Why does it happen?
The normal human brain has billions of cells or neurons which send electrical signals, accurately to voluntary muscles, so that they work in co-ordination with one-another. For example, both your eyes blink at the same time, don't they? Sometimes, an extra set of signals is sent out to the muscles from a different focus, like an infection, a tumour or a malformation in the brain. This upsets the whole electrical system within the brain, the haphazardly stimulated muscles acting out of their volition, out of harmony, resulting in what is termed Epilepsy. The physician plays a critical role in sorting out information for correct management of epilepsy, education and couselling of the patient. While treating an epileptic patient, the physician stresses mainly on how often the attacks occur, changes in medication and the side effects thereof, and of course, general
physical health. It is also important that he visit the patient and the family, which is a so
cial role. A satisfactory relationship between the patient and his physician is crucial for correct management of epilepsy.
What are the social issues attached with epilepsy?
They are social stigma, schooling, employment fear, worry about one's future and com
promised quality of life. I shall tackle each issue individually and briefly:
Social Stigma:
Social stigma is nothing but reflection of knowledge of epilepsy, which is limited or nil, amongst people in the society. An epileptic seizure is something out of control, undignified and embarrassing. It is also an un-calledfor burden on the onlookers, who wish to but cannot extend any kind of help to the patient, during the attack. Hence the patient develops a negative attitude towards this affliction-why me, of all people.
It is but natural for such patients to be aloof from others. To site a pitiful example is that an a epileptic child may not have friends in the a school or in the housing complex because many in our so-called cultured society actually believe that epilepsy is contagious! It is very difficult for an epileptic patient to adjust his emotions. Hence marriage rate among such patients is low. At this juncture, a physician plays an important role in explaining to the family that epilepsy can be treated and controlled and the patient can lead a normal life.
Epilepsy in School-Going Children:
Despite th belief that epileptic children are dullards in their studies, they can prove to be equal to the best, if a proper, supportive environment is provided. In our country, with factors such as attitudes of parents, teachers and other children, it is rather difficult to achieve this. Children wih epilepsy, who are on a drug called 'Gardenal' (Phenobarbitone) tend to become dull because of the hypnotic sideeffect of the drug and hence tend to lag behind the others. It is the physician, who prescribes the adequate dosage or a combination of drugs which control the seizure, at the same time keeping the child in alert mind. This again proves that good communication (by regular visits) between the doctor, the child's parents and the teacher is important to help the child in creating a positive self-esteem and lead a normal life.
Employment and Epilepsy:
It is difficult for a patient with epilepsy, to
find a job because the emplqycr takes it for granted that the person is going to remain absent often and may hurt himself while working. In any profession, except driving, underwater work, workiJ)g at heights or in a very noisy atmosphere, an epileptic patient can be quite competent. Here too, the physician should guide and encourage the patient with controlled seizures to choose a job suiting his/ her skills.'
Fear and Worry:
We, the human beings worry about everything between a common cold to cancer. It is but natural for epileptic patients to worry about their affliction, be afraid of what the future may hold for them. The commonest fear is that of mental retardation followed by brain damage, injuries to body and finally death. ItAlthough most patient seeking blepharoplasty do so for cosmetic reasons, a significant subgroup who have function or medical problems related to the eyelids, also request the operation. Blepharoplasty cannot correct cheek pads, peri-occular, wrinkles, and lateral brow fullness or brow ptosis and additional procedures. Eg. Brow lift may be needed. Laser blepharoplasty using CO2 laser
is one of the latest techniques in vogue.
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