Don’t ignore epilepsy, it is ‘fairly common’ and manageable

NEW DELHI - If you find your child suddenly behaving in a disoriented manner, losing focus, for a few minutes and then feeling tired after that, don’t brush it off lightly. It could be a mild epileptic attack, also known as absence seizures.

Absence seizures, which last for a few seconds, affect mainly children and can progress to general epileptic seizures.

When Renu noticed her 12-year-old son begin at times to suddenly look distracted and then stare uncomprehendingly at his surroundings, she thought it was one of his pranks.

Her son, Aditya, had a learning and behavioural disability and had also been detected with asthma, and she did not dream it could be a neurological problem.

But the minor absence seizures continued, especially when Aditya would return home from school.

“We all thought Aditya was going blank because he was tired after his day in school. Once I did think of consulting a doctor, but as he would be fine after a two-hour nap, I let it be,” said Renu, a housewife.

After about a month, the child got an epileptic attack, which left his parents shocked as they did not know the reason behind his sudden moaning and shaking while in sleep.

When they approached their paediatrician, he recognised the signs immediately and recommended an EEG (electroencephalography), a test which records the brain’s electrical activity. The test did not show up anything, much to the parents’ relief.

A second epileptic attack took place within a fortnight, and this time there was no mistaking the rolling upwards of the eyes and shaking of the body.

Aditya was unaware of what was going on during his attack. When he awoke, he was aware of a numbing headache and feeling dull and very tired.

According to Sisir Paul, senior consultant, Institute of Paediatrics at Max Super Speciality Hospital, Saket, Delhi, epilepsy among children is “quite common” and he gets around two-three new cases every month in his private clinic in Chittaranjan Park.

He explained that an epileptic attack was different from a seizure disorder, which could be due to tapeworm eggs getting lodged in the brain, also known as neurocysticercosis.

“In a true epilepsy there is no focus. In the case of tape worm eggs, it shows up in the MRI scan or CT scan. They are not true epilepsy,” Paul told IANS.

Other reasons to trigger epilepsy could also be due to a brain tumour or “scarring in the brain” from a head injury, he said.

According to Rajashekar Reddi, senior consultant neurology at the Max Institute of Neuro Sciences at Saket, “Adequate sleep for an epilepsy patient is a must. Sleep deprivation can act as a potential trigger for an epilepsy attack, and some common antibiotics can also trigger epilepsy.”

However, there are “very good” medicines to treat epilepsy nowadays.

Reddi, who gets about 15 new cases every month, said that the medication should not be stopped arbitrarily by the patient.

“Appropriate dosage of medication, and for adequate or sufficient duration, should be administered, and when a patient has not had an event (epilepsy attack) for around three years, then one can say he or she is out of danger.”

The Indian Epilepsy Association website terms epilepsy as a “common neurological disorder affecting an estimated 50 million people worldwide. India accounts for nearly 10-20 percent (5-10 million) of the global burden of epilepsy.

“India has just one neurologist for a population of 1.25 million people, in contrast to the US’ one medical expert for 26,200 people.”

According to the site epilepsy.com, absence seizures are also known as petit mal (PET-ee mahl). During the seizure, awareness and responsiveness are impaired. People who have them usually don’t realize when they’ve had one. There is no warning before a seizure, and the person is completely alert immediately afterwards.

The Indian Epilepsy Association, under the heading “Ten commandments” says:

1. Epilepsy is an eminently controllable problem.

2. Epilepsy is not a mental illness.

3. If you witness an attack, note the details, an accurate description prevents wrong diagnosis.

4. Early treatment is the secret of success.

5. The drugs prescribed have to be taken regularly.

6. The duration of treatment generally is 2 to 5 years after the last attack.

7. Restrictions for a person with epilepsy are very few; ensure adequate sleep.

8. Patients can study, work and enjoy life.

9. Women with epilepsy can marry and bear children.

10. Treat epilepsy as you would treat asthma, headache. Do not overprotect nor ostracise.

(Ranjana Narayan can be contacted at ranjana.n@ians.in)