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Epilepsy

Epilepsy - What it is

A person suffers from epilepsy when he/she has more than one episode of epileptic seizure.

A seizure is an abnormal electrical discharge of a group of brain cells. It can cause different symptoms, depending on the location of the seizure and the spread of the electrical activity through the brain.

Epilepsy - Symptoms

Types of seizure

There are 2 main types:

Focal Seizures
  • Affect one part of the body
  • Result in sensory, motor or visual disturbances
  • The patient may be conscious throughout but can also lose consciousness
Generalised Seizures
  • May start as a focal seizure and spread throughout the whole brain
  • Loss of consciousness usually lasting 30 seconds to 5 minutes
  • General muscle contraction
  • Violent rhythmic muscle relaxation and contraction lasting 1 to 2 minutes
  • Can cause tongue biting, incontinence and difficulty in breathing
Status Epilepticus Seizure
  • If a person experiences continuous seizures for more than 5 minutes; or on and off seizures without regaining consciousness in between, call 995 or go to the Emergency Department immediately. A status epilepticus is a medical emergency.
Triggers of Seizures
  • Skipping medications
  • Stress
  • Lack of sleep
  • Menstruation
  • Concurrent infection e.g. flu or fever

Epilepsy - How to prevent?

Reduce risk of seizures:
  • Take prescribed anti-epileptic medications
  • Get sufficient sleep
  • Learn to relax
  • Avoid over-consumption of alcohol
  • Seek early treatment  for illness  and fever
Prevent complications of seizures:
  • Avoid swimming alone in water levels above the chest or in the open sea
  • Avoid activities at heights without proper safety precautions
  • Avoid bathing in a bathtub
  • Avoid cooking alone or with open fire
Keep a seizure diary
  • To record the number of seizures
  • For your doctors to evaluate the effectiveness of medications and  titrate the medication

Epilepsy - Causes and Risk Factors

People with the following conditions can have epilepsy:
  • Brain injury
  • Brain infection
  • Brain tumour
  • Stroke
  • Genetic susceptibility
In approximately half the cases, a cause cannot be found.

Epilepsy - Diagnosis

Epilepsy is diagnosed based on the information of events that happened during the attack, obtained from the patient and/or observers of the events. The doctor may also order a few investigations:
  • Electroencephalogram (EEG)
This test is done to record the electrical activity of the brain and takes about 45 minutes to one hour. During the test, electrodes are attached to the patient’s head. The patient will also be asked to perform a few tasks to see if these activities cause epileptic seizures.
  • Brain Scans
    • Computerised Tomography (CT Scan)
This scan uses computerised X-ray technology to produce pictures of the brain and may reveal structural causes of seizures.
    • Magnetic Resonance Imaging (MRI)
This scan uses  a strong magnetic field, instead of X-rays. It is more sensitive in picking up subtle structural abnormality that could be the cause of epilepsy. People with metal implants are not suitable for this test because of the strong magnetic field.

Epilepsy - Treatments

  • Medical Treatment
Anti-epileptic medications are usually the first-line of treatment. There are many types of anti-epileptic medications available and a patient may be prescribed more than one type, depending on the type of seizure.
Side Effects of Medications

Common side effects include:
  • Sleepiness
  • Dizziness
  • Tiredness
Less common side effects include:
  • Hand tremor
  • Hair loss
  • Blurring of vision
  • Weight gain 

  • Surgical Treatment
Patients with focal seizures and are not responding to anti-epileptic medication might be suitable candidates for surgery depending on where their seizures originate. For patients without a clear cut resectable lesion, vagal nerve stimulation can be considered.

Epilepsy - Preparing for surgery

Epilepsy - Post-surgery care

Epilepsy - Other Information

What to do when someone is having a seizure?

DO
  • Remain calm
  • Protect the person from harm
  • Turn the person to the side
  • Observe the type and duration of seizure

DO NOT

  • Restrain the person unless there is danger
  • Put anything in the mouth
  • Crowd around the person
Epilepsy Support

The Singapore Epilepsy Foundation provides support for epilepsy patients and their caregivers, and increases public awareness  of epilepsy.

Contact: For more information, contact the Singapore Epilepsy Foundation at (65) 6334 4302 or visit www.epilepsy.com.sg
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The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

Information provided by Singhealth

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