How to remove the diagnosis of epilepsy

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How to remove the diagnosis of epilepsy

The opinions of specialists, advice and recommendations for overcoming possible problems and the conditions necessary to achieve the removal of the diagnosis of epilepsy. An attack of the disease suddenly overtakes the patient right on the street, at a bus stop, in the bus or trolleybus itself. He gets convulsions. He loses consciousness, falls, has convulsions. Foam comes out of the mouth. 

 What is called epilepsy

Many of us have seen this. An attack of the disease suddenly overtakes the patient right on the street, at a bus stop, in the bus or trolleybus itself. He gets convulsions. He loses consciousness, falls, has convulsions. Foam comes out of the mouth. And then, as the doctors recommend, it is necessary to put it so that the tongue does not close the larynx and the patient can breathe freely.

This is one of the most severe symptoms of epilepsy, due to the possibility of which there is a whole list of serious restrictions when making such a diagnosis.

They must prevent the severe consequences of an attack both for the patient and for others. This, for example, a ban on driving vehicles, possession and use of weapons. It is almost impossible to predict at what moment a seizure will begin in a driver behind the wheel.

Although there may be precursors before a seizure attack – lack of appetite, headache, weakness throughout the body. Each patient has his own characteristics of the course of the disease, associated both with his body and with the type of disease, suggesting timely, competent and professional treatment.

Types of epilepsy 

But the very diagnosis of epilepsy, according to doctors, is a serious problem, in which errors are quite possible due to many factors that can cause the disease.

The reasons are divided into congenital (hereditary) and acquired. For example, brain injury or long-term alcohol poisoning. The ways of fighting the disease and its result depend on these reasons. For example, medicine officially recognizes that the signs of epilepsy, discovered in infancy, with proper, competent treatment, can be completely cured by adulthood.

Over the years, a convenient practice has emerged in Russia to diagnose “epilepsy” for any unusual convulsions. On the one hand, such a diagnosis turns out to be convenient (they will not be taken into the army), but on the other hand, it imposes many unpleasant restrictions on the choice of a profession, driving a car, etc.  

And then it turns out that the fact of the recovery of epileptics has not been fully clarified in the special literature. There are many discussions on this topic and different, sometimes opposite opinions. Although the disease is not officially recognized as incurable. Under such circumstances, the concept of remission arises, a condition when, after effective treatment, the patient has no seizures for more than two years. The possibility of a breakdown of remission – a relapse of the disease with confirmation of an electroencephalogram is also actively discussed. 

Conditions for changing the diagnosis of epilepsy 

Theoretically, preparation for the removal of the diagnosis of epilepsy begins after five years, during which there were no classic painful symptoms. Including, with the normalization of the electroencephalogram. Then, gradually and under the supervision of a doctor, drug therapy is canceled. And if, at the same time, the signs of the disease do not return – neither seizures, nor psychosis, nor personality changes, then the doctor’s sentence must be removed.

But real practice in life often differs from theoretical principles. Basically, it depends on the position of the attending physician, who for so long had another reason to postpone the issuance of a document on full recovery for an indefinite time . This decision of the special commission of the International Antiepileptic League was published in 2014. Thus, in addition to the concept of the presence of a disease in the phase of remission or the patient’s recovery, a new term was introduced – “the resolution phase”. This is not a complete absence of the disease, but a statement of the success of the treatments undertaken. Although the risk that seizures will return is still greater than in completely healthy people. It turns out that even if epilepsy is no longer there, there is no guarantee that it cannot return. At the same time, the risk of returning decreases every year, and after 10 years it is minimal. 

All this information must be taken into account by the doctor or medical commission, which has to make a decision.

Peculiarities of making a decision to withdraw the diagnosis of “epilepsy” 

In the peculiarities of making a decision about a complete recovery, very contradictory information is found. From the belief in the complete impossibility of removing a medical verdict, if you have had at least two attacks in your life, to tried-and-tested options for proving recovery in court.

“There is nothing unrealistic in the desire to get rid of the diagnosis of epilepsy,” say the doctors of one of the professional forums, “especially if the documents confirming the normal state of health have been collected.” After all, it happens that epilepsy is diagnosed when it comes only to seizures. Then it becomes an inconvenient label.

According to professionals, any document can be refuted or canceled if no symptoms of epileptic activity, including seizures, fainting, and others, have happened for 8-10 years and the neurological status is normal. In addition, it is required to examine the fundus, do magnetic resonance imaging (MRI) of the brain, X-ray in two projections, and several other typical studies. If the results are in order, then the diagnosis should be revised as part of the re-commission re-examination procedure at a meeting of the high qualification commission. And possible contradictions and controversial issues are considered at a council of doctors with the participation of narrow specialists, including: an epileptologist, neurosurgeon, psychiatrist, neurologist and chairman of the commission. The most important thing is to know for sure yourself that epilepsy is not a sentence at all, but only a medical opinion. It can be changed over time with strong arguments. 

Many consultants emphasize that all applications for withdrawing or changing the diagnosis should be considered by a commission , after a written appeal to the head physician of the psychiatric institution. The more time has passed since its setting, the greater the likelihood of removing the patient from dispensary observation. But an additional examination is needed to find out the real state of health.

Epilepsy is a complex and problematic disease, which is treated and controlled by professionals of various specializations. Their conclusions do not always coincide, as well as the degree of responsibility for the decision to recognize a person as completely healthy. After all, removing the prohibitions from driving a car, owning a weapon and holding positions of responsibility means taking upon yourself the possible negative consequences.

It is not always easy for a layperson to understand who exactly has the right to such decisions when communicating with doctors. Therefore, trying to get rid of a limiting diagnosis, you often waste a lot of time contacting the wrong specialists. For example, in the process of treatment and counseling, patients mainly communicate with neurologists, for whom the main thing is the physiological signs of the process. And disorders associated with a person’s personality change should be monitored by psychiatrists. They are responsible for the restrictive functions in this diagnosis. It is possible to cure this disease by neurologists, but psychiatrists will not automatically remove it from the account of its limitations.   

Such actions should begin with an official letter to the head of the medical institution requesting a medical re-examination in the hospital. And at the same time, seek contact with psychiatrists in a dispensary or hospital.

The official appeal to psychiatrists must be based on the sixth article of the Law “On psychiatric care and guarantees of rights in its provision” with a warning that you are ready to appeal against the refusal in court. Which is likely to be a very convincing argument for them.

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