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What Causes Epilepsy?
Question: Hi Doctor, Need your Advice and this is for my Wife who has recently identified with epilepsy.It happened on 10th August midnight.All of sudden she got saliva from mouth and vertigo and suddenly we have taken to hospital and they have identified nothing in CT scan and MRI report will be attached if possible here.She was discharged immediately on the same night after some small packet of liquid given to her like saline.next day we met the Neurologist at Kamineni XXXXXXX With the symptoms he said it is epilepsy initial level and she need to be on medications and he prescribed oxetol 300mg and Folic Acid for 3 months.Prescription will be attached if possible .By profession she is a dentist and before marriage she is doing her practice and after marriage she has taken some temporary brake.Now iam coming to my main question where i need a brief suggestion and advises from your end so i can take good care of her.
1) What would be the length of this medication to be continued? will it be life long?
2) Any side effects ?she is 27 years old and we got married in last year only and now we are planning for a family so it is fine for pregnancy? or will there be any extra precautions or side effects? or any pros & cons?
3) Can she live a normal life as like earlier or she has to restrict her diet or stop going out or stop going for work or walking or gym etc?
4) What would be a prime reason for this epilepsy? Is the stress matters for epilepsy ?
5) Is this epilepsy is hereditarie?
please please answer all my queries....
1) What would be the length of this medication to be continued? will it be life long?
2) Any side effects ?she is 27 years old and we got married in last year only and now we are planning for a family so it is fine for pregnancy? or will there be any extra precautions or side effects? or any pros & cons?
3) Can she live a normal life as like earlier or she has to restrict her diet or stop going out or stop going for work or walking or gym etc?
4) What would be a prime reason for this epilepsy? Is the stress matters for epilepsy ?
5) Is this epilepsy is hereditarie?
please please answer all my queries....
Brief Answer:
As follows:
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Pointwise answers to your queries are-
1)Length of medications depend upon the follow-up and observation.In general,if there is a seizure free interval of 2.5-3 years on medications,then the antiepileptic medicines can be tapered and stop.If seizure occurs again after leaving medicines,in that case,medicines will have to be continued for long.To sum up,if seizures keep occurring after periodic intervals,medicines will continue for long(may be life long).
2)Common side effects of oxcerbazepine are-fatigue,ataxia,dizziness,headache,vertigo and hyponatremia(low sodium levels in blood).
Oxcarbazepine is category C pregnancy drug.That means,it should be given only if benefit outweighs risks.Main risk associated can be teratogenicity or fetal malformation.Folic acid will have to be taken along with the drug.Periodic ultrasound to detect fetal anomalies,will be needed.
This is a critical issue.Please discuss about the timing of your pregnancy,whether you want to delay pregnancy(till the time she is off anti-seizure medicines) or not?Your neurologist and obstetrician should be involved in the decision.
3)No,it is not an indication for routine life restrictions except for specific jobs like 'Driving'.Its just that you should be extra cautious and can move along with her,if possible.
4)Epilepsy do not need to have a cause necessarily.MRI is normal and no other apparent cause,so it is possibly idiopathic.Please upload EEG report,so that I can comment further about it.
5)Is there a family history of Epilepsy?Positive family history indicates hereditary epilepsy.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
As follows:
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Pointwise answers to your queries are-
1)Length of medications depend upon the follow-up and observation.In general,if there is a seizure free interval of 2.5-3 years on medications,then the antiepileptic medicines can be tapered and stop.If seizure occurs again after leaving medicines,in that case,medicines will have to be continued for long.To sum up,if seizures keep occurring after periodic intervals,medicines will continue for long(may be life long).
2)Common side effects of oxcerbazepine are-fatigue,ataxia,dizziness,headache,vertigo and hyponatremia(low sodium levels in blood).
Oxcarbazepine is category C pregnancy drug.That means,it should be given only if benefit outweighs risks.Main risk associated can be teratogenicity or fetal malformation.Folic acid will have to be taken along with the drug.Periodic ultrasound to detect fetal anomalies,will be needed.
This is a critical issue.Please discuss about the timing of your pregnancy,whether you want to delay pregnancy(till the time she is off anti-seizure medicines) or not?Your neurologist and obstetrician should be involved in the decision.
3)No,it is not an indication for routine life restrictions except for specific jobs like 'Driving'.Its just that you should be extra cautious and can move along with her,if possible.
4)Epilepsy do not need to have a cause necessarily.MRI is normal and no other apparent cause,so it is possibly idiopathic.Please upload EEG report,so that I can comment further about it.
5)Is there a family history of Epilepsy?Positive family history indicates hereditary epilepsy.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr XXXXXXX
When to Spoke to Dr XXXXXXX XXXXXXX (neurologist),the one who we spoken to on this he said you can opt for pregnancy he said he never heard any issues but u need to be careful for the first three months of the pregnancy.
Is this Epilepsy is caused by Stress ? Because why iam asking this question she feels this is because of stress.
as you advised she has to stop driving? you mean to say she cant touch either two or four wheeler right?
what you mean by "Main risk associated can be teratogenicity or fetal malformation"
what do you mean by ",so it is possibly idiopathic"
EEG is not done as they did only CT scan and MRI.please advise what is the need of EEG?so i can get this done immediately.
When to Spoke to Dr XXXXXXX XXXXXXX (neurologist),the one who we spoken to on this he said you can opt for pregnancy he said he never heard any issues but u need to be careful for the first three months of the pregnancy.
Is this Epilepsy is caused by Stress ? Because why iam asking this question she feels this is because of stress.
as you advised she has to stop driving? you mean to say she cant touch either two or four wheeler right?
what you mean by "Main risk associated can be teratogenicity or fetal malformation"
what do you mean by ",so it is possibly idiopathic"
EEG is not done as they did only CT scan and MRI.please advise what is the need of EEG?so i can get this done immediately.
Brief Answer:
As follows:
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
Here are pointwise answers to your queries:
1)I just said that the antiepileptic medicine can cause fetal abnormalities,which have more incidence in first three months.Obviously,you have to be cautious.However,I already mentioned that the drug has category C indication for Pregnancy.Its safety is not documented.Nobody can say that it is safe.
2)Stress may provoke a seizure sometimes but stress as the main causative factor,is unlikely.
3)Driving may be risky.If she gets a seizure during driving,she may meet an accident-that's the idea.
4)Teratogenicity means toxic effect of some drug causing functional or structural defects in the fetus.These fetal malformations may be spina bifida,cleft palate,cardiac abnormalities and hypospadias to name a few.
5)Any disease of unknown cause is called as 'Idiopathic'.Epilepsy can be just like that or idiopathic.
6)EEG may show abnormal electrical discharges,which can be characteristic for some specific kind of seizures,sometimes.Its better if you get it done.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
As follows:
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
Here are pointwise answers to your queries:
1)I just said that the antiepileptic medicine can cause fetal abnormalities,which have more incidence in first three months.Obviously,you have to be cautious.However,I already mentioned that the drug has category C indication for Pregnancy.Its safety is not documented.Nobody can say that it is safe.
2)Stress may provoke a seizure sometimes but stress as the main causative factor,is unlikely.
3)Driving may be risky.If she gets a seizure during driving,she may meet an accident-that's the idea.
4)Teratogenicity means toxic effect of some drug causing functional or structural defects in the fetus.These fetal malformations may be spina bifida,cleft palate,cardiac abnormalities and hypospadias to name a few.
5)Any disease of unknown cause is called as 'Idiopathic'.Epilepsy can be just like that or idiopathic.
6)EEG may show abnormal electrical discharges,which can be characteristic for some specific kind of seizures,sometimes.Its better if you get it done.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr XXXXXXX
Can he do physical activity like
Normal home work ?
Gym/Yoga?
Walking?
Travel ?
Occasional Parties?
are all these are not allowed?
Have you noticed or seen any such cases where these Epilepsy is completely treated in any patients? where post 2.5 yrs usage of medication the Epilepsy never came?
And my last question any extra care need to be taken or any precautions for her in daily life?
Regards
XXXXXXX Muntha
Can he do physical activity like
Normal home work ?
Gym/Yoga?
Walking?
Travel ?
Occasional Parties?
are all these are not allowed?
Have you noticed or seen any such cases where these Epilepsy is completely treated in any patients? where post 2.5 yrs usage of medication the Epilepsy never came?
And my last question any extra care need to be taken or any precautions for her in daily life?
Regards
XXXXXXX Muntha
Brief Answer:
No specific daily routine restrictions.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
No specific daily routine restrictions.
Normal walking,exercises(except weight bearing exercises,where there is risk for injury),yoga,travel,occasional parties-can be done.
Yes,there have been cases when after taking 2-3 years of antiepileptic medicines,seizures never came back.
Precautions-Be strict on medicines.Not to miss a dose.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
No specific daily routine restrictions.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
No specific daily routine restrictions.
Normal walking,exercises(except weight bearing exercises,where there is risk for injury),yoga,travel,occasional parties-can be done.
Yes,there have been cases when after taking 2-3 years of antiepileptic medicines,seizures never came back.
Precautions-Be strict on medicines.Not to miss a dose.
Hope that I have answered all your queries.If you have further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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