Fits/attacks of unconsciousness can occur at any age to different reasons and in various situations. Sometimes it causes difficulty in proper diagnosis and management. In addition, there are lot of associated notions and misconceptions. There are some common Queries which come to the mind while we talk about fits.
Q. What is fit?
Q. What is the usual age at which fit occur?
Q. What are the common causes?
Q. Are all fits in childhood epileptic?
Q. What are the types of epilepsy?
Q. How to recognize an epileptic fit?
Q. What should be done immediately on seeing a person in epileptic attack?
Q. What investigations are diagnostic of epilepsy?
Q. Can epileptic patients lead a normal life i.e. Education and Career?
Q. Can epileptics marry and have normal family life?
Q. Do the children of epileptic patients must have epilepsy?
Q. How long the patents of epilepsy require medication?
Usually fit is referred to be people as sudden attack of disturbed consciousness or behaviour with or without other associated features.
Q. What is the usual age at which fit occur?
Fits can occur at any age, depending upon the underlying cause. e.g. epileptic fits usually start in the childhood whereas the hysterical attacks are seen more commonly in young adults under stress. Fits occurring in older age are due to some other organic illnesses.
Q. What are the common causes?
As already said, the causes differ at different age at which
attacks start. In children, the commonest cause is EPILEPSY;
though other causes may be encountered occasionally. With increasing
stresses even in childhood, psychogenic or hysterical attacks
are also seen in children.
In adulthood - Variety of conditions can manifest as fits or
seizures. Simple reasons like exhaustion due to stress (mental
or physical) or heat or lack of sleep can cause fits. Commonest
at this age is psychological disorders-may be in form of hysterical
fit, panic attacks or anxiety attack. Other less common causes
include some heart diseases, due to some medicines in diabetics,
in alcoholics a type of migraine or strokes, all can cause seizures,
though these causes are usually seen in older age.
Epilepsy usually starts in childhood and is fairly common. it has been seen in various studies world over that about 0.3 to 0.5 percent of people suffer from this condition.
Q. Are all fits in childhood epileptic?
No, As earlier mentioned, majority of seizures/fits in childhood are epileptic fits but other uncommon causes like breath holding attacks (while excessive crying ), anxiety/ panic attacks, migraine, hysterical attacks are seen in children.
Q. What are the types of epilepsy?
There are more than hundred types of epilepsy which only the physician is able to decide. Usually epilepsy is labeled in a patient with fits when there are recurrent seizures due to some organic disturbance in brain. Epileptic fits can be generalized ( involving the whole body ). Epilepsy can also be typed by whether there is an underlying disease in the body i.e. "secondary epilepsy" or the cause of epileptic fits is not known, it is due to some abnormal electrical activity in brain i.e. "primary or idiopathic epilepsy".
Q. How to recognize an epileptic fit?
the manifestation of an epileptic fit may vary in different individuals/situations. But usually the classical epileptic attack consists of unconsciousness, abnormal movements of limbs and face, eyes rolled up or turned to one side, passage of urine/stools in clothes, clenching of teeth, frothing from mouth, tongue bite and sometimes there is shriek/cry just at the onset. The patient usually falls down and may injure himself/herself. This lasts for few minutes followed by a period of sleep/abnormal behaviour.
It is not a must that every patient has this classical presentation. Depending upon the type of epilepsy, the symptoms/ signs can be different e.g. in case of focal epilepsy, there may not be present though the patients can minic them well. After seeing an attack, the physician can most of the time judge what type of attack is it.
Q. What should be done immediately on seeing a person in epileptic attack?
There are some important do's and don's during an epileptic attack.
- Turn the patient to one side.
- To maintain the airway, put a padded spoon in between the teeth. Don't put your finger, it may get bitten.
- Remove - if spectacles or artificial teeth are there.
- Loosen the patients tight clothes.
- Do not have a crowd him/her.
- Do not try to given him/her anything by mouth.
- Let the patient rest/sleep after the convulsion.
The attack usually lasts few minutes.
No, Even a patient of established epilepsy can have different types of attacks at different times. It may be epileptic attack of other type or it could be psychogenic attack in addition.
Q. What investigations are diagnostic of epilepsy?
The most important thing for diagnosis of an attack of epilepsy is the history of patient. Some times investigation like ECG, CT Scan/MRI of brain, some blood tests may be needed. But this should be decided by physician.
Q. Can epileptic patients lead a normal life i.e. Education and Career?
Yes. Patients of controlled epilepsy can achieve their education/professional goals as other children do. Rather, they should be encouraged. Many of the internationally famous personalities have been epileptics.
Q. Can epileptics marry and have normal family life?
Yes. They can lead a normal family life. The only important thing is - proper control of fits and proper medication under guidance.
Q. Do the children of epileptic patients must have epilepsy?
No. But the risk of having epilepsy definitely increases if one or both parents are epileptics.
Q .How long the patents of epilepsy require medication?
In about 85-90% patients, after an attack free interval of 4-5 years, medicines are tapered and stopped. But rest of cases amy need maintenance dose of medicines life long.
Some myths & facts about Epileptic Fits
Epileptic Myths |
Epileptic Facts |
||
| 1. | Epilepsy is caused due to the effect of evil spirits. | 1. | No Epilepsy is caused by some disturbed electro-physiological activity in brain. |
| 2. | Epilepsy ia a contagious problem. | 2. | No. If is not infectious/contagious disease. An epileptic can mix up and share with other people normally. |
| 3. | All fits are epileptic fits. | 3. | No. All fits are not necessarily epileptic. There are other causes and diseases which can cause fits. Let the physician decide about the cause of fit. |
| 4. | Marriage is the remedy for fits in young girls. | 4. | No epileptic fits are due to some organic disturbance in the brain therefore marriage can not help it. However, in some psychogenic fits where the young individual wants to get married, it may prove beneficial to some extent. |
| 5. | Sadhus/Ojhas/Tantriks/Religious people can cure epilepsy, without medicines. | 5. | No. As epilepsy is a disease, it requires proper medication and guidance of expert physician and can not be cured by quacks. |
| 6. | During a fit, administering some pungent odour (e.g. shoe etc. in front of nose) can stop the fit? | 6. | No. These is no logical basis for such action. |
| 7. | During a fit administering water/liquids by mouth helps. | 7. | No. On the contrary, nothing should be given by mouth to an unconscious person during fit as it my go the air passages and cause complications. |
| 8. | Once a person is diagnosed as epilepsy, he should rest in bed and not go to work. | 8. | No. A person after being diagnosed epileptic should try to lead as normal as possible life with regular routine work but should take proper medicine and guidance from a physician. |
| 9. | Medicines for epilepsy are habit forming. | 9. | No, the medicines have to be taken for a long period (few years) but under guidance of physician, they are stopped at appropriate time. |
| 10. | All epileptic children are dull/weak in studies/ have low I.Q. | 10. | Though there are some causes where low I.Q. and epilepsy is present in same patient e.g. mental retardation, cerebral palsy etc. but properly controlled epilepsy does not cause low I.Q. |
