epilepsy – myths & facts dr.h.v.srinivas consultant neurolgist sagar apollo hospital &...
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EPILEPSY – MYTHS & FACTS
DR .H.V.SRINIVAS
CONSULTANT NEUROLGIST
Sagar Apollo Hospital & Agadi Hospital
Indian Epilepsy Association
Other Names used in practice Seizures Fits Convulsions
EPILEPSYHow common is Epilepsy ? About 1% of the population across the world. Age group 10-20 yrs 50-60 yrs Poor / rich ; developing / developed countries Literate / illiterate ; Male / Female.
EPILEPSY• World wide about 40 million People With Epilepsy (PWE)• India about 80 lakhs of PWE• It is well recognised that PWE suffer less from a seizure disorder and more from stigmatisation social prejudices, thus affecting their quality of life.• This is all because of lack of adequate knowledge of epilepsy.
EPILEPSY
- Early Greek view epilepsy as a visitation from the Gods and thus a sacred disease.
- Christians in medieval times followed biblical belief that epilepsy was one result of demonic possession.
1857- epilepsy colony
6Dr R P Joshi
EPILEPSY
IN THE PASTKnowledge- Possessed by Devils- Mental Illness - No Drugs available- Hereditary
Attitude & Practice.- Sorcery - Witchcraft - Cannot be cured. - Cannot marry - Families ostracised
Common mythsCurse Intelligence is affectedSpreads to others by touchingAffects studies, careerCan not marry/have childrenCan not be curedLife long medication
EPILEPSY
Knowledge- Brain Disorder- Nearly 80% well
controlled with drugs - Hereditary only in about
4%. - 2-5 yrs of treatment
Attitude & Practice.- Mental Illness - Cannot be treated or
life long treatment - Hereditary- PWE are not normal –
Marriage, Education, Employment.
IN THE PRESENT
-
- Why should you know about Epilepsy ?
- In Hypertension, Diabetes, …… patients & immediate family members require education and information about illness.
- In Epilepsy – patient, family, friends and the society too needs education
-- To dispel Myths & Stigma attached to epilepsy and integrate the person with epilepsy into society.
EPILEPSYSocietal attitude towards PWE affects - Education - Employment - Marriage - Children - Sports - Travel Ultimately SELF ESTEEM
What 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 footwear/
onion near noseApril 18, 2023
X
During the attack
Stay calm, do not panic
Loosen neck tie, tight collar
Remove spectaclesPrevent injuries to
person
During the attack
burn to stop attack !!
EPILEPSYWhy does epilepsy occur
- Due to excessive & abnormal electrical discharge from the brain.
- Largely reasons NOT known.- Infrequently due to brain
tumour, tape worm infection blood clot, Brain TB etc.
EPILEPSYAre there any specific
investigations ?
• EEG – for Type of epilepsy & NOT for diagnosis of epilepsy.
• CT / MR – for cause of epilepsy ( When suspected ) E g. TB, tapeworm, brain tumour.
EPILEPSYA person with epilepsy is totally normal in between
the attacks
What precautions to prevent next attack ? - Absolute regularity in drug intake
- Adequate and regular sleeping hours 6-8 hours- Avoid total fasting- Inform your doctor if seizures recur inspite of above.- Physical exertion or mental tension does not aggravate
epilepsy
EPILEPSYIs Epilepsy controllable ?
- Yes in 75% - 80% seizure free with drugs.
- 70-80% of these can stop medication depending on type of epilepsy.
EPILEPSYIs it life long treatment ?
- Certainly NOT
- It is 2 to 5 yrs of seizure free period.
EPILEPSYIs epilepsy hereditary illness ? Certainly
Not
Gen population -1%
One parent / sibling - 4% One parent & sibling - 8%
This also in some types of epilepsy only.NOT all types.
EPILEPSYWhat are the food restrictions ? NIL – No food items causes /
cures epilepsy.
EPILEPSYWhat about education ?
YES – like any other individual.
EPILEPSYHow about employment ?
To avoid – Working near open machinery, live electrical cable, unprotected heights.
EPILEPSY Can a person with epilepsy marry ?
- Why Not ?- Marriage, sex, children – like any other
person.- Remember the person with epilepsy is
NORMAL in between the seizures.
EPILEPSYLaw prohibiting PWE from marriage repealed in UK - 1970
USA – 1980
India – 1999.
EPILEPSYWhat about pregnancy , breast feeding ?
- NO PROBLEM.- Largely neither epilepsy nor the drugs
affect the course of pregnancy / delivery / breast feeding.
- Where as, if seizures are not controlled it may result in fall, abortion, premature delivery.
EPILEPSY• Can a person with epilepsy watch TV. Use
computers ?• OF COURSE YES – They do not harm any
way.
EPILEPSY
SPORTS ?
YES - Except adventure sports E.g Rock climbing, Motor racing.
What does the LAW say ?
Driving for PWE allowed if seizure free period is
3 to 12 months - USA, Australia 6 to 12 months - UK , Canada. 1 year to 2 years - Korea, Malaysia.
Epilepsy & Driving.
Accidents due to epilepsy – 0.01%Accidents due to alcohol abuse – 5-10% in USA.
In PWE accidents due to Carelessness, alcohol - 89% Epilepsy - 11%
Epilepsy & Driving.
Epilepsy & Driving.
What about driving in India ?
- In India legally Not permitted. - However people with epilepsy do drive
merrily without mentioning epilepsy or without driving licence ! !
EPILEPSYCan we prevent epilepsy ? Yes – To some extent. - Reducing head injury - wear helmet for 2 wheelers. - wear seat belts for 4 wheelers. - Adequate antenatal care for pregnant women and ensuring safe delivery of child to prevent birth injuries to brain.
- Reducing the incidence of neuroinfections like Tape worm infection , brainfever, TB meningitis.
EPILEPSY
If a person with epilepsy can lead a normal life, why the societal attitude is so negative ?
It is due to - Prejudice, stigma Myths, misunderstanding, etc.Prevalent since several centuries
EPILEPSY
WHO NEEDS TO BE EDUCATED ?
• Patients with epilepsy• Relative of patients• General Public• School teachers• Medical students• Doctors.
While the Recent advances have improved diagnosis & treatment, ignorance, myths, prejudices, social stigma and human suffering persists.
EPILEPSY
NATIONAL EPILEPSY WEEK – 18th – 24th December 2008 (U K)
• Our campaign this year is to combat stigma, which unfortunately still surrounds epilepsy to this day despite education that is available,
• A recent survey of 20,000 teenagers on their current belief and understanding of epilepsy.
• Almost half thought it could be contagious, almost half thought it was a mental illness and two thirds wouldn’t date someone with epilepsy.
EPILEPSY Legal Sanctions in USA
• 1956 – 18 States had statutes that provided for eugenic sterilization of PWE.
• Until 1970 – it was legal in most states, to deny PWE access to restaurants, theatres etc.
• 17 States prohibited PWE to marry in the recent past.
International Bureau for Epilepsy (IBE )
Established 1961- An organisation for lay persons & professionals interested in the field of epilepsy.
Addresses social problems- education, employment, marriage , insurance, diriving licence restrictions, public awareness.
Worldwide organisation- 118 members in 92 countries
WHEN IT COMES TO EPILEPSY EVERY COUNTRY IS A DEVELOPING COUNTRY!!
IBE – 118 Members in 92 countries
Bangalore •
• Mumbai
•Delhi
•Visakhapatnam
Cochin •
Mangalore •
•Trivandrum
•Nagpur
• Ahmedabad
•Jodhpur
•Jaipur
•Chennai
• Kakinada
•Hyderabad Shimoga •
• Lucknow
•Patna
•Ranchi
•Tirupati
•Guwahati
•Anand
• Belgaum
• Indore
•Kolkota
•Pune
Indian Epilepsy Association.
• 28 chapters
•Nellore
•Trichy
1997 – Joint Venture of IBE, ILAE & WHO
Socrates
Fyodor Dostoyevksy
Charles Dickens
Alexander The Great
Napoleon Bonaparte
Julius Caesar
Vincent van Gogh
Sir Isaac Newton
World famous Cricket players Tony Grieg
Jonty Rhodes
EPILEPSY Famous people with epilepsy -1 Agatha Christie -
- Richard Burton. - Michael wilding - Lewis carol - Martin Luther - Margaux Hermingway.
Elton John
Famous people with epilepsy –2
Buddy Bell – Baseball player
Bobby Tones - Basket ball player
Chanda Gunn – USA Olympic women`s Ice Hockey team goal keeper
EPILEPSYConclusionlet all of us join hands to improve the quality
of life of all persons with epilepsy, and integrate them into the society.
School awareness programmes
Public awareness programmes- rural