Understanding Epilepsy and Seizure Management: Dispelling Myths - Dr Pavan Pai

Epilepsy is a neurological condition characterized by recurrent seizures, typically not provoked by systemic or acute neurologic insults. It is prevalent worldwide, with an incidence of 45 per 100,000 individuals per year and a cumulative lifetime incidence of around 3%. In India, the burden of epilepsy is substantial, with approximately 10-20% of the global epileptic population residing in the country.

Despite significant advancements in medical and surgical treatments for epilepsy, there remains a considerable treatment gap. However, addressing misconceptions about seizures is equally crucial, as fear often stems from lack of understanding. Here, we explore common myths surrounding seizures and debunk them with factual information.

Myth 1: Everything that shakes or moves means epilepsy

Fact: It's a common misconception that every transient movement indicates epilepsy. Few individuals exhibit abnormal movements that are transient, leading to incorrect diagnoses and unnecessary treatment with anti-seizure medications.

However, there are various other conditions, including movement disorders, tremors, and chorea, that can manifest similarly and require specialized evaluation by a neurologist for accurate diagnosis and tailored treatment. Therefore, it's essential to consult a healthcare professional to differentiate between these conditions and ensure appropriate management.

Myth 2: One will always have shaking limb as a part of the seizure

Fact: Seizures can manifest in various ways, and limb shaking is not always present. Some seizures involve a Prodrome or aura that the patient experiences beforehand.

Additionally, Dyscognitive Seizures may occur without any limb movement, leaving the person in a dreamy state or conscious but unresponsive. Caregivers should be vigilant about these phenomena and communicate them to their doctor for proper evaluation and management.

Myth 3: If one did not have a seizure recurrence for a few days, is it ok to stop the medication?

Fact: The decision to discontinue seizure medication is made by the treating Neurologist or Epileptologist. This process must be gradual and occur over a period of time.

Abruptly stopping seizure medications is not recommended, as it can result in breakthrough seizures or status epilepticus, characterized by continuous seizures that may induce a coma-like state.

Therefore, careful monitoring and a structured tapering schedule are essential when discontinuing these medications.

Myth 4: There is no cure for epilepsy which has been ongoing for years and treated with multiple medications

Fact: There are alternative treatment modalities available for these patients, but they require careful screening by a trained medical team before surgical intervention can be considered.

Certain types of Epilepsy Syndromes, such as Mesial Temporal Sclerosis and Cortical Dysplasia, may be eligible for surgical treatment, offering the potential for remission.

This underscores the importance of thorough evaluation and specialized care when considering surgical options for epilepsy management.

Myth 5: One cannot lead a normal life with Epilepsy

Fact: Yes, it is entirely possible to lead a normal life with epilepsy. Epilepsy is simply a medical condition that requires specialized medical care, including drug treatment and prioritizing patient safety.

Many individuals with epilepsy have successfully built families and pursued fulfilling careers while effectively managing their condition. This highlights the importance of proper medical management and adherence to treatment plans in achieving a high quality of life despite epilepsy.

Here are some common practices to follow and avoid when dealing with seizures:

• It's crucial to inform your doctor about any changes in your seizure frequency.
• Ensure you get enough sleep, aiming for at least 8 hours each night.
• Avoid working late shifts or irregular work hours whenever possible.
• Adhere to your medication regimen diligently, taking your medications as prescribed.
• Always carry your "rescue medication," which your Neurologist may have recommended for use during significant seizures.
• Refrain from driving to prevent potential harm to yourself and others.
• Minimize or avoid alcohol consumption altogether.

Additionally, prioritize leading a healthy lifestyle by consuming nutritious meals, engaging in regular exercise, and practicing meditation. Remember, while epilepsy presents its challenges, it's essential to integrate it into your overall life in a positive and proactive manner.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.