epilepsy[/caption]Epilepsy is a disease which has been known to mankind since ancient times but is as yet one of the many unsolved puzzles of medicine. Some doctors think it is not a disease entity, but only a symptom of an underlying condition, which we fail to understand.
Many diseases of childhood, as, for instance, scarlet fever and pneumonia, often start with convulsions, but the convulsion is only a symptom of the oncoming disease. In epilepsy there might be a systemic upset, chemical hormonal or nervous in character, which when understood may likely be possible to control.
What doctors call Jacksonian epilepsy is an epileptic state following severe injury to the head and causing adhesions in the skull. When the patient is operated on and the adhesions or scars are removed, the patient becomes free of convulsive attacks for ever after.
The same happens when a removable tumor in the skull can be discovered. But the discovery of these causes of epilepsy is not easy and requires special effort and skill, and the cases in which injury or tumors prove to be the causes are few. In children epilepsy is often caused by disease or abnormalities such as eyestrain, worms, abnormalities of the genito-urinary organs, chronic appendicitis, adenoids and enlarged tonsils, and alcoholism or syphilis in the parents.
Epilepsy starting after the age of 35 years is mostly symptomatic of brain tumor or syphilis. In the great majority of cases, and there are many hundreds of thousands in the U.S.A, the electro-encephalograph merely confirms the presence of epilepsy and is of no value as to finding the cause or as a help to treatment.
however, medical advice and care can do such for some cases and help make life easier for many others. Shoemakers do not know a thing about the chemical science and art of leather-making, yet they can tell the quality of leather and are able to produce a fine and comfortable pair of shoes from that leather.
The octor also can do that much if he devotes himself attentively to a favorable case of epilepsy. But he can perform no miracles. He does not know much about is disease, so how can he produce the rather? There are two main types of epilepsy: 'he first is the "petit mal" in which there merely a twitching of various groups of muscles.
The patient stops in the midst ,of conversation or work for a few seconds, his eyes become blank and glassy, he may twitch around the mouth or other parts of the face, or twist his fingers or shrug his shoulders or neck. In a moment it is all over and the patient will go in with his talk or work just where he left off.
But don't get the idea that a flicker of an eyelash, the twitching of a muscle or habitual tics and shrugs have ,anything to do with "petit mal." "Petit mal" attacks usually recur often and some children suffering with it may develop the "grand mal" later. "Grand mal" is the more common type, and is accompanied by loss of consciousness, convulsive contractions of muscles and involuntary action of bladder and bowel.
These attacks last much longer than the "petit mal" attacks. After the attack, the patient may get up feeling exhausted for a while or he may sleep for hours. There is a third type, the "Psychomatic," which is more rare. In this the patient acts like a person wandering in his sleep. He will do things and go places without realizing what transpired.
Epilepsy, when not brought on by an injury or tumor, is undoubtedly set going by a change in the internal environment of the body; that is, there is some vital change in the orderly chemical and electrical processes going on in the complicated body mechanism.
It may involve . just an upset in molecular chemistry and a change in the normal hormone production, or it may be an actual atom-splitting explosion which reverses the normal physiological functions. Fear, worry and excitement may cause an attack, which suggests that there is a change in hormone or internal secretion production.
It has been found that habit plays a part in the frequency of attacks, so that when the patient learns how to overcome and control the situation he can, by this means, greatly reduce the frequency of the attacks. It is well known that many abnormalities in body functioning can be controlled by the patient's decision and the will power to change his diet, his temperament and his mode of life.
Examples are: constipation, heart attacks, pulse rate, high blood pressure, migraine headaches and aberration in eyesight. Many epileptic patients have a sort of premonition or warning of the coming of an attack by experiencing certain sensations (aura). It may be the sensing of a certain odor in the air (not necessarily disagreeable), or they may have a dizzy sensation or something like a feeling of indigestion or a sinking sensation in the pit of the stomach.
These signs offer them the opportunity to ward off the attack, or at least, in the case of "grand mal," prepare for it by placing themselves in a safe position or by summoning assistance to prevent injury to themselves and others. During attacks of "petit mal" or of psychomotor epilepsy there is nothing special you can or need do.
These types require general treatment. But in case of "grand mal" precautions must be taken to prevent injury, exposure and tongue-biting. Often the "grand mal" attacks induce a high temperature. Remove things out of his way, or place him on a bed, put a rolled-up, clean linen hand-kerchief or any piece of clean, rolled-up linen between his teeth to prevent tongue injury, loosen tight collar, belt or girdle and do not otherwise disturb him during the convulsion.
When he is relaxed, sponge him to reduce the fever; if he is able to swallow give him a tablespoonful of Epsom salt in half a cupful of water or as an enema. The Epsom salt may be repeated every five or six hours. A capsule of Dilantin, 1,5 grains, should be given to an adult and 0,5, grain to a child, if he is able to swallow it. Calcium chloride tablets, 5 grains each, should be given every 3 hours. Keep the person at rest in a quiet room for a few days after the attack.
All types of epileptics must lead a quiet life, free from anxiety, fear and excitement, must eat moderately of simple, nourishing- food, get plenty sleep y of sleep and fresh air day and night. They must also keep the bowels clean, take warm baths followed by an alcohol rubdown, and take good care of their mouth and throat hygiene.
Light outdoor employment or other easy employment is of great help Some of the greatest artists, writers, philosophers and leaders of historical 'fame have been sufferers from epilepsy. The percentage of mentally deteriorated individuals is no greater among epileptics than among the rest of the population.
Affliction with this illness as well as with any other chronic illness should be no bar to leading a normal, useful and interesting life. Occupying oneself purposefully and usefully is of the greatest help in all chronic diseases. Dilantin is a necessity in "grand mal" cases. Patients may take 1,5, grains 3 times a day, a child 0,5 grain 3 times a day. If the patient tolerates the drug without stomach upsets, he may take it more often.
When improvement is noticed, reduce the dose to one a day. Calcium chloride or calcium gluconate (5 grain tablets) should also be taken 3 times daily by all epileptic patients. Epsom salts should also be taken frequently between attacks, a teaspoonful or a tablespoonful daily, or once in three or four days, depending on the bowel effect.
Right after an attack of "grand mal" Epsom salt must be taken every few hours for a day or two. Natural d-g]utamic acid is of great hell in stopping "petit mal" attacks. It can be started in 7,5, grain tablets 3 times a day after meals and increased to 3 or 4 after each meal, if well tolerated.
The "ketogenic diet" has proven of value in "petit mal," often stopping all attacks. It is a diet very low in protein and in carbohydrates (starch and sugar), but high in fat. One does not have to be too strict in following this diet, lest symptoms of starvation and acidosis develop .
The general idea is to eat some fruit and vegetables of low starch content 3 to 10 %(see under topic Carbohydrate), 2 ounces of meat once a day bran muffins or crackers (unsweetened') one at every meal. But have plenty of cream and butter at every meal; use cream on the fruit and vegetable salads use it on jello dessert, in the vegetable soup and in all salad dressings.
Fat bacon may be had once a day, and the same goes for ice cream. Vegetables containin 20% carbohydrate may be used once day as a salad or soup. After a couple months of being on the "ketogenic diet, when improvement is noted, a gradual increase in the carbohydrate intake should be tried for a month with an equivalent decrease in the daily fat intake at the same time; then an increase ii protein should be tried for a month the same manner.
All diets for epileptic should be salt-free, and the water an liquid intake generally should be reduce to a minimum in all cases. In the light of present-day knowledge, water intake need not he restricted if the patient is on a salt-free diet, because in that case i the water will not be retained in the body. Retention of too much water it the body has been found to he harmful in epilepsy, but when no salt is consumed very little water is held back.
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