Ten questions and ten answers about epilepsy

  1. Can people with epilepsy get married?  Yes! Not only do people with epilepsy have the right to fall in love and get married, they also have the ability to start a family. Moreover, most patients have more stable emotions and lives after getting married, which is more conducive to controlling seizures.  2. Can people with epilepsy get pregnant and have children?  Most can. There are 4 aspects here: (1) If you can stop taking antiepileptic drugs in the first 6 months of pregnancy and are seizure-free, the probability of producing a normal baby is about 98%, similar to normal pregnant women; (2) If you still have frequent partial seizures, or severe seizures such as generalized tonic clonic or tonic seizures after stopping the medication, and taking antiepileptic drugs can control the seizures, then continuing to take antiepileptic drugs during pregnancy (3) If antiepileptic drugs must be used during pregnancy, it is recommended to switch to Class C drugs such as levetiracetam, lamotrigine, oxcarbazepine, etc. before pregnancy if possible, and avoid or use Class D or E drugs such as valproate, phenobarbital, phenytoin sodium in small doses as much as possible. This is too complicated to consult an epilepsy specialist, follow up regularly, monitor blood levels and adjust drug doses; (4) Visit the obstetrics department for regular checkups and ultrasound examinations during pregnancy, and terminate the pregnancy promptly if significant or obvious malformations are found.  3. Is epilepsy hereditary?  The vast majority of epilepsy is not related to heredity, but is caused by congenital or acquired causes of brain damage, and is not inherited to children; clinically, the majority of epilepsy patients have no history of similar disease in both parents for several generations.  4. Can epilepsy be cured?  The data of decades at home and abroad show that 70%-80% of patients with regular application of anti-epileptic drugs can be completely controlled, and most of them can be cured by stopping the drugs, which is no worse than the effect of treating hypertension.  5. Are the toxic side effects of western drugs significant?  The instructions of anti-epileptic drugs and other western drugs generally only have 1-3 lines of indications for the treatment of diseases, and 20-60 lines are reminders of toxic side effects, which often frighten our people and are even used and maliciously promoted by people with bad intentions as “western drugs have a lot of toxic side effects and Chinese medicine is safe”. In fact, Western medicines for clinical application are subject to much, much stricter scrutiny than Chinese medicines, and can only be marketed and sold to the people when the benefits to patients far outweigh the risks, so safety is basically guaranteed; and informing and reminding patients of the risks of more than one in 10,000 is a kind concern of Western culture, so don’t misunderstand. On the other hand, milk is a good thing, but some people have diarrhea after drinking it; by the same token, most of the toxic side effects are caused by both human and drug factors, and there should be a basic understanding of this. Please believe that all doctors will treat and handle the toxic side effects of drugs seriously, and ask patients and their families to pay attention to the observation and inform the doctor in time.  6. Can surgery cure epilepsy?  There is no doubt that removal of the sclerotic hippocampus, the vascular malformation or tumor causing epilepsy is one of the important methods of epilepsy treatment. However, for the vast majority of patients with epilepsy without a clear lesion, drug therapy is the preferred, most economical, quickest and most effective method. Surgery is only considered for patients who have not been treated with regular, systematic drug therapy. The prerequisite for surgical treatment is that the precise location of the epileptogenic focus must be clarified, for which a 7-21 day, expensive preoperative evaluation, including long-range EEG, MRI, SPECT, PET, and psychological assessment, is required; moreover, most patients still require antiepileptic medication after surgery; even in foreign countries, there are still patients whose seizures cannot be controlled and even require secondary surgery. Therefore, it is unscientific and unrealistic to hope for a “one-size-fits-all” cure for epilepsy without medical treatment.  7. Why do we need repeated EEGs?  Seizures are random and unpredictable, and few people can reach the hospital or receive an EEG when they have a seizure, and the positive rate of a general EEG is only 30%. The EEG should be reviewed several times during the treatment period.  Why should I not take medication in the morning on the day of the blood level check?  The continuous and stable concentration of antiepileptic drugs in the blood is the key to seizure control. The patient should take antiepileptic drugs after the examination.  What do patients with epilepsy need to pay attention to in their daily life?  (1) Abstain from alcohol. All alcohol such as white wine, red wine, beer and health wine can induce epilepsy, so do not touch them. and repeat medication is as important as avoiding putting on and taking off a raincoat in the rain.  (3) Take antiepileptic drugs regularly for more than 2 years.  The most important thing is to avoid missing medication and repeat medication, just like avoiding rain and rain. This is not only unscientific, but also anti-scientific. This is not only unscientific, but also anti-scientific. Our experience in treating more than 3,000 patients is that a normal diet will not aggravate seizures, and the patient and family members are more relaxed, which is good for seizure control.