Epilepsy is a clinical syndrome, a chronic brain dysfunction disease caused by a variety of etiologies, characterized by the malfunction of the central nervous system due to recurrent excessive neuronal discharges in the brain during the course of the disease, with muscle convulsions and/or loss of consciousness as its important manifestations, in addition to sensory, motor, behavioral, autonomic and other disorders.
To summarize the previous clinical care experience, the common triggering factors for epilepsy are considered to include
1. poor compliance with antiepileptic drugs; patients stop, change or increase or decrease their medication during the medication period;
2, the patient’s psychological state, such as the number of seizures or the onset of epilepsy patients, they do not know enough about the dangers of the disease, can not cooperate well with doctors, and most patients feel pessimistic, disappointed, low self-esteem, self-abandonment due to long-term seizures and discrimination by some people in society, these negative emotions will directly affect the treatment;
3, the patient’s health concept is weak, irregular life;
4, bad habits, such as smoking, drinking alcohol, playing video games, computers, playing cards, etc..
Patients need to be hospitalized for a short period of time except during acute attacks or when the condition is serious, most of the time need to take medication at home to recuperate, that patient at home, we how to better care for the patient, the following I outlined for you to organize in home care we need to pay extra attention to the points.
1. Avoid injury
When the seizure aura is found, the patient should be quickly placed flat on the ground to avoid falling, loosen the collar buckle and belt, take off glasses, denture, put soft things at hand such as quilts, towels, etc. under the patient’s head and remove the dangerous things around.
If the teeth are closed, wrap the towel with a small spoon and gently pry it open. Use dental pads or thick gauze to stuff between the upper and lower molars to prevent biting the tongue and cheek.
After seizure, the patient may have a short period of blurred consciousness. Disable the oral table for temperature measurement to prevent the patient from biting off the thermometer and damaging the oral mucosa.
Place bed rails to prevent patients from falling out of bed during seizures; when seizures occur, do not press the limbs violently to avoid fractures, muscle tears and joint dislocations. Do not place dangerous objects on the bedside table, such as hot water cups, etc.
2. Keep the whistle open
Put the patient’s head down and to the side when seizure occurs, so that the secretions of the whistling tract flow out from the corners of the mouth, and have a bedside suction device available to keep the whistling tract open.
Do not feed water or food during seizures to avoid choking and suffocation. Observe whether there is difficulty in inspiration, rapid heartbeat, expression of terror , two hands grasping and other asphyxiation performance, the appearance of asphyxia immediately take the pillow flat position, tilt the head to the side, pat the back, absorb sputum and oral secretions, if possible, oxygen, and promptly sent to the hospital.
3. Record epilepsy notes
The notes should be a detailed record of the onset and daily life of the epileptic patient, a snapshot of the epileptic patient’s life. When the patient goes to the hospital for review, the doctor can use these records to gain an in-depth understanding of the patient’s condition, so that he or she can judge the condition more comfortably and accurately, and facilitate treatment.
The patient may not feel it before the first few seizures, but as the number of seizures accumulates, the patient will definitely have a sense of signs. So the patient should record these pre-seizure expressions, language, and actions in detail so that they can be used as a reference for future predictions.
Convulsions: This is a very important record and is a visual response to the condition. The patient’s family should not only do first aid in time when the patient has a seizure, but also record the time, frequency and symptoms of the patient’s convulsions during the seizure, so that the doctor can understand the specific situation of the seizure in detail during the follow-up consultation.
Diet: It is to record the patient’s daily diet. If the patient suddenly has a seizure, the family can check what the patient actually ate and whether he or she mistook something that caused the seizure. If there is such a detailed record, then the family can find out what caused the patient to have a seizure and try to avoid it next time.
4. Dietary guidance
The patient should be instructed to develop a good routine and eating habits, such as eating regular meals and forbidding smoking and alcohol. The patient should have a comprehensive and balanced nutrition and a reasonable diet.
The patient should not be partial or picky, food should be light and easy to digest, avoid spicy and stimulating food, such as chili, cola, coffee, strong tea, eat more vegetables and fruits, coarse grains, and keep the bowel movement smooth.
Starvation can lower blood sugar, and hypoglycemia is often prone to induce epilepsy as well.
Overeating and excessive drinking can overstrain the stomach and can also trigger epilepsy. After the patient has bloating and vomiting resulting in a large loss of body fluid, water and electrolytes should be replenished in time to maintain water and electrolyte balance to avoid inducing seizures.
5.Guidance on daily life
Avoid doing work and activities with danger, such as working at height, swimming, driving, welding, etc.
Life should be regular, pay attention to the combination of work and rest, avoid sleep deprivation, over-sleep and over-exertion.
The water temperature should be moderate when bathing, avoiding too cold and too hot; when the seasons change, you should also pay attention to prevent winter colds and summer heatstroke.
Bedridden patients should be turned regularly and have functional training to prevent pressure sores and disuse atrophy of limbs.
Physical exercise should be carried out daily according to the physical condition. Ask the patient not to go out alone and carry a card with him/her when he/she goes out. The card should include the patient’s name, age, address, telephone number and name of the contact person for timely treatment in case of an attack, preferably accompanied by someone.
Avoid dangerous places and dangerous goods as much as possible, and do not engage in high-altitude work and highly concentrated and stressful work, such as mountain climbing, swimming, driving, bicycling, etc. Children should not be alone by the river or fireside, especially do not do modern high-altitude games, such as bungee jumping, roller coasters, etc. to prevent seizures.
6. Psychological guidance
Epileptic patients with long duration and recurrent seizures are prone to mood swings, mostly manifesting as depression, dependency and other psychological disorders, giving positive psychological guidance to patients with different psychology. The first thing you need to do is to give the patient strong psychological support and tell them that epilepsy can be cured. Keep in touch with the patient, keep abreast of the patient’s psychological status, and adopt supportive psychological guidance such as comfort and encouragement to keep the patient in a happy mood.
Instruct the patient to build self-confidence and eliminate the feeling of inferiority. Let the patient do what he or she can do by himself or herself, and help him or her build up the belief that “I can do it, I can do it, I can do it”.
Explain to patients the type of epilepsy they have, its clinical features and possible triggers, and help them face the reality and treat their disease correctly. Provide the patient with correct information about the disease related and medication knowledge, and help the patient to master self-care to minimize the number of seizures. Encourage family members to express to the patient the emotion of not disliking and affectionate care to relieve the patient’s mental burden.
7. Childbirth
Patients with epilepsy during childbearing need to understand the risk of their offspring developing epilepsy, the appropriate timing of pregnancy, the effect of pregnancy on seizures, and the effect of seizures and antiepileptic drugs on the fetus. epilepsy or obstetrician to determine if pregnancy is possible, and genetic testing can be performed if available.
(1) Patients with primary epilepsy.
(2) Both partners are close relatives of a person with primary epilepsy.
(3) Both partners have a family history of epilepsy.
(4) One partner has epilepsy and the other has only an EEG abnormality without seizures.
(5) One partner has a family history of having a child with epilepsy.
(6) Women with epilepsy who have a clear family history of epilepsy.
(7) Patients with generalized seizures who have extensive EEG abnormalities and whose siblings also have similar EEG manifestations.