As a GP, I will see many patients with epilepsy throughout my career. Given that there are about 500,000 people with epilepsy in the UK, about 1 in 100 will be affected by this condition, most GPs like myself will have about 12 or more patients on their medical list. It’s important therefore, for GPs to have a good level of knowledge about this not uncommon condition, and that patients themselves know that the GP is in a position to advise and support them.
As GPs we will have people of many different ages living with epilepsy as it usually starts in childhood, but can affect people of all ages for different reasons. The GP is also expertly placed to advise patients about self-care and living the kind of lifestyle that will help to control their symptoms manage their condition to an optimal degree and ensure that they can still enjoy an excellent quality of life. When the diagnosis is first made, it can be daunting for the individual and for their family. Many myths abound concerning epilepsy but with a good degree of knowledge, good control of symptoms can usually be achieved.
What is Epilepsy?
This is a condition that affects the brain and its electrical activity. When electrical signals are disrupted, it can have far-reaching effects on the rest of the body, resulting in repeated seizures. It occurs in many different forms ranging from a trance-like state lasting just a few seconds right through to loss of consciousness following convulsions lasting for many minutes. Sometimes just a small area of the brain is involved, in which case the seizures may be partial, or larger areas of the brain can be affected in which case the seizures may be generalised.
Often, there may be some degree of brain damage responsible for the condition, and the damage may be obvious, such as following a serious head injury, following meningitis or encephalitis or a brain tumour. In other instances there may be only minimal damage which is not visible on tests but there is an association with other conditions such as learning difficulties. In many cases however, no cause is identifiable in which case the epilepsy is known as idiopathic.
It’s important to understand that anybody can have one seizure during the course of their lifetime for a variety of reasons but this does not constitute epilepsy. Epilepsy is where seizures are repeated and require treatment. The diagnosis is often suggestive from the description of the first few seizures. An electro-encaphalogram and a scan may sometimes throw further light on the underlying problem and confirm the condition clearly. It’s important to reach an accurate diagnosis as many different conditions can produce similar symptoms to epilepsy, although the treatment needs to be tailored to the individual and a precise underlying diagnosis.
Treatment is vital in order to control seizures. The medicines used are called anti-epileptic drugs or AEDs and in 70% of cases, these are successful in managing the epilepsy and allowing the individual to lead an otherwise normal healthy life. Often, the type of medication and the dosage may need to be adjusted to achieve optimal results.
Living with the Condition
The vast majority of people lead normal, satisfying fulfilling lives to the full. An important aspect of self-care is leading a healthy lifestyle which involves plenty of regular exercise, a healthy well-balanced diet, and the avoidance of excess alcohol or exposure to other recreational substances. Considerations may need to be given to activities such as driving, taking the contraceptive pill and pregnancy, but your GP, your hospital specialist and epilepsy support groups can play a fantastic role in advising and supporting people with this condition.
Alarms and Sensors
Furthermore, new technological developments such as Telecare24’s new Epilepsy Alarms website together with the special Epi-Care epilepsy sensor which it offers can provide peace of mind and extra support.
Knowing what the triggers are and how to avoid them is key and sometimes keeping a diary to this effect is a good idea. It’s important to take the medication prescribed exactly as directed for best effect, and a regular review by the GP or the specialist is vital. There is no reason why people diagnosed with epilepsy and treated to the optimum and under regular review with help from friends and family should not be able to live entirely normal and happy lives.
There are many charities that offer fantastic support to people of all ages who have epilepsy. Here are a few helpful links.
Epilepsy Action – This is the working name of the British Epilepsy Association. The website has lots of advice and information on the condition. They also have a network of local groups where you can find support and get involved with raising awareness. They also have a helpline on 0808 800 5050 or email them on [email protected].
Young Epilepsy – Established in 1897, Young Epilepsy aims to provide advice, support and help for young people so they reach their full potential. They also offer specialist education at their St piers School and college for young people with neurological conditions. Young Epilepsy also offers Rehabilitation Services. You can contact them on 01342 832243 or via [email protected].
Epilepsy Society – This is the working name for The National Society for Epilepsy. The Epilepsy Society are a powerful voice in the community and are involved in medical research as well as providing a range of medical and care services for patients and their families. You can speak to them on 01494 601400.