• Lack of sleep
• Illness or fever• Excessive alcohol consumption and sudden
Withdrawal
• Drugs (e.g. cocaine, amphetamines, ecstasy,
LSD, withdrawal from marijuana)
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Dr R P Joshi
Slide24Diagnosis Epilepsy is a clinical diagnosisThe great majority of seizures cause an ictal scalp electroencephalogram (EEG) abnormality and the gold standard diagnosis is made by ictal electroclinical correlation.Investigations like EEG, scan, blood tests are needed in selected cases
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Dr R P Joshi
Slide25AED Dr R P Joshi25AED
- Anti Epileptic DrugsMany different types availableShould be taken only on doctor’s advice and SHOULD NOT be stopped suddenly even though PWE
is seizure free
Slide26Many medicines are available to treat epilepsy26
Dr R P Joshi
Slide27Treatment resultsDr R P Joshi2770-80% seizure free with available medicinesDuration of
AEDs = 2-3 years seizure freeCompliance importantNeuro surgery in certain cases
Slide28Treatment gapOnly 25% PWE are treated with AED because of lack of awareness, misconceptions and socio-economic issuesWith proper treatment, patients of epilepsy can also lead a normal, healthy life and actively contribute to the society.
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Dr R P Joshi
Slide29Neurosurgery for epilepsyDr R P Joshi29
A proportion of the p
atien
ts with epilepsy will benefit from surgery
Slide30First aid during an attackDr R P Joshi30Epilepsy is very common
An attack can occur anywhere Inside classPlay groundOn the roadAt Home
Every educated person should know about what to do and what not to do in an epileptic attack
Slide31During the attack Stay calm, do not panicLoosen neck tie, tight collarRemove spectaclesMove furniture etc if causing obstaclePrevent injuries to personDO NOT shift unless absolutely necessary
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Slide32What NOT to do during the attackDO NOT - Push spoon in the mouth.DO NOT
- Pour water in the mouth.
DO NOT
- Restrain movements
DO NOT
-
Keep keys/iron rod in hand
.
DO NOT
– put socks/ onion near nose
X
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Slide33First aid AFTER the seizure attackStay calm, talk soothing wordsTurn the person to one sideStay with the person until he/she is fully consciousThere may be mild confusion soon after the attack – it will recover fully WITHOUT any treatmentGive water etc ONLY if person is able to hold it in his/her hand and drink
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Slide34First aid34
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Slide35Important facts about first aidSeizures are relatively brief episodes of unresponsiveness- don’t require any specific first-aid measuresThe only aim is to Prevent injury to the personDO NOT cause harm to the person by restraining him or putting iron objects in hand
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Slide36Status epilepticusStatus epilepticus (SE) is a life-threatening condition in which the person gets repeated seizures without recovering in between.Please call for medical help
immedietly
IT IS A MEDICAL EMERGENCY
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Slide37What can you do to mitigate the problem?Role of educated is very important for spreading scientific awareness about epilepsy in our societyPeople like you know have access to information and intelligence to understand itLearn about epilepsy, there are many ways you can help
We CAN and SHOULD REMOVE
the social stigma attached to epilepsy
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Dr R P Joshi
Slide3838Dr R P Joshi
Slide39Global Campaign against Epilepsy:
Out of the ShadowsDr R P Joshi
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Slide40Summary Dr R P Joshi40
Epilepsy is a common neurological and eminently controllable conditionFirst aid in epileptic seizure is to prevent injury –otherwise NOTHING need to be done. The seizure is self limiting
Patients can study, work and enjoy life
Do not overprotect nor ostracize
PWE
.
Learn about epilepsy and tell others also
Slide41EPILEPSY -FAQDr R P Joshi41Is it a communicable disease?
NO .Epilepsy DOES NOT spread from person to person
Slide42EPILEPSY -FAQIs it life long treatment ?Certainly NOTMedicines are gradually stopped after 2 to 3 yrs of seizure free period.
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Slide43EPILEPSYIs epilepsy hereditary illness ? Certainly Not Gen population -1%
One parent / sibling - 4% This also in some types of epilepsy only.
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Slide44Food retsrictionsDr R P Joshi44No food restrictions in epilepsy
Slide45EPILEPSYDr R P Joshi45
What about education ?
YES
– like any other individual.
The children with epilepsy can achieve all their life goals
Scholastic performance DOES NOT get affected by epilepsy/medicines
Slide46EPILEPSY -FAQHow about employment ?To avoid – Working near open machinery, working at heights where risk of injury is high;
Otherwise ANY job can be performed
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Slide47EPILEPSYDr R P Joshi47
Can a person with epilepsy marry ?
Person with epilepsy can marry , have children and lead a normal life like any other person.
Slide48EPILEPSYDr R P Joshi48
Can a person with epilepsy watch TV. Use computers ?Sure, NO problem
Slide49EPILEPSY – DRIVING vehiclesDr R P Joshi49
What about driving ?
In India legally Not permitted.
In many countries like USA and UK, person can drive after a seizure free interval of 2 years
Slide50SPORTS ?Dr R P Joshi50
YES - Except adventure sports like Rock climbing, most of the sports activities can be undertaken
We have many
sportpersons
with epilepsy who have achieved international fame
Slide51Email- ieablr@vsnl.netdrrpjoshi@gmail.comWebsite: www.epilepsyindia.org
Dr R P Joshi
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