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Frequently Asked Questions On Epilepsy

INVESTIGATIONS:

Q: What is the role of different investigations like EEG, CT scan, and MRI scan in the diagnosis of epilepsy?

MRI Brain ScanA: The electroencephalograph (EEG) which records the electrical activity of the bairn cells has its own limitations. It is helpful, when it is clearly abnormal but 40-50% of patients with epilepsy have a normal single inter-ictal EEG. On the other hand, about 5% of non-epileptic patients may have non-specific EEG abnormalities. Despite its limitations, the EEG is a simple non-invasive and relatively inexpensive test that gives useful information if used judiciously and correlated with the clinical description of seizures. When abnormal, it is helpful in making a correct diagnosis of epilepsy and may even help in the choice of anti-epileptic drug therapy in a given case. The availability of CT scanning in larger cities of our country has been of a great help in the management of some cases of epilepsy, epecially where an underlying pathology is suspected as the cause of seizures. Magnetic resonance imaging (MRI) is now established to be a better and safer diagnostic modality than CT scanning for the detection of an epileptogenic focus or the suspected abnormality in the brain of patients with seizures.

Q: Blood levels of anti-epileptic drugs are frequently prescribed by doctors. What is the role of getting blood levels done?

A: There is no role of routinely checking the blood levels of anti-epileptic drugs. However, estimation of blood levels is important to check compliance, to correlate side effects with drugs, to know the drug interactions in patients receiving more than one drugs for control of their seizures, and in certain situation where metabolism of drugs may be altered like during pregnancy, very old or very young age, and in presence of hepato-renal disease.

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MRI Scan
MRI Scan

Myths & Facts

Myth
Epilepsy is due to the effect of "evil spirits" or "supernatural powers". It is also a form of "madness". So, epilepsy should be treated by faith-healers, sorcerers (witch-craft) or in a
lunatic asylum.

Fact
Epilepsy is a disease of the brain. Hence, epilepsy should be treated by neurologists, epileptologists, physicians and paediatricians.


Myth
One should never touch a patient having a seizure in order to avoid the disease being passed on to you.

Fact
If a patient is having a seizure, he/she needs your help and care. Epilepsy cannot be passed on to others by touching the patient.


Myth
An epileptic seizure can be terminated by putting a key in the patient's hand or by making a patient smell onions or a dirty shoe.

Fact
None of these non-medical measures are of any use. Family members and teachers should be made aware of first-aid measures required during a seizure.


Myth
Children with epilepsy are dull and cannot learn. They should not be sent to school.

Fact
Children with epilepsy can be extremely intelligent. It is usually ignorance about various aspects of epilepsy that prevents parents from sending their children to school. Many times the teachers also have misconceptions and do not encourage children with epilepsy to attend school.


Myth
Treatment for epilepsy with modern medicines is ineffective and expensive.

Fact
"Seizures" or "fits" that occur in epilepsy can be completely controlled by using a single, inexpensive medicine in 60-70% patients. Another 15-20% patients can be helped by the use of new, but slightly expensive drugs. A few cases can be successfully treated with surgery. Epilepsy can even be cured in some cases.
No Seizures & No Fits