Epilepsy Health Corner Page 2

Epilepsy and Seizure First Aid.

Guidelines for Seizure and Epilepsy

Living and Managing with Epilepsy.

Driving, Workplace and Pregnancy.

Epilepsy and Seizure First Aid  

First aid is an essential part of life and every person should know it for their own good. Knowing how to help someone during and after an epileptic seizure may help you, and then, feel more confident if a seizure happens. First aid for epilepsy is basically very simple. It keeps the person safe until the seizure stops naturally by itself. It is important for the public to know how to respond to all seizures, including the most noticeable kind which is the generalized onset seizure. Helping a person in an epileptic seizure may depend on the type of seizure he/she has. Most seizures last less than three minutes, so by the time an emergency medication is ready to be administered, chances are the seizure is over. The most important thing to do during a seizure is to stay calm and protect the person experiencing the seizure. People administering first aid for seizures should roll the person to his or her side to prevent choking, remove sharp objects that the person might hit during the seizure, and loosen any tight clothing around the neck. Do not put anything in the person's mouth -- not even medicine or liquid. Sometimes, an ambulance will need to be called, such as if the person having the seizure is pregnant or has diabetes, or if the seizure lasts for more than five minutes.

First Aid Tips.

If you see someone having a seizure with convulsions or loss of consciousness, here's how you can help:

  • Roll to the side to prevent choking on any fluids or vomit.
  • Cushion the head.
  • Loosen any tight clothing around the neck.
  • Keep the person's airway open. If necessary, grip the jaw gently and tilt the head back.
  • Remove any sharp or solid objects that might be hit during the seizure.
  • Stay until the seizure ends.
  • Don't shake the person or shout.
  • Do not restrict the person from moving, unless in danger.
  • Do not put anything into mouth, not even medicine or liquid. These can cause choking or damage to the jaw, tongue, or teeth. Contrary to widespread belief, people cannot swallow their tongues during a seizure or any other time.
  • Note how long the seizure lasts and what symptoms occurred so you can tell a doctor or emergency personnel if necessary.

When to Call for help?

Call for emergency assistance if:

  • The person is pregnant or has diabetes.
  • The seizure happened in water.
  • The seizure lasts longer than five minutes.
  • An injury caused by the seizure.
  • The person does not begin breathing again or does not return to consciousness after the seizure stops.
  • Another seizure starts before regaining consciousness.

After the Seizure

After the seizure ends, the person will probably be groggy, tired and may has a headache or be confused and embarrassed.
Be patient, and try finding a place to rest him/her if being tired or doesn't feel well. If necessary, offer to call a taxi, a friend, or a relative to help getting home safely. If you see someone having a non-convulsive seizure, remember that the person's behavior is not intentional (like wandering aimlessly or making alarming or unusual gestures).

Living and Managing with Epilepsy  

Epilepsy and Driving.

The laws in many countries all over the world prevent people with active seizures from obtaining driving license. The golden rule here for people who drive and having a seizure is that they have to stop driving. This is true for all types of seizures whether you have had a diagnosis of epilepsy or not. A person with a seizure disorder that causes lapses in consciousness may be putting the public at risk if they are driving. Not only can a seizure itself causes an accident, but anticonvulsants often have side effects that include drowsiness. People with epilepsy are more likely to be involved in a traffic accident than people who do not have the condition, although reports range from minimally more likely up to seven times more likely. It is for this reason that most people diagnosed with epilepsy are prohibited or restricted by their local laws from operating vehicles. However, most places have exceptions built into their laws for those who can prove that they have stabilized their condition. In general, the risk of having a seizure-related traffic accident is greatly reduced in people who have been seizure-free for 12 months. Driving may be safe for some people with epilepsy after a shorter seizure-free period, depending on individual circumstances. People who always have an aura before a seizure begins are also at reduced risk; the aura acts as a warning, which may give a driver time to pull over before the seizure begins. Not taking antiepileptic medication as prescribed (missing a dose, for instance) increases the risk of having an accident, so it is especially important for people with epilepsy who choose to drive to take their medication correctly and on the proper schedule.
Some countries prohibit people who have ever had a seizure from driving. In these countries, it is common for people with epilepsy to hide their condition from authorities in order to not be denied a driver's license. Other places allow those who have had seizures to drive after a seizure-free period, which ranges from months to years. It is extremely a person’s responsibility to inform the local authorities about his/her medical condition before applying and obtaining a drivers license. For more details about law and applicability to drive and obtaining a driving license, please contact your local authorities.

Driving is a privilege that carries serious responsibility with it. You can help protect yourself and others as follows:

  • If your doctor changes your medicine, don't drive until you know how the change is going to affect you.
  • Don't drive if your seizure control isn't good enough to get a license, or if you start having seizures again after getting a license.
  • If you have a seizure, don't drive yourself to the doctor's office afterwards. If you need medical attention, call a friend or take other transportation.
  • Follow the rules regulating driving with epilepsy.

Once you are seizure-free for a defined period, seek medical advice to determine your eligibility for driving  

Epilepsy and Pregnancy

You should know that most women with epilepsy who have children give birth to normal and healthy babies. In fact, chances of having a healthy child are great. Experts say that you shouldn't let the fact that you have epilepsy discourage you from trying to have a family. But, there is a slightly higher risk of having a baby with a birth defect or developmental problem, or a harm coming to a baby if you have a serious seizure whilst pregnant or due to medication, so it's important to get the right support. Years ago, women who had epilepsy were often discouraged from getting pregnant. Today, that's no longer the case.

Women with epilepsy who are thinking of having children need to know about the genetics of epilepsy; the effects of pregnancy on the medical management of seizures; the effects of seizures and medication on the developing fetus; and the planned management of seizures during labour and after birth. If you find out you're pregnant, don't stop taking your anti-epilepsy medicine until you've spoken with your doctor or specialist.
Women with epilepsy taking certain anti-epileptic drugs (AEDs) may experience failure of hormonal birth control methods. Some of the medications may lower concentrations of estrogen, thus reducing effectiveness of the hormonal contraceptive.

Researches have indicated that women with epilepsy have a higher incidence of menstrual irregularities, polycystic ovarian disease and reproductive endocrine disorders. Any of these may cause a reduce in fertility.
According to an article on ncbi-nlm, published by Dove Medical Press Limited, Menstrual disturbances were present in 28.8% of studied women with epilepsy. Increased prevalence of menstrual abnormalities was associated with epilepsy itself (younger age at onset of epilepsy) and its treatment (ongoing use of clonazepam), as well as with chronic use of medications other than AEDs.

Breastfeeding: for most women taking antiepilepsy medicines is generally safe. For further details and information, you may contact your doctor.
What are the risks that your child will also have epilepsy?......In general, the probability is low that a child born to a parent with epilepsy will also have epilepsy. However, it can partly depend on your family history, as some types of epilepsy run in families. Therefore, genetic counselling may be an option to consider if you or your partner has epilepsy and also a family history of epilepsy.

Does epilepsy make it more difficult to conceive?.......Some women who have epilepsy have menstrual irregularities and other gynecological problems that may make it harder to conceive. Medication may be an issue as well. Some drugs used to treat seizures may contribute to infertility.
Specific problems which may affect infants: Babies born to mothers with epilepsy face a host of specific problems such as: Malformation, Development delay, Hereditary epilepsy, Infant mortality, Neonatal internal hemorrhaging, Low birth weight.

Epilepsy and Workplace

Epilepsy affects people in different ways, therefore people with epilepsy can be found in most occupations, with or without reasonable adjustment. However, there are some jobs which, for health and safety reasons, may not be suitable for a person who is still having seizures, and medical advice should be sought on whether it is safe for the individual to undertake these duties. These include:

  • At unprotected heights.
  • Near open water.
  • With high voltage or open circuit electricity.
  • With unguarded apparatus or machines.
  • On or near moving vehicles.
  • With chemicals, unguarded fires, ovens & hot plates.
  • On isolated sites and places.
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