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Dr. Debasmita Dey

Living with epilepsy is a curse. The patient never knows when he will have the next attack. If he happens to be near fire, water or working at a height at the moment he starts to throw seizures it might cost him his life. Left untreated, it causes extensive brain damage. Today’s blog is a general overview of this dangerous disease and its treatment.

What causes epilepsy
The human brain is a complex network of nerve circuits that fire at specific intervals. These circuits work in perfect synchrony to maintain normal brain functioning. However, sometimes they may go awry and fire in a frenzy. Such faulty brain circuits cause abnormal activation of various brain regions, resulting in seizures. A series of such recurrent seizures is called epilepsy.

How epilepsy presents
Our idea of epilepsy is a person thrashing his/her limbs about violently, frothing from the mouth, with up rolling eyeballs and clenched teeth. While that is not incorrect, it is important to understand that epilepsy has many faces. This classic manifestation of a seizure is not always present. Sometimes the patient may just lose consciousness and fall down. Children often have recurrent spells of apparent absent-mindedness when they simply ‘phase out’, not responding to being called. They cannot recall these episodes, which last a few seconds, later. Naturally they do not remember what happened during those spells, resulting in poor academic performance. At other times, the patient simply notices a loss of sensation or movement or an abnormal sensation in a specific body part.

Sequel of epilepsy
If an ongoing attack of epilepsy is not rapidly controlled, it might cost the patient his/her life. Left untreated, over long time, it causes extensive brain damage. The patient’s intelligence is compromised. He/she may develop mental disorders. Therefore, it is absolutely mandatory to treat epilepsy as early as possible.

Management of Epilepsy


  • The patient is not to be left alone near fire, sharp objects, waterbodies or at heights. An epileptic attack may occur anytime, causing death.
  • Not a single dose of medication should be skipped. Even a single missed dose may precipitate an attack of epilepsy.
  • If travelling alone, the patient should always carry an identity card with contact number of a family member


  • Tests like imaging of the brain, Electroencephalogram and several blood investigations are usually necessary for proper management. The time and type of investigation is based on the doctor’s clinical judgement.


  • Antiepileptic drugs are prescribed to control seizures. The dose is titrated upwards till the seizures are controlled or the patient experiences unacceptable adverse effects. Periodically, blood investigations are done to check the blood levels of the drug and also to check for adverse effects. It is important to note that antiepileptics are prescribed for quite a long time, sometimes lifelong. If discontinued without the doctor’s consent, there is risk of relapse of seizures.

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