EPILEPSY

Pateint ID : Patient ID- 3244/ 46 Years/ Male

Address : Mathura/ Uttar Pradesh/ India./ Mathura/ Uttar Pradesh/ India/ 281001

Occupation : Government Employee

Patient Category : New

Patient Presentation : Patient and his wife visited Dr. Sohan Lal Clinic as he was diagnosed of having epileptic fits for the past 5 years. His wife informed that he had the last fit 10 days ago and gave the details of the fit. They are referred by one of our happy patient.

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Chief Complaints : There is altered consciousness at the onset and may be associated with an epileptic cry. Fit starts simultaneously with generalised tonic state which lasts for few seconds to minutes. Patient is unconscious and is cyanosed, does not breathe and pupils are dilated. Heart rate changes and may even stop. This is followed by clonic state, where rhythmic jerks appear, and lasts for one to few minutes. Tongue may be bitten and urinary or bowel incontinence may occur. This is followed by post-ictal phase where patient passes off into sleepy state and has headache and vomiting. At initial few minutes he is not arousable and is totally flaccid. On gradual recovery he may be confused and show automatic behavior. Whole phase may last from few minutes to 1-2 hours.

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Family History : NIL

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Treatment History : Patient is not satisfied with his previous treatment.

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Dr. Anand Kumar gave a proper explanation regarding epilepsy to remove the stigma associated with the disease. He advised the patient to take the following general precautions-

1-Adopt an occupation at which neither the patient nor the society is put to risk.

2-Avoid exposure to moving machinery and working at heights.

3-Driving only as per regulations (free of attacks for 2 years during waking hours)

4-Adequate sleep.

5-Avoid hyperpyrexia, flickering lights, and emotional disturbances.

Dr. Anand Kumar advised that during a fit-

1-Protect from injury by moving the patient away from fire, sharp and hard objects.

2-Padded gag inserted within teeth.

Follow up 1-Dr. Anand Kumar informs the patient that in majority of cases, epilepsy is idiopathic and the cause is unknown. There maybe a positive family history, onset is in childhood and has a genetic background.

Follow up 2- There is no epileptic fit and the patient is advised not to travel alone.

Follow up 3-Patient suffers a moderate fit in his house and his wife gives the details of the fit. He is unconscious followed by rhythmic jerks. He passes off into sleepy state and has headache and vomiting. He is not arousable and was flaccid. On recovery he was confused. Whole phase lasted for 30 minutes. His wife put a padded gag within teeth and protected him from injury during the fit.

Follow up 4-There is no epileptic fit for 3 months. Patient is asked to strictly follow the general precautions advised above.

Follow up 5-Patient informs that he can sense that he is going to get a fit as he gets irritable and aggressive before the fit. He tries to send an alarm to his wife.

Follow up 6-There is no epileptic fit for 6 months. Patient is asked to regularly continue the medicines.

Follow up 7-There is no epileptic fit for the past 1 year. Patient is happy and satisfied.

Follow up 8-There is no epileptic fit for the past 2 years. Patient is responding well to his treatment.

Follow up 9-Dr. Anand kumar informed the patient that antiepileptic therapy can gradually be withdrawn, if he is totally seizure free for 3 to 5 years depending on the seizure type, age, and previous seizure control.

Follow up 10-Patient is seizure free and very happy with his treatment.

 

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Result : Patient achieved remarkable recovery. We have many patients who are leading a seizure free life by our treatment.;

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