New Delhi: The International Epilepsy Day, observed annually on the second Monday in February, helps to raise epilepsy awareness. This year, International Epilepsy Day is being observed on February 14.


The global event is a powerful opportunity to highlight the problems faced by people with epilepsy, their families and carers around the world.


As many as 50 million people worldwide are said to be affected by epilepsy. 


In an emailed conversation with ABP Live, Dr. (Lt Gen) CS Narayanan, VSM, HOD and Consultant, Neurology, HCMCT Manipal Hospital, Dwarka, answers some frequently asked questions related to epilepsy.


1. Are there any tell-tale signs of epilepsy other than fits? When should we approach a doctor?


A seizure is a sudden, uncontrolled electrical disturbance in the brain. One manifestation is loss of consciousness associated with stiffening of the body followed by jerking of the limbs. This may be accompanied by frothing from the mouth, tongue bite and involuntary passage of urine and stools. This sequence of events is called convulsive fits.


When a person has two or more unprovoked seizures they are said to be suffering from Epilepsy.


While fits are a common manifestation of epilepsy, there persons with epilepsy could have other  symptoms such as sudden blanking out, change of mood, twitching or numbness in some part of the body


2. Is it true that people with epilepsy should not drive or swim? Can you lead a normal life with epilepsy? 


Persons with Epilepsy should be encouraged to lead a normal life with certain precautions. They should avoid situations which would harm them if they have recurrence of seizures. This may include going close to moving machinery, open fires and climbing heights.


Swimming should always be done when someone who is aware of their medical condition is around to help them if the need arises


Driving is not advisable till the seizures are well-controlled with medication. The legal requirements vary from country to country and must be complied with.


3. Do you need to take medicines lifelong if diagnosed with epilepsy? In short, is epilepsy curable or reversible? 


Epilepsy is a symptom of a number of underlying conditions that affect the brain. The manifestations and treatment for each condition varies widely. In some cases, treatment can be discontinued after a seizure-free interval of a few years. In some other conditions, such as juvenile myoclonic epilepsy, it is recommended that treatment is continued life-long.


4. Do epileptic women need to be careful about pregnancy?


It has been proven by studies that anti-epileptic medications should not be discontinued during pregnancy for those who need them. It is desirable that the lowest possible dose of a single medication is given to pregnant women as the risk to the fetus increases with multiple medications and with higher doses. It is also important to choose drugs which are relatively safe in pregnancy and avoid drugs like sodium valproate which are associated with substantial risk to the mother and fetus.


5. A surgery is recommended at what stage? Is surgery the only option? What are the other treatment options available?


Surgery is available for certain types of epilepsy. However this is performed after detailed evaluation in specialized centres. For the vast majority of patients with epilepsy management is with medications. It is important that medications are taken under close supervision and monitoring by neurologists. In some rare types of epilepsy which do not respond to medications, some other treatment options are available such as deep brain and vagal nerve stimulation.