How to Diagnose and Manage it
There are different ways of diagnosing epilepsy; some of which when added together give a better and more precise picture of the existence of the disease condition. It is usually advisable to carry out a comprehensive investigation before trying to make a diagnosis because of the social importance of the situation.
i. The presenting signs and symptoms can give a clue to diagnosis.
ii. Electro-encephalogram (EEG): This will help detect the electrical discharges of the brain.
iii. Blood test: To determine the glucose and calcium levels of the blood.
iv. Lumbar puncture: To detect if there is any infection that may have likely spread to the brain. V. X-ray of the skull: This will help in identifying any tumor of the brain.
vi. Physical and neurological examination.
First Aid management of Epilepsy a. Give a helping hand to the patient quickly to prevent him from injury during a fall.
b. Loosen tight clothing from around the neck, chest, and abdomen.
c. Place a spatula in-between the teeth to prevent him from biting his tongue or lips.
d. Remove dangerous instruments around the patient e. Allow enough air to reach the patient by controlling the crowd around him f. Do not restrict patient during fit/jerking to prevent injury/fracture g. Reassure on-lookers
h. Observe vital signs
i. Note whether patient sustained injury or had incontinence. Also, note the time the fit stopped and how long it lasted.
j. Remove his clothes if they are soiled and give him a bath
1. Anti-convulsants: e.g., Phenobarbitone, Epanutin (Phenytoin Sodium), Mysoline, Tegretol, etc. may be given as recommended by the doctor.
2. Tranquilizers: e.g., Chlorpromazine (Largactil), Diazepam (Valium).
3. Electroconvulsive therapy (ECT)
Nursing management i. Admit patient into epileptic ward ii. Nurse in a low bed with adequate ventilation and good lighting iii. Observe vital signs and maintain a proper record iv. Provide comfort measures
v. Give easily digestible, semi-solid diets to prevent choking vi. A patient should be encouraged to have enough rest and sleep. Soft pillows should be removed from him to avoid suffocating himself with the pillows during fits vii. Personal hygiene should be encouraged viii. Give psychological support.
Advice to patients
1. Patients should not swim, climb or operate machinery
2. Patients should have an identity card to show they are epileptic
3. Patient must guide against an open fire
4. Take prescribed drugs regularly
5. Remove dentures before sleeping
6. Avoid sleeping with soft pillows
7. Do not bath alone especially if you have to use the bathtub
8. Do not go to River, stream, pond or well to fetch water alone. Somebody must accompany you
9. Avoid sharp instruments or corrosive liquids if a fit is frequent
10. Don’t drive if a fit is recurring.