It should be ensured that the neck of the patient is straight, and his tie and other clothes should be loosened. He should be turned to one side, and a spoon should be placed in between the back teeth so that the tongue is not bitten. If there is any debris nearby, it should be removed so that the patient may not injure himself. The jaw, if tightly closed, should not be forced open to insert the spoon. It should be checked that there is no injury to the head.



At the same time, one should not try to hold the person and try to stop the convulsions, as once an attack occurs, it takes its own time to subside. In general, it is over within 1-2 minutes. It is also important that the patient should be duly cared for till he or she becomes fully conscious. He should be allowed to sleep after the convulsive attack is over, and he should not be disturbed unnecessarily, although he should be constantly kept under watch. However, an emergency / first aid treatment at the spot, and shifting a patient to the hospital should not be unnecessarily delayed.

After the diagnosis of epilepsy has been established in a particular case, the next important step. is the treatment of the condition.

An underlying cause of epilepsy, if available (a brain tumour, etc.), must be treated and given priority. However, drug treatment to control an attack/ s of epilepsy remains the same, whether the patient suffers from a case of idiopathic epilepsy or symptomatic epilepsy, where though the cause has been detected, but nevertheless, drug treatment is needed.

As regards drugs, it is the rule that the patient should be given a single drug as a trial. The drug should commensurate with the type of epilepsy the patient is suffering from. In other words, the type/pattern of the attack of epilepsy decides the choice of the drug. It is highly important that the drug should be given in proper dosages, depending upon the age of the patient.

To begin with, a very minimal quantity of drug should be started, say even one-fourth of the normal dose required, and the dose should be increased gradually, say, weekly, or every 34 days, depending upon the severity of the disease. Otherwise, it is very likely that the drug may cause undue drowsiness in a person, and may be rejected by the patient, especially in the case of a child. However, it is usually well tolerated in most of the cases in due course of time.

Above all, continuity of the drug therapy for the full-length duration of the treatment plays a very significant role in the control of attacks..

By and large, a properly administered drug treatment works very well, and people with epilepsy get permanent remission after about 3 years of treatment, or may be more in some of the cases. Great patience is the key to success of monotherapy (single drug trial) in cases of epilepsy, and the parents / family members of epileptics, especially, as seen in the case of children, should not compel the physician for a quick control of the disease, or doubt the expertise of the physician, or the authenticity/potency of the drug prescribed.

However, there are some cases which do create a problem, when their attacks are not controlled with a single drug. Provided an appropriate drug has been started, it does work in the majority of the cases, though in a few the effect of the drug may not be up to the mark, so that the patient may get an attack of epilepsy, though much less in intensity as compared the original attack, and the frequencies may also be reduced. In such cases, the physician or specialist makes his own judgement, and either changes or adds another antiepileptic drug, so as to give lasting relief to the patient.

The patient is also required to know about the details of the toxicity of the drug that has been prescribed, so that he can report to his physician well in time. In case the antiepileptic drug is being given to a pregnant woman, its teratogenic effect on the foetus, which may be responsible for congenital abnormalities in the newborn, should be explained to the woman. However, this may not happen in all the cases. It is advisable to seek a consultation with/ or counseling from the physician before the pregnancy is planned.