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| Sunday, 4 July 2004 |
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Features |  |
| News Business Features Editorial
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Tomorrow is National Epilepsy Day : Epilepsy and women Epilepsy is a most common treatable neurological disorder in pregnant women. Yet 90 per cent of pregnant women with epilepsy give birth to normal babies.
For this year's Epilepsy Day and Awareness Week the chosen theme is "Women and Epilepsy". This was chosen to highlight the important role women play in the management of epilepsy. Women form the nucleus of the home and the family. They face unique challenges as a result of epilepsy. It not only affects their own life, but has a significant bearing on their family. Epilepsy can affect all aspects of their life starting from their adolescence, and during marriage and pregnancy. Women have an important role as mothers, teachers and even as health professionals to alleviate the social stigma surrounding epilepsy. There are many problems that epileptic women face during marriage. They often find it difficult to obtain a partner for marriage due to the myths and misconceptions surrounding epilepsy. Ideally the partner should be informed about epilepsy before marriage. A doctor's assistance can be sought to explain the facts and clarify any issues. Epilepsy is a common neurological disorder in pregnant women. Most pregnancies are routine and most of the babies delivered are healthy. Epileptic patients with child bearing potential require special attention and care before, during and after pregnancy. However, pregnancy is often inappropriately discouraged by all concerned, including healthcare providers, due to myths and misbeliefs. Epileptic women are encouraged to have a planned pregnancy. It is vital that they consult their doctor prior to considering pregnancy to see whether the anti-epileptic medication needs to be adjusted, changed or withdrawn. Patients should remember never to stop taking anti-epileptic drugs or change the dose of their medication without the advice of their doctor. All patients should commence taking folic acid supplementation, before conception and continue to do so during the pregnancy. This is important to help reduce the risk of congenital malformations, as a result of anti-epileptic drugs. It is important to note that more than 90 per cent of pregnant women with epilepsy, who are on anti-epileptic medications give birth to normal healthy babies. Patients need a better and close supervision of their seizures during the pregnancy. Good seizure control is vital to ensure healthy outcome of the pregnancy. Seizures during pregnancy can harm both the mother and the baby. For most women with epilepsy, staying on medication poses less of a risk to their own health and health of their babies, rather than discontinuing medication. Most women with epilepsy can breast feed normally. Certain precautions in parenting may need to be taken by women with uncontrolled seizures. Epileptic women face a multitude of problems when seeking employment. Finding and keeping a job is the biggest challenge. Due to myths and misconceptions, employers are discouraged from giving employment to epileptics. Epileptics themselves feel that they are unfit to work because of poor self-esteem. They usually end up being looked after by their families or given less responsible jobs. Only a few jobs are not recommended for epileptics. Precautions need to be taken when working with firearms, swimming and diving, driving vehicles and climbing heights. As a solution, epileptic children should be guided at a young age to pursue a suitable career. They should be encouraged to attend school regularly and be able to obtain job training and skills development to help seek employment. Vocational training centers would help epileptics to obtain the necessary training. It is also important to correct the negative attitudes of employers and co-workers by proper public awareness. Women working as teachers play an important role in the management of children with epilepsy. Since over 60 per cent of the first seizure in children occurs before primary school years, there is a large population of children who have their seizures during the school years. Therefore it is important for teachers to learn and educate themselves about epilepsy. They should promote epileptic children to attend school regularly and not to prevent them from coming to school. The help of the teacher is essential for epileptic children to reach their true potential. Children should be allowed to take part in most sports and other school programmes and activities. They should also educate the other children about epilepsy and first aid, help dispel the myths and misconceptions, and the social rejection they face. Epilepsy is not a contagious illness. It is usually not inherited unless it is a symptom of another inherited disorder. Epileptic women can marry, have normal children and do most jobs. Yet epileptics continuously face social stigma. We should do the utmost to reduce the stigma by raising public awareness regarding epilepsy. **** Symptoms of epilepsy
Frothing at the mouth Violent movements and stiffening of limbs (tonic and clonic movements) Passing urine and excreta involuntarily (at times) After an attack avoid... Breaking rest Remaining hungry or skipping meals Climbing trees, hills or heights such as a ladder Bathing or swimming in rivers, streams or tanks without protective care Bathing at or wandering around unprotected wells without protective care Wandering around high risk areas such as near fires, heights or where there are dangerous chemicals Children with epilepsy are a vulnerable group. If your child gets an epileptic fit here's what you should be...
Desist from poking fingers, spoons etc into the mouth If he does not recover within a few minutes remove him to hospital. Be vigilant and ensure that the prescribed medication is followed meticulously By detecting symptoms and referring the child for treatment as early as possible, impediments in the way of the child's mental development may be averted Make detailed notes in writing about the symptoms when epilepsy occurs in a child In most instances this disease can be cured or controlled by simple treatment. Courtesy: National Epilepsy Task Force ***** Epilepsy: The Lankan scenario Epilepsy is characterised by recurrent seizures due to a sudden excessive discharge of a group of neurons in the brain. Almost 90 per cent of epilepsy can be effectively treated with drugs. However, there is more to the management of epilepsy than drug treatment alone. Patients need physical, psychological and social support in addition. The majority of them can lead a normal and successful life. There is a deep-rooted stigma attached to Epilepsy. People with Epilepsy have been viewed with fear, suspicion and misunderstanding. They have been treated as outcasts and subjected to enormous social stigma. Hence most people with epilepsy do not come forward to take treatment and the disease remains shrouded in secrecy. The actual prevalence figures in Sri Lanka are not known. However, a study conducted by Sarvodaya in the Kandy district showed that 9/1000 people are affected, with approximately 250,000-300,000 being affected islandwide.Epilepsy affects people in areas of social interaction, marriage, education and employment. The social problems that surround Epilepsy have far and wide reaching consequences. Children with epilepsy have a very high school drop out rate in Sri Lanka. Only 25 per cent of children study upto GCE (O/L) because parents have very low expectations with regard to education in such children. They are reluctant to send their children to school due to the fear of seizures. Teachers also discourage the parents from sending the child to school. The prospects of obtaining employment are also significantly reduced due to social stigma and myths surrounding the disease. Most patients end up being cared for by their families. In many countries, people with epilepsy have been prevented from marrying or having children. This is due to false and baseless beliefs that epilepsy is an impediment to childbearing and successful marriage. These facts illustrate very clearly the grave but needless consequences of Epilepsy. Epilepsy care programme Developing a comprehensive Epilepsy Care programme has been a compelling need in our health care system. The Epilepsy Task Force was set up at the National Hospital of Sri Lanka to improve the care of epilepsy patients in this country. Several milestones have been achieved since the inception of the Epilepsy Task Force, namely: 1. Commencement of the first Tertiary Care Epilepsy Clinic at the National Hospital of Sri Lanka inaugurated on February 8, 2001 to provide a comprehensive service to the patients. 2. Epilepsy surgery has also commenced for the first time in this country. About 2-5 per cent of patients with medically refractive partial epilepsy would benefit from epilepsy surgery. It is a form of surgery that is carried out specifically to control epileptic seizures. *************** Medical update : Fruits ward off vision problems Eating fruit regularly earlier in life may help ward off macular degeneration, the leading cause of vision loss in older adults, a study said yesterday. But the report said there appeared to be no strong protective effect from vegetables, vitamins or carotenoids - the compounds that make some fruits and vegetables red, orange or yellow - as some earlier research had suggested. The study from Brigham and Women's Hospital in Boston looked at data from 77,562 women and 40,866 men who were followed for from 12 to 18 years as part of long-term studies tracking them for a variety of health issues. It found that both men and women who consumed three or more servings of unspecified fruit a day had a 36 per cent decreased risk of developing macular degeneration. "People are living longer, healthier lives and age-related illnesses, such as blindness, can significantly impact an otherwise healthy quality of life," said Eunyoung Cho, the study's lead author. *************** New guidelines to treat heart attacks Aggressive new guidelines have called for quick treatment of a common form of heart attack marked by chest pain and shortness of breath. The American Heart Association and American College of Cardiology issued the joint guidelines for treating ST elevation myocardial infarction or STEMI, a severe heart attack in which an artery is completely blocked. While heart attack patients may be unsure about their symptoms and wait to call an ambulance, every minute counts in this form of heart attack. The Heart Association said an estimated 500,000 Americans have a STEMI every year. "Treating this type of heart attack requires fast action, because if blood flow is not restored to the heart within 20 minutes, permanent damage will occur," Antman said. "Speedy treatment not only means the difference between life and death, but also between disability and a return to an active lifestyle after a heart attack. Researchers said that earlier guidelines were not always helpful to doctors trying to make fast decisions about treatment. One crucial decision is whether to open the blocked artery with a clotbusting drug or by using tiny flexible tubes called stents that prop open blocked arteries. The new guidelines, published in the journal Circulation and the Journal of the American College of Cardiology, distil this decision to four issues: How much time has passed since the onset of symptoms? How great is the risk of death? How great is the risk of bleeding in the brain if clot-busting drugs are used? How long will it take to get the patient into a cardiac catheterisation lab for stenting? The guidelines, found on the Internet also recommend that patients take aspirin and drugs called beta-blockers after a heart attack. It also strongly endorses the use of angiotensin-converting enzyme (ACE) inhibitors for all patients to improve heart function," Antman said. And all patients with low-density lipoprotein cholesterol or LDL of 100 or more should get cholesterol-lowering statin drugs, the guidelines say. (from Kuwait Times) *************** From a reader... How good is Nivithi for the silent disease? This is regarding the news article titled two million Lankan women afflicted with 'silent disease' published in Sunday Observer on June 6. It gives readers a brief account on Osteoporosis and how to prevent this 'silent disease.' However, the last sentence of the last paragraph which says eating green vegetable Nivithi would cause Calcium deficiency in human body is wrong. The Nivithi found in Sri Lankan markets is botanically known as Basella. (Family Basellaceae)and is also commonly known as Ceylon Spinach or Malabar Spinach. It is a good source of Protein, Niacin, Vitamin B6 and Phosphorus, and a very good source of Dietary Fiber, Vitamin A, Vitamin C, Thiamin, Riboflavin, Folate, Calcium, Iron, Magnesium, Potassium and Copper. There is another species of Spinach widely cultivated in America and Europe as a green vegetable and is botanically known as Spinacia Oleracea (Family Chenopodiaceae). Although this species is much lauded as a nutritional vegetable rich in Calcium, the rate of absorption of Calcium is almost nil due to the presence of oxalic acid in the plant. The oxalic acid binds Calcium into an insoluble salt (Calcium Oxalate), which cannot be absorbed by the body. So, this is the species they are referring in the article and we cannot find this species in Sri Lankan market (rarely in canned form in supermarkets) and is not called Nivithi. Therefore readers should not worry; it's very safe to eat the Nivithi we have in Sri Lanka. - Aruna Weerasooriya. |
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Fainting, losing consciousness and falling on the ground, sometimes
screaming.
When an epileptic seizure occurs, protect the child from injury,
placing him immediately on a flat surface and turn the head and the body
to a side. This will prevent suffocation.
