Saturday, March 15, 2008

What qualifies someone as suffering from Epilepsy?

Dr. Robert Bonwetsch, a member of the Danbury Hospital's Department of Medicine, Section of Neurology, and practicing physician at Associated Neurologists, P.C., defines seizures as a change in awareness, sensation or behavior due to abnormal electrical changes in the brain.
"Having at least two unprovoked seizures qualifies a patient for having epilepsy," said Dr. Bonwetsch, who recently spoke at a Medical Town Meeting sponsored by Danbury Hospital called Epilepsy Update 2008.

The incidence of epilepsy is highest right after birth and then goes up again after age 50. Because epilepsy does not discriminate among races and can develop at any age, doctors must keep a watchful eye on seizure-prone patients.

Some patients with epilepsy will undergo electroencephalography (EEG) monitoring to determine in which part of the brain their seizures are beginning.

Although seizures can derive from almost any part of the brain, they most commonly initiate from the temporal and frontal lobes.

"We use EEG to help us decide which medications will be most appropriate," said Dr. Bonwetsch. "For patients with continuous episodes, we also use video-EEG monitoring which can be done at Danbury Hospital."

In cases that may require surgery, it is common for patients to receive CT scans or MRIs so their doctor can look for any abnormalities that may be causing the seizures.

Treatments for epilepsy are very patient specific, meaning that one particular treatment will not cure the general population of seizure sufferers.

While medication is the most utilized treatment, it is reported that only 70 percent will gain control over their seizures. It also is common for adult patients to remain on medication for the rest of their lives.

Just as there are treatments, there are potential long-term side-effects of which patients must be aware while staying on these long term medications.

Some side effects include weight gain or loss, overgrowth of the gums, numbness caused by neuropathy, hair loss and an increased risk of osteoporosis.

"We typically require patients who have been on the older anti-epileptic medication for over five years to receive bone density scans to evaluate them for signs of osteoporosis," Dr. Bonwetsch adds.

"We like to make sure our patients are getting enough calcium and vitamin D, and I would personally recommend weight-bearing exercise and no smoking."

Complications with medication typically arise in women by interacting with birth control and causing various fertility issues.

The elderly are also affected by running the risk of developing an altered metabolism, enhanced sensitivity to various side effects, and conflicting issues with drug-to-drug interactions.

There are several treatment options in development, including the surgically implanted NeuroPace device.

Those seeking additional information may visit or call the hospital, 203-739-7247.


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