Living with epilepsy

Epilepsy is a chronic disease of the human brain that has various causes and is characterized mainly by repeated seizures and the gradual development of personality changes. This is one of the most common neuropsychiatric diseases: in the general population, there are 7-10 cases per 1000 population. Regular administration of anticonvulsants leads to the prevention of further epileptic seizures in approximately 70% of patients. The choice of the drug depends on the type of seizures, the age of the patient and possible side effects. Over the past decades, scientists have developed second-generation drugs that are better tolerated. 

In a previous publication on the topic of epilepsy, we already talked about the fact that in Russia this disease was called “epilepsy”, simplifying its Latin name “caduca”, and such famous people as V. Van Gogh, G. Flaubert and F. Dostoevsky suffered from the disease … We briefly described the causes, manifestations and forms of epilepsy, and also touched on the complex topic of new directions for its treatment. The time has come to highlight some other applied aspects related to “Herculean disease”.  

Personality Changes in Epilepsy

The severity of personality traits in patients with epilepsy, according to most researchers, depends on the duration of the disease and the severity of its course. If an illness accompanies a person for a sufficiently long time, the so-called “epileptic character” begins to form in the latter. The patient increasingly manifests in his behavior traits that were not previously characteristic of him:

• The circle of interests narrows, only one’s own health remains in the center of attention . 
• Formed internal selfishness, pickiness, pettiness, vindictiveness, even revenge.
• Often, at the same time, ostentatious tenderness and courtesy, obsessive flattery and sweetness are manifested in an exaggerated form.
• Slowness, inactivity, restraint in gestures that are now not expressive (including facial expressions).
• Tendency to edifying teachings.
• Violent attacks of anger come suddenly.  
• With a general “inhibition” emotions are extremely labile and quickly replace each other, moving from one extreme to another.
• The sense of “justice” is sharply sharpened (while the concept of justice is interpreted from their own positions and very one-sided).
• Extreme forms of pedantry with regard to their clothes, special order in the house or at the workplace are not uncommon (patients make sure that there is perfect cleanliness everywhere, and that objects stand in their places).
• Thinking becomes viscous, with a tendency to thoroughness and excessive detailing, since the patient loses the ability to separate the main thing from the secondary and any trifle seems important to him.
• The vocabulary narrows and there is a tendency to use diminutive-caressing forms (eyes, little hands, stools, cribs, doctors, little patients, etc.).

As you understand, it is completely optional that all of the listed behavioral and personality traits will be manifested in each patient with epilepsy. On the contrary, more often than not, there is a vivid demonstration of only a few of them. For example, the Soviet psychiatrist E.K. Krasnushkin in 1960 ranked typical manifestations of an epileptic nature, determining that in the first place is slowness (90.3%), then – viscosity of thinking (88.5%), ponderousness (75%) , irascibility (69.5%), selfishness (61.5%), rancor (51.9%), thoroughness (51.9%), hypochondriacal (32.6%), litigiousness and quarrelsomeness (26.5%) and neatness and pedantry close the list (21.1%).  

Is life with epilepsy all about prohibitions and restrictions?

We will not deny that people with epilepsy have to put up with some restrictions, but most of them have little effect on the quality of life. In other words, they “can” almost anything, but limitedly and without fanaticism. For example, you cannot go in for professional sports (although there are such examples), but you can do physical education. Classes should be arranged wisely to minimize the possibility of head injuries or hyperventilation (rapid breathing, which can trigger an attack). Any physical exercise can be made safe: you can even swim, but only in a life jacket, accompanied by loved ones and not making long march-throws.  

Epilepsy and rest . Many people believe that summer vacations, especially those associated with long-distance travel, are harmful for people with epilepsy, as they can provoke exacerbations and seizures. This is partly true, however, the same travels perfectly help patients in the formation of independence and an active life position, reduce the feeling of rejection, loneliness and isolation. Positive emotions and new impressions, in turn, stop seizures, and do not increase them at all. The choice of a place of rest should be approached carefully, be sure to consult with your doctor. It should be remembered that patients should avoid open fire, altitude (high mountains), water (open bodies of water), direct sunlight, and stuffy and hot rooms.   

Can you predict when the next epileptic seizure will occur? Attacks can occur at any time of the day: morning, afternoon, evening, night, differ in nature, frequency and severity, so it is impossible to predict what type of attack and when it will develop. Sometimes a seizure is preceded by a so-called aura (the Greek word meaning “breath”, “breeze”), which the patient can track on his own, but this does not always happen. It must be remembered that stress, fatigue, alcohol intake, disturbance of sleep, nutrition, rest can increase the risk of an attack. Certain conditions of the body can also be provoking factors (for example, the onset of menstruation). Environmental conditions (for example, flickering light) also play a role .   

What is the prognosis for epilepsy?

In most cases, the prognosis is favorable. As we said at the beginning of this article, remission occurs in 70% of patients with medication and there are no seizures for 5 or more years. If no improvement is observed, then the patient is prescribed several anticonvulsants at once or additional treatment methods are involved. It is important to understand that the effect of the drug will be noticeable only if its concentration in the brain is constant and sufficient to be ready to prevent and control an attack whenever it occurs. The temptation to give up the pill at the moment when the period of visible well-being sets in is dangerous for humans. A certain dose of the drug should always be present in his blood, since its more or less sharp fluctuations worsen the course of the disease and provoke the development of seizures.