Thank you for getting back to DoctorSpring.
Hope your friend is doing better now. Here are the answers to your specific queries.
· Some of the factors that can trigger or increase the likelihood for the seizure to happen are, flashing lights, flickering television screen, high pyrexia, intense exercise, loud music, strong emotions, chronic alcohol abuse, stress, sleep deprivation. Certain mediation such phenothiazines, monoamine oxidase inhibitors, tricyclic antidepressants, SSRIs, amphetamines, lidocaine, propofol and nalidixic acid sometimes provoke it either in overdose or at therapeutic dose in individuals with low seizure threshold. Even withdrawal of antiepileptic drugs especially phenobarbital and benzodiazepines may trigger seizures. And yes alcohol can trigger seizures. The trigger factors varies in different individuals. Mostly the patinet will be able to identify and avoid triggering factors over time.
· Usually you can’t predict when and where a seizure can happen. But sometimes you might have aura before the episode. A vague odd feeling, unusual smell, taste, blurry vision or seeing lights that do not exist, unexplained confusion, tingling or numbness anywhere in the body, period of memory lapses may be noticed. Again the patinet will learn to identify this over time.
· Clinically it is classified as generalized and partial seizure. In generalized seizure activity appears abruptly and involves entire brain simultaneously whereas in partial seizure, it starts focally. Usually loss of consciousness occurs in generelaized type of seizures.
· Cognitive and behavioural difficulties, depression, head trauma, fractures and others may result due to the fall, aspiration, pulmonary edema, dehydration are some of the complication.
· There is no complete cure for seizure. BUT It is generally managed by controlling seizure activity by using antiepileptic drugs, and avoiding the factor that provoke the episodes and maintaining or restoring quality of life. And many cases the seizure free period can be years or even life long. BUT DO NOT STOP medications without your Doctor's recommendation.
· Yes, EEG and other types of tests help to diagnosis. It helps to confirm the clinical diagnosis and rule out syncope and other psychogenic non- epileptic seizure. They also help to differentiate generalized attacks from the focal epilepsies. Certain tests such as CSF examination, analysis of metabolic parameters, neuroimaging help to find the cause of epilepsy.
· Antiepileptic drugs such as valproic acid, phenobarbital, phenytoin, lamotrigine and surgery treatment for epilepsy when an underlying brain abnormality such a benign tumor or for those cannot be controlled by adequate attempts with multiple medications are available as treatment of seizure. In refractory cases where surgery cannot be performed, ketogenic diet (stringently controlled high fat and low protein/carbohydrate diet) has proven to help to some extent.
· It is better to avoid because binge drinking or chronic alcohol abuse can trigger seizure activity. Especially since there is a history of trigger.
. Ketogenic diet is worth a trial. There are are positive results about this method. Yes you can go ahead and give it trial.
Hope this helps
Feel free to ask followups.
Patient replied :
Can you tell me more about the Ketogenic diet? Are there sample plans one can follow? How does this diet affect weight? Do you gain weight, lose weight or maintain weight?
May I know the reason you are planning to go on Ketogenic diet ? Weight loss ? Seizure control ?
Also you body weight / height ?
Patient replied :
Main reason would be for seizure control but didn't know if weight loss happens being on this diet. 5'7, 165 lbs
Please see this attached file that contains detailed information on Ketogenic Diet. (emailed separately ) This is from UpToDate a peer reviewed reference material. In my opinion this is the best resource available. Please go through it and let me know if you have any queries.
Feel free to ask followups / specific queries
(with inputs from Dr.Deepu Sebin Sebastian)