Epilepsy is a neurological disorder that can alter certain aspects of daily life, but in most cases it does not represent an impediment to maintaining a routine. Isabel Manzanares, nurse Hospital Clinic Barcelonaexplains that “a person with epilepsy can lead a perfectly normal lifestyle, always depending on the seizures they have and their frequency.” Currently, around 50 million people in the world live with this disease, adapting to it in different ways. However, with appropriate treatment and following the recommendations of health professionals, it is possible to control it and reduce its impact on daily life.
Epilepsy is a disorder caused by an alteration in the electrical activity of the brain, which causes sudden and transient symptoms in perception, behavior and mobility. These manifestations, known as epileptic seizures, can include a wide variety of symptoms. During a crisis, the patient may experience fear, nausea, tingling, and the perception of abnormal lights, colors, shapes, smells, and sounds. Automation, rigidity, muscle twitching, seizures, confusion, and speech problems may also appear. In some cases, the crisis ends with the loss of knowledge.
With medical treatment, seizures are adequately controlled in 70% of patients.
When the diagnosis of epilepsy is confirmed, it is essential to start personalized treatment that guarantees a favorable prognosis. This treatment begins with the adoption of healthy lifestyle habitssuch as limiting the consumption of alcohol and energy drinks, practicing regular physical exercise and maintaining a sleep schedule of between 7 and 9 hours a day. Epilepsy can also generate a significant psychological and social impact, promoting passivity and low self-esteem. To manage these consequences, which are often disabling, psychological intervention can be of great help.
Pharmacological treatment is key to controlling epileptic seizures. “With medical treatment, seizures are adequately controlled in 70% of patients,” says Dr. Mar Carreño, neurologist at Hospital Clínic Barcelona. The choice of antiepileptic drug, or the combination of several, will depend on the type of seizure and the characteristics of each patient. If the seizures cannot be controlled with drugs, it is considered drug-resistant epilepsy and it is evaluated whether the patient is a candidate for surgical treatments, such as removal of the brain area where the seizures originate, or for new therapies, such as thermocoagulation, thermotherapy or neurostimulation.
Sometimes, patients themselves can sense that a crisis is going to occur. Fran Gil, a neurologist at Hospital Clínic Barcelona, points out that this is essential, especially for diagnosis: “It is important to describe if there are any symptoms that announce that a crisis is coming.” However, in most cases, crises are unpredictable. Therefore, both the patient and those around him must know how to act to minimize the risks. The most important thing is to remain calm, reassure the patient and make sure they are comfortable, as well as remove dangerous objects that are nearby. The patient should not be restrained tightly, as this could cause injury and increase confusion and agitation.
In the diagnosis it is important to describe if there are any symptoms that announce that a crisis is coming.
Another fundamental issue when accompanying a person with an epileptic seizure is to pay attention to the duration: time it from the beginning to the end, write down how long it took the person to recover and ask for help if it lasts longer than usual. It is also important to monitor your breathing. If the person is lying down, placing them on their side will help make breathing easier and prevent saliva from collecting in the mouth or airways. During a seizure, it is normal for the patient to stop breathing momentarily due to muscle contraction, but breathing is restored once this phase ends. Under no circumstances should water, food or medication be offered until the person is completely recovered.
The risk of experiencing new seizures is significantly higher when their origin is related to a structural brain injury or genetic causes, compared to seizures caused by external factors. Although there may be acute complications, they are not very common. Chronic cognitive or behavioral effects are also rare, although in cases of severe epilepsy focal alterations may arise, such as selective deficits in visual or verbal memory, as well as anxiety and depression. However, these cases can be prevented by following appropriate treatment and recommendations from health professionals. In fact, between 60% and 80% of patients remain seizure-free for five years.
When to call the emergency room?
In the following situations:
1
If the crisis lasts 5 minutes or more.
2
If the crises are repeated without the person regaining consciousness between them.
3
If the attacks are more frequent than usual.
4
If the person is not breathing well or shows signs of suffocation.
5
If the crisis occurs in the water.
6
If the person is injured during the crisis.
7
If it is the first crisis that person has had.
8
If the patient himself requests medical attention.
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