The care of the patient comprises social and psychological as well as pharmacological aspects.
Patients and their relatives and too many of the general public believe that epilepsy bears a stigma.
Many patients are more socially disabled by feelings of bitterness and aggression engendered by society's rejection than by their fits.
Simple, rational explanations of the nature and causes of seizures should be given.
•Restrictions should be kept to a necessary minimum.
Children, in particular, are often in danger of being overprotected by their parents until fits are well controlled.
It will not be recommended for children to cycle on public roads; nor should they swim alone at sea.
An epileptic child should be educated at a normal school unless there is an intellectual deficit.
• An adult should be guided into an occupation in which neither the patient nor the community is put at risk by a propensity to fits.
•Exposure to moving machinery and work at heights should be avoided.
The legal restrictions about driving should be explained to patients.
In Britain no one who has suffered from fits may drive a motor vehicle until free of attacks during waking hours for 3 years.
Continued treatment with anticonvulsants and the occurrence of nocturnal fits do not debar the patient from driving.
•Some patients have fits only during sleep, or when they have pyrexia.
Others recognize that certain sensory stimuli, such as flickering light or emotional disturbances trigger their seizures.
•During a fit the patient should be protected from injury.
It will rarely be possible to break the fall during a grand mal attack because the warning is too short.
•The patient should be moved away from fires and sharp and hard objects.
•A padded gag should be inserted between the teeth if this can be accomplished without force.
The incident should be treated with a minimum of fuss.
Embarrassment because of public attention is usually the most distressing aspect of a fit from the patient's viewpoint.
•Anticonvulsant drugs will usually be needed to control fits.
Phenytoin, phenobarbitone, primidone and carbamazepine are all effective in grand mal and focal epilepsy.
The dosage needs to be tailored to the individual needs and responses of patients.
Phenytoin and phenobarbitone have half-lives which are greater than twenty-four hours and can be given once daily.
Carbamazepine and primidone should be given in divided doses twice or thrice daily.
An average daily dose, for an adult, of phenytom is 200 to 400 mg and of phenobarbitone 60 to 120 mg daily.
Primidone is given in a dosage between 750 and 1500 mg daily and carbamazepine between 600 and 1800 mg daily.
Patients and their relatives and too many of the general public believe that epilepsy bears a stigma.
Many patients are more socially disabled by feelings of bitterness and aggression engendered by society's rejection than by their fits.
Simple, rational explanations of the nature and causes of seizures should be given.
•Restrictions should be kept to a necessary minimum.
Children, in particular, are often in danger of being overprotected by their parents until fits are well controlled.
It will not be recommended for children to cycle on public roads; nor should they swim alone at sea.
An epileptic child should be educated at a normal school unless there is an intellectual deficit.
• An adult should be guided into an occupation in which neither the patient nor the community is put at risk by a propensity to fits.
•Exposure to moving machinery and work at heights should be avoided.
The legal restrictions about driving should be explained to patients.
In Britain no one who has suffered from fits may drive a motor vehicle until free of attacks during waking hours for 3 years.
Continued treatment with anticonvulsants and the occurrence of nocturnal fits do not debar the patient from driving.
•Some patients have fits only during sleep, or when they have pyrexia.
Others recognize that certain sensory stimuli, such as flickering light or emotional disturbances trigger their seizures.
•During a fit the patient should be protected from injury.
It will rarely be possible to break the fall during a grand mal attack because the warning is too short.
•The patient should be moved away from fires and sharp and hard objects.
•A padded gag should be inserted between the teeth if this can be accomplished without force.
The incident should be treated with a minimum of fuss.
Embarrassment because of public attention is usually the most distressing aspect of a fit from the patient's viewpoint.
•Anticonvulsant drugs will usually be needed to control fits.
Phenytoin, phenobarbitone, primidone and carbamazepine are all effective in grand mal and focal epilepsy.
The dosage needs to be tailored to the individual needs and responses of patients.
Phenytoin and phenobarbitone have half-lives which are greater than twenty-four hours and can be given once daily.
Carbamazepine and primidone should be given in divided doses twice or thrice daily.
An average daily dose, for an adult, of phenytom is 200 to 400 mg and of phenobarbitone 60 to 120 mg daily.
Primidone is given in a dosage between 750 and 1500 mg daily and carbamazepine between 600 and 1800 mg daily.