KARACHI: Change in lifestyle for epileptics suggested
KARACHI, April 27: Epilepsy, a life-long condition for patients, may not be curable but could be effectively managed through extremely cautious approach on part of doctors prescribing drugs. This was stated by John Hopkins University’s Epilepsy Control Programme Director Dr Fauzia Siddiqui while giving her presentation on “Advances in epilepsy management”, at PMA House here on Wednesday.
Underscoring the need for main focus on improved quality of life, she warned of every possibility that patients had more seizures with increased medication due to the increase in toxicity.
Reminding that there are no less than 20 different anti-epileptic drugs besides several formulations available across the globe to treat epilepsy, she mentioned that none of these could cure epilepsy but decrease the frequency and severity of seizure.
Calling upon doctors that their goal must be to maximize life quality of the patient, she said overall strategy should be “monotherapy”. Highlighting the importance of life style modifications, which have extreme relevance in the management of the epilepsy, she enumerated adequate sleep, avoidance of alcohol and stimulants, stress reduction and good, proper diet as factors that could help in improving life quality of the individual suffering from the condition.
According to her, efficacy of all drugs is almost the same and difference could only be in terms of side effects.
At the very onset of her presentation, she reminded that despite all medical advances epilepsy remained a clinical diagnosis and obtaining of eyewitness account is critical adding that since history is also important a doctor must be at least 98 per cent sure of what they have as history.
It is only when concerned health care provider may not be sure about the available information that he or she may resort to available tests as CT, MRI, SPECT, PET (two of the last are rarely available in Pakistan). “Tests are to help us confirm our diagnosis and not to give the diagnosis,” she reiterated.
Elaborating the stance, Dr Fauzia said that there could be two different instances; a person might have abnormal EEG but no seizure while another could have seizures but normal EEG. In such cases, a neurologist could go forward with other tests to assess and conform what actually may be causing seizure, she recommended.
According to her, the EEG is almost 100 per cent accurate in assessing “absence seizure” which occurs primarily in children.
Referring to absolutely no diagnosis or inadequate diagnosis coupled with inappropriate management of the condition, Dr Fauzia Siddiqui mentioned that incidence of sudden death was much common in epileptic population than in general population - mostly in untreated epileptics.
Quoting WHO estimates that epilepsy causes an economic burden of US$12.5 billion, she strongly recommended provision for proper diagnosis, education, addressing psycho-social issues and lifestyle modifications.
The presentation was followed by a question and answer session. Interesting queries were raised by the audience including senior family physician, Dr Aziz Khan Tank.
PMA Karachi General Secretary Dr Qaiser Sajjad offered vote of thanks at the end. —APP
