Epilepsy

Dear Dr. A. Razak,
You may see the details and remedies of this disease in Chapter Epilepsy in Borick 'Select Your Remedy'.

However, I have experienced of a patient of epilepsy and prescribed him
Kali Phos-6x and mag.Phos-6x according to his symptoms. He get relief.

Dr. mahfooz

Dear Abdul,

Epilepsy (sometimes referred to as a seizure disorder) is a common chronic neurological condition that is characterized by recurrent unprovoked epileptic seizures.[1][2] These seizures are transient signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.[3] It affects approximately 50 million people worldwide.[4] Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood.

Classification
Epilepsies are classified five ways:

By their first cause (or etiology).
By the observable manifestations of the seizures, known as 'semiology.'
By the location in the brain where the seizures originate.
As a part of discrete, identifiable medical syndromes.
By the event that triggers the seizures, as in primary reading epilepsy.
In 1981, the International League Against Epilepsy (ILAE) proposed a classification scheme for individual seizures that remains in common use.[5] This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy and is outlined later on in this article. In 1989, the ILAE proposed a classification scheme for epilepsies and epileptic syndromes.[6] This can be broadly described as a two-axis scheme having the cause on one axis and the extent of localisation within the brain on the other. Since 1997, the ILAE have been working on a new scheme that has five axes: ictal phenomenon, seizure type, syndrome, etiology and impairment.

[edit] Diagnosis
The diagnosis of epilepsy requires the presence of recurrent, unprovoked seizures; accordingly, it is usually made based on the medical history. EEG, brain MRI, SPECT, PET, and magnetoencephalography may be useful to discover an etiology for the epilepsy, discover the affected brain region, or classify the epileptic syndrome, but these studies are not useful in making the initial diagnosis.

Long-term video-EEG monitoring for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost, low availability and inconvenience.

Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions. These non-epileptic seizures can be hard to differentiate and may lead to misdiagnosis.

Epilepsy covers conditions with different aetiologies, natural histories and prognoses, each requiring different management strategies. A full medical diagnosis requires a definite categorisation of seizure and syndrome types.[8]

Causes
The cause of an individual's epilepsy can be divided into two categories: symptomatic and idiopathic.[6] Symptomatic epilepsies originate due to some structural or metabolic abnormality in the brain. This may be the result of:

genetic conditions such as tuberous sclerosis and ring chromosome 20 syndrome
complications during pregnancy or birth
stroke
head injury
neurosurgical operations
bacterial or viral encephalitis
parasitical infection
alcohol
vaccination (especialy during or shortly after having a fever)
The term cryptogenic is used to describe epilepsy where the cause is suspected to be symptomatic but the underlying illness or damage has not been identified.

The term idiopathic means 'a disorder unto itself', and not 'cause unknown'.[7] No other condition has been implicated as the cause of the epilepsy. Idiopathic epilepsies are often but not exclusively genetic and generalized - for example Juvenile Absence Epilepsy.


[edit] Triggers
The diagnosis of epilepsy requires that the seizures be 'unprovoked', with the implication that the provocant is assumed to be something obviously harmful. However, in some epilepsy syndromes the provocant can reasonably be considered to be part of normal daily life. Examples of these normal provocants include reading, hot water on the head, hyperventilation, and flashing or flickering lights. This last provocant is a special type of reflex epilepsy called photosensitive epilepsy. Although assumed to be a common trigger for epilepsy, amongst both patients and the public, only around 5% of people with epilepsy are affected by flickering lights.

Certain environmental factors can lead to an increased likelihood of seizures in someone with epilepsy or in certain syndromes. For example:

being asleep
the transition between sleep and wakefulness
tiredness
illness
constipation
menstruation
stress
alcohol consumption

[edit] Epidemiology
The most common ages of incidence are under the age of 18 and over the age of 65. It has been estimated that about 1% of the population meets the diagnostic criteria for epilepsy at any given time, but some theorize that the prevalence may be much higher in fact.


[edit] Seizure types
Main article: Seizure types
Seizure types are organized firstly according to whether the source of the seizure within the brain is localized (partial or focal onset seizures) or distributed (generalized seizures). Partial seizures are further divided on the extent to which consciousness is affected. If it is unaffected, then it is a simple partial seizure; otherwise it is a complex partial seizure. A partial seizure may spread within the brain - a process known as secondary generalization. Generalized seizures are divided according to the effect on the body but all involve loss of consciousness. These include absence (petit mal), myoclonic, clonic, tonic, tonic-clonic (grand mal) and atonic seizures.


[edit] Seizure syndromes
There are many different epilepsy syndromes, each presenting with its own unique combination of seizure type, typical age of onset, EEG findings, treatment, and prognosis. Below are some common seizure syndromes:

Infantile spasms (West syndrome) is associated with brain development abnormalities, tuberous sclerosis, and perinatal insults to the brain. It affects infants (as implied by its name), which by definition is between 30 days to 1 year of life. It carries a poor prognosis such that only 5-10% of children with infantile spasms will develop normal to near-normal function, while more than two-thirds will have severe deficits. The typical seizures are characterized by sudden flexor and extensor spasms of head, trunk, and extremities. The key EEG finding in these patients is a hypsarrhythmia, or a high-voltage slow wave with multifocal spikes. The first line treatment for these patients is adrenocorticotropic hormone (ACTH or corticotropin) since traditional antiepileptic drugs generally cannot adequately control seizure activity. Vigabatrin is also used in many countries, and is particularly effective when tuberous sclerosis is the cause of seizures.

Generalized 3 Hz spike and wave discharges in EEGChildhood absence epilepsy affects children between the ages of 4 and 12 years of age. These patients have recurrent absence seizures that can occur hundreds of times a day. On EEG, one finds the stereotyped generalized 3 Hz spike and wave discharges. A subset of these patients will also develop generalized tonic-clonic seizures. This condition carries a fairly good prognosis in that these children do not usually show cognitive decline or neurological deficits. First line treatment for pure absence seizures is ethosuximide. If patients do not respond or have mixed seizures along with their absence seizures, then valproic acid can be used.
Benign focal epilepsies of childhood The most common syndromes comprising the benign focal epilepsies of childhood include Benign Childhood Epilepsy with Centro-Temporal Spikes (or benign rolandic epilepsy), and Benign Childhood Epilepsy with Occipital Paroxysms. Benign rolandic epilepsy begins in children between the ages of 4 and 13 years. Apart from their seizure disorder, these patients are otherwise normal. Seizures occur at night and sleep promotes secondary generalization. As such, parents only report generalized seizures because focal manifestations are often subtle and go unnoticed. Between seizures, patients have a stereotyped EEG pattern that includes di- or triphasic sharp waves over the central-midtemporal (Rolandic) regions. Prognosis is uniformly good with seizures disappearing by adolescence. There is no consensus on the first line treatment, however most cases respond well to most anticonvulsants.
Juvenile myoclonic epilepsy (JME) begins in patients aged 8 to 20 years. These patients have normal IQ and are otherwise neurologically intact. JME is thought to be genetic, though that is not to say that JME will show in immediate family members. The seizures are morning myoclonic jerks often with generalized tonic-clonic seizures that occur just after waking. 'Petit mal' or absence seizures are less common in cases of JME, but are known to occur more often in young girls. EEG readings reveal generalized spikes with 4-6 Hz spike wave discharges and multiple spike discharges. Interestingly, these patients are often first diagnosed when they have their first generalized tonic-clonic seizure later in life when they experience sleep deprivation (e.g., freshman year in college after staying up late to study for exams). Alcohol is a major contributing factor and those with severe JME should monitor their intake of units. Valproic acid is the first line treatment, whereas carbamazepine can actually worsen symptoms. This condition is lifelong, thus patients must be taught appropriate sleep hygiene to prevent generalized tonic-clonic seizures. The severity of JME varies from person to person - some will experience full blown tonic-clonic seizures regularly, others will suffer only under sufficient stress from lack of sleep and intoxication.
Temporal lobe epilepsy is the most common epilepsy of adults. In most cases, the epileptogenic region is found in the mesial temporal structures (e.g., the hippocampus, amygdala, and parahippocampal gyrus). Seizures begin in late childhood and adolescence. There is an association with febrile seizures in childhood, and some studies have shown herpes simplex virus (HSV) DNA in these regions, suggesting that perhaps this epilepsy has an infectious etiology. Most of these patients have complex partial seizures sometimes preceded by an aura. If the patient does not respond sufficiently to medical treatment, surgery may be considered.
Fetal alcohol syndrome (FAS) is caused by prenatal alcohol exposure and results in central nervous system (CNS) damage. Seizure disorders due to prenatal alcohol exposure are one of several possible criteria for diagnosing FASD; however, any seizure disorder due to postnatal insult does not qualify as a diagnostic criterion for FASD.[9]
Frontal lobe epilepsy
Lennox-Gastaut syndrome
Occipital lobe epilepsy

[edit] Treatment
Epilepsy is usually treated with medication prescribed by a physician; primary caregivers, neurologists, and neurosurgeons all frequently care for people with epilepsy. In some cases the implantation of a stimulator of the vagus nerve, or a special diet can be helpful. Neurosurgical operations for epilepsy can be palliative, reducing the frequency or severity of seizures; or, in some patients, an operation can be curative.


[edit] Responding to a seizure
In most cases, the proper emergency response to a generalized tonic-clonic epileptic seizure is simply to prevent the patient from self-injury by moving him or her away from sharp edges, placing something soft beneath the head, and carefully rolling the person into the recovery position to avoid asphyxiation. In some cases the person may seem to start snoring loudly following a seizure, before coming to. This merely indicates that the person is beginning to breathe properly and does not mean he or she is suffocating. Should the person regurgitate, the material should be allowed to drip out the side of the person's mouth by itself. If a seizure lasts longer than 5 minutes, or if the seizures begin coming in 'waves' one after the other - then Emergency Medical Services should be contacted immediately. Prolonged seizures may develop into status epilepticus, a dangerous condition requiring hospitalization and emergency treatment.

Objects should never be placed in a person's mouth by anybody - including paramedics - during a seizure as this could result in serious injury to either party. Despite common folklore, it is not possible for a person to swallow their own tongue during a seizure. However, it is more likely the person will bite their own tongue.

After a seizure, it is typical for a person to be exhausted and confused. Often the person is not immediately aware that they have just had a seizure. During this time one should stay with the person - reassuring and comforting them - until they appear to act as they normally would. Seldom during a seizure the person may have soiled themselves. In some instances the person may also vomit after coming to. People should not eat or drink until they have returned to their normal level of awareness, and they should not be allowed to wander about unsupervised. Many patients will sleep deeply for a few hours after a seizure - this is common for those having just experienced a more violent type of seizure such as a tonic-clonic. In about 50% of people with epilepsy, headaches may occur after a seizure. These headaches share many features with migraines, and respond to the same medications.

It is helpful if those present at the time of a seizure make note of how long and how severe the seizure was. It is also helpful to note any mannerisms displayed during the seizure. For example, the individual may twist the body to the right or left, may blink, might mumble nonsense words, or might pull at clothing. Any observed behaviors, when relayed to a neurologist, may be of help in diagnosing the type of seizure which occurred.


[edit] Pharmacologic treatment
Main article: Anticonvulsant
Some medications can be taken daily in order to prevent seizures altogether or reduce the frequency of their occurrence. These are termed 'anticonvulsant' or 'antiepileptic' drugs (sometimes AEDs). All such drugs have side effects that are idiosyncratic and others that are dosage-dependent. It is not possible to predict who will suffer from side effects or at what dose the side effects will appear.

Some people with epilepsy will experience a complete remission when treated with an anticonvulsant medication. If this does not occur, the dose of medication may be increased, or another medication may be added to the first. The general strategy is to increase the medication dose until either the seizures are controlled, or until dose-limiting side effects appear; at which point the medication dose is reduced to the highest amount that did not produce undesirable side effects.

Serum levels of AEDs can be checked to determine medication compliance and to assess the effects of drug-drug interactions; some physicians do not use serum levels to fine tune medication, but other physicians believe that serum levels provide excellent data for tailoring medications to suit an individual's specific and relatively variable body chemistry. For example, therapeutic doses (the dose at which seizures are controlled and side effects are minimal and tolerable) may vary widely from among patients. The therapeutic ranges provided by pharmaceutical companies are only ranges and by using blood serum levels and seizures diaries, better seizure control can sometimes be reached. In some cases (such as a seizure flurry) serum levels can be useful to know if the level is very high or very low.

If a person's epilepsy cannot be brought under control after adequate trials of two or three (experts vary here) different drugs, that person's epilepsy is generally said to be 'medically refractory.'

Various drugs may prevent seizures or reduce seizure frequency: these include carbamazepine (common brand name Tegretol), clobazam (Frisium), clonazepam (Klonopin), ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin (Cerebyx), flurazepam (Dalmane), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), mephenytoin (Mesantoin), phenobarbital (Luminal), phenytoin (Dilantin), pregabalin (Lyrica), primidone (Mysoline), sodium valproate (Epilim), tiagabine (Gabitril), topiramate (Topamax), valproate semisodium (Depakote, Epival), valproic acid (Depakene, Convulex), and vigabatrin (Sabril).

Other drugs are commonly used to abort an active seizure or interrupt a seizure flurry; these include diazepam (Valium) and lorazepam (Ativan). Drugs used only in the treatment of refractory status epilepticus include paraldehyde (Paral) and pentobarbital (Nembutal).

Bromides were the first of the effective anticonvulsant pure compounds, but are no longer used in humans[10] due to their toxicities and low efficacy.


[edit] Surgical treatment
Surgical treatment can be an option for epilepsy when an underlying brain abnormality, such as a benign tumor or an area of scar tissue (e.g. hippocampal sclerosis) can be identified. The abnormality must be removable by a neurosurgeon.

Surgery is usually only offered to patients when their epilepsy has not been controlled by adequate attempts with multiple medications. Before surgery is offered, the medical team conducts many tests to assess whether removal of brain tissue will result in unacceptable problems with memory, vision, language or movement, which are controlled by different parts of the brain. These tests usually include a neuropsychological evaluation, which sometimes includes an intracarotid sodium amobarbital test (Wada test) - although this invasive procedure is being replaced by non-invasive functional MRI in many centres. Resective surgery, as opposed to palliative, successfully eliminates or significantly reduces seizures in about 50-90% of the patients who undergo it (the exact percentage depends on the particulars of the case and surgeon in question.) Many patients decide not to undergo surgery owing to fear or the uncertainty of having a brain operation.

The most common form of resective surgical treatment for epilepsy is to remove the front part of either the right or left temporal lobe. A study of 48 patients who underwent this operation, anterior temporal lobectomy, between 1965 and 1974 determined the long-term success of the procedure. Of the 48 patients, 21 had had no seizures that caused loss of consciousness since the operation. Three others had been free of seizures for at least 19 years. The rest had either never been completely free of seizures or had died between the time of the surgery and commencement of the study.[11]

Palliative surgery for epilepsy is intended to reduce the frequency or severity of seizures. Examples are callosotomy or commissurotomy to prevent seizures from generalizing (spreading to involve the entire brain), which results in a loss of consciousness. This procedure can therefore prevent injury due to the person falling to the ground after losing consciousness. It is performed only when the seizures cannot be controlled by other means. Resective surgery can be considered palliative if it is undertaken with the expectation that it will reduce but not eliminate seizures.

Hemispherectomy is a drastic operation in which most or all of one half of the cerebral cortex is removed. It is reserved for people suffering from the most catastrophic epilepsies, such as those due to Rasmussen syndrome. If the surgery is performed on very young patients (2-5 years old), the remaining hemisphere may acquire some rudimentary motor control of the ipsilateral body; in older patients, paralysis results on the side of the body opposite to the part of the brain that was removed. Because of these and other side effects it is usually reserved for patients who have exhausted other treatment options.


[edit] Other treatment
Ketogenic diets may occasionally be effective in controlling some types of epilepsy; although the mechanism behind the effect is not fully understood, shifting of pH towards a metabolic acidosis and alteration of brain metabolism may be involved. Ketogenic diets are high in fat and extremely low in carbohydrates, with intake of fluids often limited. This treatment, originated as early as the 1920s at Johns Hopkins Medical Center, was largely abandoned with the discovery of modern anti-epileptic drugs, but recently has returned to the anti-epileptic treatment arsenal. Ketogenic diets are sometimes prescribed in severe cases where drugs have proven ineffective.

Vagus nerve stimulation is a recently developed form of seizure control which uses an implanted electrical device, similar in size, shape and implant location to a heart pacemaker, which connects to the vagus nerve in the neck. Once in place the device can be set to emit electronic pulses, stimulating the vagus nerve at pre-set intervals and milliamp levels. Treatment studies have shown that approximately 50% of those treated in this fashion will show significant seizure reduction.

The Responsive Neurostimulator System (RNS) is currently undergoing clinical study prior to FDA approval. This system relies upon a device implanted just under the scalp. The leads attached to the device are implanted either on the brain surface or in the brain area itself and are located close to the area where the seizures are believed to start. When a seizure begins, an electrical shock is delivered to suppress it. This system is different from the VNS system in that the RNS relies on direct brain stimulation and the RNS is a responsive system. The VNS pulses at predetermined intervals previously set by medical personnel. The RNS system responds to detected signs that a seizure is about to begin and can record events and allow customized response patterns which may provide a greater degree of seizure control.

A seizure response dog is a form of service dog that is trained to summon help or ensure personal safety when a seizure occurs. These are not suitable for everybody and not all dogs can be so trained. Rarely, a dog may develop the ability to sense a seizure before it occurs.[12]

A number of systematic reviews by the Cochrane Collaboration into treatments for epilepsy looked at acupuncture[13], psychological interventions[14], vitamins[15] and yoga[16] and found there is no reliable evidence to support the use of these as treatments for epilepsy. Further studies are needed on the subject.


[edit] Pathophysiology
Mutations in several genes have been linked to some types of epilepsy. Several genes that code for protein subunits of voltage-gated and ligand-gated ion channels have been associated with forms of generalized epilepsy and infantile seizure syndromes.[17] Several ligand-gated ion channels have been linked to some types of frontal and generalized epilepsies. Epilepsy-related mutations in some non-ion channel genes have also been identified.

One interesting finding in animals is that repeated low-level electrical stimulation to some brain sites can lead to permanent increases in seizure susceptibility: in other words, a permanent decrease in seizure 'threshold.' This phenomenon, known as kindling (by analogy with the use of burning twigs to start a larger fire) was discovered by Dr. Graham Goddard in 1967. Chemical stimulation can also induce seizures; repeated exposures to some pesticides have been shown to induce seizures in both humans and animals. One mechanism proposed for this is called excitotoxicity. The roles of kindling and excitotoxicity, if any, in human epilepsy are currently hotly debated.


[edit] History and stigma
The word epilepsy is derived from the Greek epilepsia, which in turn can be broken in to epi- (upon) and lepsis (to take hold of, or seizure)[18] In the past, epilepsy was associated with religious experiences and even demonic possession. In ancient times, epilepsy was known as the 'Sacred Disease' because people thought that epileptic seizures were a form of attack by demons, or that the visions experienced by persons with epilepsy were sent by the gods. However, in many cultures, persons with epilepsy have been stigmatized, shunned, or even imprisoned; in the Salpêtrière, the birthplace of modern neurology, Jean-Martin Charcot found people with epilepsy side-by-side with the mentally retarded, those with chronic syphilis, and the criminally insane. In Tanzania to this day, as with other parts of Africa epilepsy is associated with possession by evil spirits, witchcraft, or poisoning, and is believed by many to be contagious.[19] In ancient Rome, epilepsy was known as the Morbus Comitialis ('disease of the assembly hall') and was seen as a curse from the gods.

Stigma continues to this day, in both the public and private spheres, but polls suggest it is generally decreasing with time, at least in the developed world; Hippocrates remarked that epilepsy would cease to be considered divine the day it was understood.[20]


[edit] Legal implications
Most people diagnosed with epilepsy are forbidden by their local laws from operating vehicles. However, there are usually exceptions for those who can prove that they have stabilized their condition. Those few whose seizures do not cause impairment of consciousness, or whose seizures only arise from sleep, may be exempt from such restrictions, depending on local laws. There is an ongoing debate in bioethics over who should bear the burden of ensuring that an epilepsy patient does not drive a car or fly an airplane.

In the U.S., people with epilepsy can drive if their seizures are controlled with treatment and they meet the licensing requirements in their state. How long they have to be free of seizures varies in different states, but it is most likely to be between three months and a year.[21] [22] The majority of the 50 states place the burden on patients to report their condition to appropriate licensing authorities so that their privileges can be revoked where appropriate. A minority of states (including California) place the burden of reporting on the patient's physician. After reporting is carried out, it is usually the driver's licensing agency that decides to revoke or restrict a driver's license.

In the UK, it is the responsibility of the patient to inform the Driver and Vehicle Licensing Agency (DVLA) if they have epilepsy.[23] The DVLA rules are quite complex[24] , but in summary[25] , those continuing to have seizures or who are within 6 months of medication change may have their license revoked. A doctor who becomes aware that a patient with uncontrolled epilepsy is continuing to drive has, after reminding the patient of their responsibility, a duty to break confidentiality and inform the DVLA. The doctor should advise the patient of the disclosure and the reasons why their failure to notify the agency obliged the doctor to act.


Now about Homoeopathic treatment we can not provide treatment by name of disease only. But still we have medicine on Symptom Epilepsy without aura....

Medicine is Zincum Valerianicum according to Boericke.
If you want to treat him Homoeopathically then we need details of the case.

Hope this information help you.

Dr.Dinesh Sharma

Dear Doctor,

I have been suffering from Temporal Lobe Epilepsy. I would really be grateful if you could look up my case and suggest me medicines to control my attacks or better still I need to be cured.

I had taken the questionare from the forum. hope they suffice. I have been living with it for a long time. Neither allopathy nor homeopathy from the local doctor has brought me relief. Memory is not very sharp in fact you could say I have a week memory. Certain things I would recall only after some time. I would also repeat statements very frequently not aware that I had already mentioned earlier. If I am doing anything regularly, then I tend
to remember. In case somebody pops up to my house, tell me her name, I would not be able to immediatly recollect her name. Hence what ever I could recall, I am listing below.

My life has also become miserable. Even my husband and kid treat me differently. I have to spend a good amount of money for my allopathy meds and a fair amount of money for homeopathy. This has also eaten into all our savings. There are no tests which have not been done on me.MRI, EEG etc.



First Name: Reny
Age: 40
Height: 5’5”
Weight:45

CHIEF COMPLAINT:

1. What is your chief complaint (CC)? Tell as much about it as you can,
including what is the worst part of it and why it's the worst: the
sensations, the kind of pain, the location, how your energy has been
affected (for example, has the complaint made you restless, weak, nervous,
anxious, irritable, hypersensitive, effected your thirst and appetite, your
body temperature, and so on).
- Temporal Lobe Epilepsy – Severe headache in the forehead (not always),Gets a relief when I tie something on the head, restless, weak, nervous. Not able to sleep well. Tired, pains all over the body. lethargic, Thirst is less and ravishing appetite .There isn't a day without any problems.Cannot stand cold. even in summer if there is a fan, I need to cover my self.No initiative to do any work. Would prefer to lie down instead. When get angry or critisised would feel like leaving the house and ending my life.

2. When did this problem begin? What happened in your life around that
time? What do you think caused it?
- When I was 9 years old, while playing I hit my forehead on a tree. I lost a teeth

3. What aggravates the CC and what brings it on?(for example, certain types
of food or weather, movement, light, noise, company, talking, heat/cold, or
anything else that you can think of; please be specific) and what makes the
CC better (for example hot or cold, massage, eating, lying still, music,
company...)? What does it make you do to try to feel better?
- Whenever I am tensed or under some stress, periods etc. There is no particular reason. Just comes on It lasts for a minute or two and am back to normal. The other day while coming from the market along with my daughter, an attack came. I Lost my purse on my way. It included money, the house keys and our locker keys. but then no attack came because of it.

4. At what time of the day or night is the CC the worst? Specify an hour if
you can.
- Mostly it is in the daytime. It occurs at other time of the day also but very rare.

5. What symptoms can you identify that accompany the CC (whether directly
related or not; for example, headache with nausea; or menstrual cramps with
diarrhea; a cold with irritability and anger)?
- Whenever an attack(epileptic attack) comes, I loose all controls for just
a few minutes. If I hold something in my hand it drops. At times if I were
clasping some thing, I just hold it tight. There are instances where I have
not dropped my children when an attack comes. Once I was about to fall on
the gas cooker. I was held back.
- I have also noticed that if my periods are prolonged or earlier, I tend to have an attack. I had an attack when my period started and I had an attack the next day morning. Earlier after an attack, I used to feel drained and totally tired. I have to lie down and after a
few minutes of rest I am back to normal. Nowadays I come to grips immediately
after an attack.


GENERAL QUESTIONS

6. Environment: With regard to the seasons, weather, outdoor temperature,
indoor temperature, drafts, air quality, airconditioning, ocean air,
mountain air, humidity, the sun/rain/thunderstorms/clouds/fog, etc.: what
environmental factors give you comfort and relief, and which ones cause
discomfort and distress? Try to give examples.
- I am very averse to cold climate especially winters. I prefer to stay in
warm climate, rooms.

7. What position is most uncomfortable for you?
- I tend to sleep on the sides. No particular sides.

8. a)Do you tend to be chilly or warm? Are there parts of your body that
are colder or warmer than the rest of you? Is there a special time of day or
night when they are colder or warmer?
- I am more of the chilly kind. A little bit of change in weather, I tend
to catch a cold and I have to cover myself with blanket or a thick bedsheet.

b) Do you perspire a great deal? If so, when? And where on the body? (feet,
head, hair, chest, armpits, etc) Does it leave a stain of a particular
color? Is there a particular odor?
- I don’t sweat.

9. Describe what your tongue looks like.
-

MENTAL/EMOTIONAL

10. What do you worry about? How do you deal with worries?
- Lately we are in a financial mess. Income is meagre and that makes me
very worried. I just tend to brood.

11. How do you keep your house/your desk/your room/your study/your
bathroom?
- Untidy, Not very clean - I am unable to attend the regular chores of the
house. Very frequently something or the other would be falling. There are
lots of broken cups and crockery’s. Very lethargic. Just need to lie down.
Most of the time I would be lying down someplace or the other.

12. How easily do you cry? In what situations?
I tend to weep for any small reasons. Even when I am sad, or I am
criticized for any thing.

13. When you are upset, what do you do to help yourself feel better?
- When I am sad or worried, I normally say my prayers. I am a very
religious person. Tend to observe fast etc.

14. What makes you angry? What do you do when you're angry?
- Slightest provocation makes me angry. No banging stuff. Just cribs and
grumbles at anything and everything. Who so ever comes in between, gets a
piece of my anger.


15. Do you have an emotion that predominates; such as anger, depression,
irritability, anxiety, jealousy, joy...or possibly two emotions that tend
to alternate predictably?
I get angry and mostly I am depressed.

16. What fears do you have?
- No fears at all.

17. What have been the most difficult circumstances in your life? How did
you cope?
- When my husband had to quit his overseas job and for almost 2 years was
jobless. Very difficult to pull on with 2 children who are studying. Partly
he had to quit his jobs because of me. I was not able to pull on or control
anything. Even our younger daughter had failed in her school in the lower
grades.

18. What are the greatest joys you have had in your life?
My children when they were born and when my husband left for his job
overseas. We happen to live in India.

19. What was your childhood like?
- We were a family of eight people.2 of them did when they were kids. They were also epileptic. 3 brothers all elder to me and 3 sisters. I happen to be the one in the middle. My family was fairly rich and as such our parents did not deprive of anything. They were a bit on the orthodox type and as such we were not allowed to binge. We are on the
religious side.

20. What bothers you most in other people? How, if at all, do you express
it?
- Nothing particular, I hate if anyone criticizes me. I tend to stay away
from the person. They should be symphatatic towards me and should be look
on me. Or they should care about me.


21. What causes the most problems in your relationships?
Criticism, and lack of understanding

22. Do you have any recurring dreams? What are they about?
- Mostly my dreams are about death of near ones or probably my family. My
parents, brothers and sisters

23. What would you need to feel happy?
- A happy family life. No financial worries etc

24. What do you do for work? Ideally, what would you like to do?
- Housewife. Education was not very successful, have failed 3 times for my
high school graduation. Was fairly good in the lower grades and in sports.
Later on by the time I came to high school I was forgetting and lack of
concentration. Was forgetting everything. I had to appear 3 times to clear
my high school.

25. When people have criticized you, what were they complaining about?
Similarly, when people have praised you, what did you receive praise for?
- Untidiness and unworthiness. I do not tend to do anything properly. It’s
a total mess. During my childhood I was praised for my sports and religious
attitude. I did not want to marry. I wanted to go into a convent. My family
was against it. They could not stand their daughter going to a convent.

26. What would you like to change most about yourself?
My illness and my positive approach to life. Lead a fuller life.


FOOD

27. How do you feel before, during and after meals? How do you feel if you
go without a meal?
- No appetite at times. There are times when I don’t feel like eating.

28. What would you most like to eat (if you did not have to consider
calories, fat, anything you've read about the right way to eat)?
- I eat anything and everything. Like a bit on the hotter, spicy food. Like
pickles. Love coffee.

39. What foods do you dislike and refuse to eat? What foods do you react
badly to, and in what way?

30. How much do you drink in a day? Include sodas, juice, coffee, tea,
milk,and alcoholic beverages as well as water. How thirsty do you tend to get? What
temperature would you like your drinks to be?
- Water intake is fairly ok. Around 10 glasses of water. If coffee is
around
I don’t mind it. I prefer drinks which are warmer. I do not take alcohol
etc. I eat ice creams etc. just about it.




SLEEP

31. How is your sleep?
- No proper sleep. Unsatisfactory. By the times we have our dinner, and
with the children around, I go to bed late and get up early to send them to
school. Given a chance I would just go on sleeping. Very lethargic. You
would never find me sitting, given a few minutes of free time, I would be
lying on any surface.

32. Do you do anything during sleep? (speak, laugh, shriek, toss about,
grind your teeth, drool, snore, walk, talk, etc.)
- I twitch and tremble a lot. Like jerking. Also toss about a lot. A wee
bit of snoring

33. Do you have trouble falling asleep? What keeps you awake? Do you wake
always at a certain time? What causes you to wake up? What position do you
sleep in?
- If by any chance I happen to sleep in the afternoon, I have trouble
falling asleep. And if my sleep is broken abruptly or any other
disturbance, I tend to have a headache. I tie a cloth or something tightly
to my forehead. If it becomes too unbearable I take a paracetamol.

WOMEN

34. Number of pregnancies, number of children, number of miscarriages,
number of abortions
- 2 children. Both caesarians.. No miscarriages or abortion. Stopped
pregnancy.

35. At what age did your menses begin? If you have gone through menopause,
at what age?
- At the age of 13 my periods started.

36. How frequently do they (or did they) come?
- They were regular. At times it has got delayed. Once it was delayed for
more that 10 days. I suddenly became worried, whether I was pregnant. Did a
urine test. Negative. Doctor gave me some meds and after a day my periods
started.

37. What about their duration, abundance, colour, time of day when flow is
greatest; any odour or clots?
- My period normally lasts for 4-5 days. The first and the last day the
flow is thick and great.

38. How do you (did you) feel before, during and after menses?
- I feel well. Like everything is working fine.

HEALTH HISTORY

39. What medications are you taking at present?
- Tegritol, Freezium and Diamox , Have taken Plumbum met, cuprum met, bufo rana Oenae, Kali sulp.l, Nat Mur

40. How frequently do you get colds and flus?
- A slight aggravation, change in climate or the kids getting it from
school. I should say that I tend to be sick always. Right from the top of
the head to the toe of the feet. Something or the other I am sick

41. Have you had any childhood illnesses twice, or in a very severe form,
or after puberty?
- My epileptic bout has started from my childhood. Also I had Chicken pox.

42. Have you had any vaccinations since the standard childhood ones? Have
you ever had an adverse or unusual reaction to a vaccination?
- None -

43. Have you had any surgery? What and when?
- Nothing – just my 2 caesarian operations.

44. Have you had at any time (mention year): warts, cysts, Polyps, or
tumors? Where were they located? How were they treated?

45. Do you tend to have any discharges (nasal, vaginal, etc.)? What is the
color, consistency?

SENSITIVITY

46. a) Do you tend to need a smaller dose of medications than most other
people?
- No
b) Do you need less anaesthesia than others, or have a hard time coming out
of it?
- No
c) Do you tend to react to vitamins and herbs and/or need hypoallergenic
vitamins?
- No
d) Are you sensitive to paint fumes, exhuast, dry cleaning fluid,
fragrances etc.?
- No

47. Family history: Mention diseases, causes and ages of deaths of father,
mother, sisters, brothers and grandparents on both sides.
- Grand parents death normal. Three elder siblings died in their childhood.
Have heard from my parents that they had high fever and they died. Mother
died of Brain Hemorrhage and dad did of kidney failure. He was sick through
out. I carry all his traits. Body structure, face probably everything. He
loved me more than all his kids. He was also worried about me and my
epileptic attaks.

48. Construct a time line: Mention from birth on to the present day, all
IMPORTANT events (emotional and physical traumas, heartbreaks, divorces,
work-related events, diseases or traumas your mother had while being
pregnant with you, family stress, death in the family or of friends,
disappointment, etc.) Mention the symptoms experienced at those moments or
which you can date to those traumas.

49. When you stand in line at the bank or supermarket, how do you feel?

50. When your family member was last sick, what did you do?

51. How is your sexual energy?
- Normal – But I do not crave for it nor do I initiate it. I tend to get
aroused when my breasts or pubic parts are rubbed or fondled.For the past year had no sexual contact.

52. How do you react to consolation
- I like sympathy or rather I need to be consoled

53. What part of your life do you have the most difficulty coping with.

>54. What are your hobbies?
- Just watching TV now. Listening to prayers or devotional songs.

I on my part have not been able to do any job successfully, there would
always be a problem.

Best Rgds

Dear Reny,

Well give me some time to study your case and I will come back to you very soon.

Dr.Dinesh Sharma

Dear Doctor,

Please review my case.

Rgds

Reni

Dear Reny,

Sorry for late reply. I studied your child's case and also discussed it with other doctors also. We advise you to start with Zincum Valerianicum 30C thrice a day (6-10 pellets as one dose).
DO not give raw onion,garlic,ginger,coffee. Restric television for 30 mins only. Make his daily routiene easy time bounded like early to bed n early to rise.

Report after 7 days.

Dr.Dinesh Sharma

Dr Sharma,

Thank you for suggesting the medicine. I would let you know the outcome.

By the way, it is for me and not for my child. By the Grace of God, my children do not suffer from Epilepsy.

Thank you,

May God Bless You,

Reni

Dear Reny,

Please do not take that medicine. As it was for the case of Dr.Abdul Razzq. And not for u. Sorry for wrong information.

For you We advise you to take Natrum Sul 30C thrice a day for 5 days and report.

DO not take raw onion,garlic,ginger,coffee. Restric television for 30 mins only. Make daily routiene easy & time bounded like early to bed n early to rise.

Report after 5 days.

Dr.Dinesh Sharma