Epilepsy Treatment According To Age Group: How Approaches Differ - Doctor Speaks

National Epilepsy Day 2023: On a day meant to increase awareness about epilepsy, a doctor shares how the chronic noncommunicable disease of the brain has to be differently approached depending on whether the patient is an adult or a child.

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Epilepsy is a chronic noncommunicable disease of the brain and is one of the most common neurological diseases globally, according to the World Health Organization (WHO). "It is characterised by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function," the WHO website reads. 

On the occasion of National Epilepsy Day, which is observed on November 17 every year, Dr Rima Chaudhari, Senior Consultant – Neurology, Fortis Hospital Mulund, shares, "Epilepsy is a condition which affects the brain, thus leading to seizures. In India, around 12 million people suffer from epilepsy. The treatment of the condition begins with making a correct diagnosis. It is essential to be certain, as a treating neurologist, that the patient indeed has seizures and then epilepsy." She adds, "Often, we see a number of patients on seizure medications, for a single episode of loss of consciousness, which may not have been a seizure. A thorough history or perhaps a video of the event may help the treating physician strategise the patient’s treatment plan."

Treating Epilepsy In Children And Adults: Different Approaches

Epilepsy changes its forms and associations across ages. According to the age group, treatment has to be determined, says Dr Rima Chaudhari, who adds that treating epilepsy across ages involves a different set of counselling strategies. Here are the different age groups and corresponding treatments:

Children With Epilepsy: A child with seizures will have a certain set of associations or prognosis for his epilepsy as against an older adult who recently had a seizure after a stroke. If the child has epilepsy, it is essential to have this conversation with the parents so that they are confident dealing with the same. "In a child’s case, I spend a lot of time with the parents of a kid who has seizures and explain them about it and also inform them what to expect, how to mitigate falls or seizures in schools and how they could work with their respective teachers etc. While every child does not respond to the same treatment, we first start them on medication for seizure prevention and these help in the reduction of episodes of seizure and symptoms of Epilepsy. However, in some cases the drugs might not work, then the alternative treatment is dietary therapies, using brain stimulation surgeries to control and prevent seizures, and brain surgery," Dr Chaudhari adds.

Adults With Epilepsy: "I take that extra time discussing with my older patients, and especially their caregivers, about the risks of falls in this vulnerable population after a seizure. It is the most important part of my treatment as a neurologist. Adult patients, especially adults who have comorbidities and stay alone, may have a hard time managing the condition. Adults too require the same line of treatment as children, however, the cause of epilepsy might differ and they might suffer from the condition due to strokes, tumours, imbalance of neurotransmitters or brain damage from injury or illness," explains Dr Chaudhari.