An interview with Dr. Githanjana Mendis MBBS, MD, FRCP (Eng.) Consultant Neurologist

by Zanita Careem
Epilepsy which is also known as seizures occurs worldwide affecting about 50 million people. In Sri Lanka, the incidence is about 6% of the population and this condition can be controlled enabling the victims to lead a normal life.

What is the age group — more common among the young, specially children.

It is also known as Idiopathic that is epilepsy without a cause. It can happen in adults and in old age group it is less common.

What are the causes?

85% of the time no causes. Epilepsy without a cause is known as Idiopathy, common among children. It is sometimes infectious. The causes are high fever, trauma to the head, therefore scan in the brain, kidney failure, low calcium level and rarely tumors.

Trauma could occur with accidents, blast injuries etc. Usually this occurs above the age of 45 years. 10% of the patients with fits suffer due to tumors.

What are the types of epilepsy.

1) Generalised Epilepsy (known as grandmal)

2) Partial Epilepsy (Patimas)

(A) Myoclonic jerks

(B) Absence attacks

(C) Fits affecting arm or leg.

Types of Epilepsy in details.

1) General Epilepsy — Every family usually has one case of epilepsy. Most common form here is loss of consciousness preceded by aura, it means flashing of lights, feeling unwell and then followed by convulsions that is a fit which lasts about 3 to 4 minutes followed by frothing, tongue biting, passing of urine and foam. Complete recovery is possible, but sometimes one can endure headaches, giddiness and injuries due to the fit.

2) Partial Epilepsy — This is where only one part of the body is involved with no loss of consciousness.

(A) Myoclonic jerks — Sudden jerking of the body which lasts for a few seconds, common in children.

(B) Absence attacks — Here the patient looks at an angle and just waits without any gestures.

(C) Fits affecting one part of the body — This can convert into a generalised epilepsy.

What is the management? First investigations EEG (Electro Encephalo Gram) is the most important tool of investigation. Most of the time this investigation will show evidence of a fit, its causes but sometimes the investigations could be negative. Whenever the need arises blood tests have to be done. CT or MRI scan has to be done to exclude tumor. In required patients a skull x-ray could help in the absence of a brain scan.

Now a days very effective medicines are available to control Epilepsy. It is important to undergo a two or five years of treatment regime. Monotherapy that is single medicine (that is one medicine) is preferable to polytherapy. Rarely surgery is needed to remove scans infective lesions and tumors.

What is the social aspect of Epilepsy. People after an attack of epilepsy should lead a normal life without being cornered by society.

A child affected by Epilepsy can have normal education, take part in sports, but swimming is prohibited. He or she can have a good normal education, can enter a vocation, have a normal married life like others and have children.

To have full control of epilepsy medication is necessary.