Aging Begins at 30

Living with Epilepsy

My friend in the fifth grade never had another epileptic fit in the five more years I knew him. He must have been given effective treatment.

Most doctors will start chronic treatment of epilepsy if two or more attacks occur in a short interval. A single drug is chosen and levels are monitored to assure adequate absorption and to avoid overdosage. Dilantin has the advantage of being given once daily. The success rate of stopping convulsions is over 80%. Patients need to know that changing or stopping the dosage may have serious consequences. Some generic medicines in this disease have unfortunately not worked as well as the brand name originals.

Epilepsy cannot be cured like an infection with antibiotics but contiuous suppression for 2 or more years can lead to an ability to live without treatment in 60%. With treatment or after treatment is discontinued the patient need not stop leading a productive life.

A few epileptics may get irritability, nausea, a rash, or clumsiness from their medication but a reduced dose or switching to another effective anticonvulsant will usually get rid of the side effects. Some drugs need regular blood tests. In the elderly it's often helpful to count out a week's supply and store it in a special container marked for the days of the week that can be bought in any drug store. When traveling you should carry a copy of your prescription.

The sooner treatment is started the more likely are fits to be eliminated. Surgical treatment is available for a very few with locatable scars that can be removed. Ensure, isocal, and other nutritional supplements in the nursing home may interfere with dilantin absorption due to complexing with calcium salts. Phenobarbitol does not complex.

Unfortunately there are 30-40% of active epileptics not getting the easily available effective treatment.

There are about 2 million epileptics in the U.S. It is 10 times as common as multiple sclerosis. The incidence of epilepsy is highest in childhood and lowest in early adult life. It rises again in the elderly. About 1 in 200 of the population are affected in the western world. About 3% of the population have had a convulsion at some time in their life. About three quarters of the 100,000 new cases each year begin in childhood. About 56% have grand mal, 24% focal, and 14% both types of attacks. The elderly form 5% of all cases of epilepsy. In the elderly, about 10% of people with paralytic strokes get epilepsy. Episodic pain in a paralysed limb can be epilepsy and occurs in about 16% of stroke victims. The incidence at age 40-59 is 12 and rises to 82 per 100,000 in the population over age 60.

The outlook is good for the majority of elderly epileptics. 65% of epileptics are active for less than 5 years; others are successfully suppressed over many year periods. Unfortunately, 22% are never in remission.

Society is uncomfortable with and pitying about epilepsy. Diagnosis and management, however, have emerged from medieval sorcery to modern effective treatment.

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