PURPLE DAY 2020 MARCH 26th
EPILEPSY/ SEIZURE AND CORONAVIRUS (COVID-19)
- PROF DR.M.A.ALEEM M.D., D.M.,(NEURO)
EMERITUS PROFESSOR OF NEUROLOGY
THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY
PAST PRESIDENT TAMILNADU PONDICHERY ASSOCIATION OF NEUROLOGISTS
FORMER VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL
CONSULTANT NEUROLOGIST AND EPILEPTOLOGIST (TRAINED AT INSTITUTION OF NEUROLOGY QUEEN`S SQUARE . LONDON . UK.) ABC HOSPITAL, ANNAMALAI NAGAR , TRICHY -620018
SECRETARY NEUROLOGISTS ASSOCIATION TIRUCHIRAPPALLI
DIRECTOR ABC HOSPITAL TRICHY
Purple Day – international epilepsy day – returns on Thursday 26 March 2020. Did you know that 87 people are diagnosed with epilepsy every day. Epilepsy can affect anyone, anytime, any place and can change lives in a moment.
In Purple day 2020 during the Pandemic of coronavirus COVID-19 infection, this is appropriate to present about Epilepsy / Seizure and Coronavirus
1. Are people with epilepsy at higher risk of developing COVID-19 (coronavirus)?
Epilepsy is a “family” of many different disorders that lead to seizures. Some people will have easily controlled seizures, have no other health problems, and become seizure-free on medications. Or they may have epilepsy with occasional seizures but no other health problems. For these people, the available data suggests that just having epilepsy alone
a.Does not increase the risk of getting COVID-19
AND
b. Does not increase the severity of COVID-19
There is no evidence that people with epilepsy alone have a weakened immune system. They should not be considered “immunocompromised” and would not have an “immune deficiency” from having seizures. People with different types of epilepsy, certain causes of epilepsy or other health conditions may have factors affecting their immune system.
2.What factors may increase the risk from COVID-19 for a person with epilepsy?
Some people with epilepsy regardless of seizure control have other health conditions that put them at higher risk from COVID-19.
aThey may be taking. medicines to control seizures that also. affect their immunesystem (for example, ACTH ,steroids,
everolimus, immunotherapies). It is important to note that. most seizure medicine. do not affect the. immune system.
b.Some people may have.other neurological or developmental issues that affect their immunity. People in these situations are at greater risk of developing more severe symptoms with viral illnesses.
c.People with epilepsy may have other medical problems that could place them at higher risk of developing more severe symptoms with COVID-19.
¡.For example, people who have problems of swallowing or frequently inhale food or liquids into their lungs (aspiration) are at higher risk for pneumonia.
¡¡.People with diabetes or underlying heart or lung problems also appear to be at higher risk for severe COVID-19.
Regardless of your situation, it is important for anyone with epilepsy to talk to their treating health care provider about their individual risks and if any specific medical precautions are needed. Take precautions to avoid getting sick too.
3.Does the use of seizure medicines increase the risk of coronavirus infection?
There is no evidence that using seizure medicines (also called antiepileptic drugs or antiseizure drugs or medicines) increases the risk of coronavirus infection, except for ACTH, steroids, everolimus, and immunotherapies. If you have any questions about the medicine you take, do not stop it - talk with your doctor about your concerns.
a.People with seizures and epilepsy should make sure they take their medicine regularly and as prescribed at all times.
b.Make a plan with your doctor about what to do if you miss any doses.
4.What should I do if I think I have COVID-19?
First call your doctor . The symptoms of COVID-19 are similar to the flu or common cold. Your doctor will ask you a number of questions to see if you are likely to have COVID-19 or some other illness.
a.The most common symptoms of COVID-19 are fever, cough, or difficulty inbreathing. If these symptoms are mild to moderate, your doctor may recommend that you stay home. This means “quarantine” yourself – don’t go out in public or have others come into your home.
b.Symptoms can often be treated at home. Ask your provider...
¡.Which over-the-counter medicines are safe to use with your seizures
¡¡.For specific instructions about when to call if symptoms change or don’t get better in a few days
¡¡¡.If you should be tested for the flu and COVID-19. If the symptoms are mild, they may not do tests right away.
c.If symptoms don’t get better or you develop shortness of breath or pain, call your doctor.
d.If you live with other people, try to keep away from them. Stay in one room, use your own bathroom, and don’t share food or utensils.
e.If you help care for another person who is at risk for serious symptoms of COVID-19, stay away from them. Enlist help from other family, friends, home care agencies or volunteers who can safely care for this person.
f.If seizures increase, call your epilepsy team or neurologist.
5.Are seizures a symptom of COVID-19?
Seizures are not a symptom of COVID-19. At the very end stages of serious forms of COVID19, damage to other body organs can happen, including damage to the brain. This happens with other respiratory infections too. Under these circumstances, seizures could occur with COVID-19 in a person without epilepsy.
People with epilepsy could have more seizures if they are also sick with COVID-19 due to a number of factors.
6.Can seizures increase if a person gets COVID-19?
When a person with epilepsy gets sick with another illness, especially with a fever, they may see a change or increase in their seizures. The illness is a physical and emotional stressor to the body that could make seizures more likely. The same happens if someone is sick with COVID-19. However, early information from countries where outbreaks have occurred suggests that the risk of worsening seizures with COVID-19 seems low for most people with epilepsy.
You can reduce the chance of COVID-19 affecting your seizures by taking care of yourself. Try to avoid or prevent seizure triggers, for example:
a.Be extra careful taking your seizure medicine – don’t miss any doses. You may be out of your usual routines so do whatever will help you take them at regular times.
¡.Set reminders on your phone.
¡¡.Use sticky notes.
¡¡¡.Have someone remind you when to take medicines or ask if you’ve taken them.
¡v.Use a checklist to make sure you took them.
v.Use a pillbox.
v¡.Use an app like Texting 4 Control or a seizure diary.
6.How can I manage
my stress and works
This is a stressful time for everyone. People may be alone or caring for many people at once. Routines are changed or you may not have any routines as things change quickly. Listening to news may be making people more scared of getting sick.
While we can’t prevent all stress, everyone should look at how they are managing it. Chronic stress can lower one’s immunity. This may make you more prone to getting sick. Consider different ways to manage stress.
7.What if I have a change in my seizures, with or without another illness?
¡.Right now it’s better to avoid the hospital, an emergency room or urgent care clinic unless you really need it. Don’t go to an emergency room on your own unless it is an emergency. Many times you can be treated at home.
¡¡.Call your doctor first. Don’t just go to their office without an appointment – this could put you or other people at risk for getting the virus.
¡¡¡.Many providers are offering “virtual visits” (called telehealth) by phone or computer. These can be just as useful as an in-person visit.
¡v.If needed, your provider may recommend an adjustment in seizure medicine or recommend a rescue medicine to use during periods of increased seizures. If you already have been prescribed a rescue medicine, talk to your pharmacist about an emergency supply.
v.However, just like any other time, if you or a loved one have an emergency, such as seizures lasting too long or more seizures than usual, seek emergency help.
8.Should I keep routine appointments for my epilepsy?
Many clinics and offices are cancelling or rescheduling routine appointments. This is being done to limit exposure to others who have acute illnesses like COVID-19 and to free up doctors and nurses to deal with urgent visits. Other clinics and practices may do visits with you by phone or by computer (called telehealth visits).
¡.Before your visit, call your provider’s office to check if the visit is still on and how it will be done.
9.When should I go to an emergency room for seizures?
COVID-19 is likely to result in busier emergency rooms. There will be many more patients than the doctors and nurses usually see so expect waits. Also, emergency rooms will have sick people and you can pick up illnesses there! Try to avoid emergency rooms and urgent care clinics as much as you can. This will reduce the risk of you or a loved one contracting COVID–19.
a.If you think you need to be seen urgently, try to talk to your doctor’s office first if it’s safe to do so.
Despite planning, epilepsy is not predictable. The following are examples of when you may need to go to an emergency room:
a.A seizure with loss of consciousness longer than 5 minutes that has not stopped and no rescue medicine is able to be taken at home.
b.Seizures continue after a person has taken a rescue medicine.
¡.Remember – first give the rescue medicine enough time to work!
¡¡.How long the rescue medicine takes may vary by the drug taken or the form, whether rectal, nasal, or under the tongue or between the cheek and gum.
b.Seizures happen in a different pattern than usual, are longer than usual, and are not responding to a rescue medicine.
c.Seizure emergency that can’t be treated safely at home – for example a person has seriously injured themselves or is having trouble breathing.
d.Seizure where someone has hit their head very hard.
10.Can COVID-19 increase the risk of sudden unexpected death in epilepsy or SUDEP in a person with epilepsy?
To our knowledge, there is no credible evidence that COVID-19 increases the risk for sudden unexpected death in epilepsy (SUDEP). However, regardless of whether a person has epilepsy or not, COVID-19 does carry a risk of complications and even death. People should do everything they can to avoid exposure to the virus and pay attention to seizure control.
11.How can I get more medicine if my doctor prescribes it? Will it be covered by my insurance?
You can contact and inform your insurance provider.
12.What if I have other questions about insurance coverage related to COVID-19 testing or treatment?
Talk to your health care provider or insurance plan if you are have questions. You can get information for coronavirus infection from people ofTamilnadu Chief minister health insurance scheme and Ayusman scheme
13.Are there shortages in seizure medicines in India?
There are no reported shortages of seizure medicines in the india that we know of now.
14.If COVID-19 is in my community, what should I do?
You may need to stay home for a period of time. Follow your local public health recommendations.
Avoid crowds and being too close to other people. This is called social distancing.
Update your seizure action plan for what to do if there is a change in seizures and who to call.
Talk to your doctor about an extra supply of prescription medicines. If you can’t get the seizure medicine from your local pharmacy, look into a mail-order pharmacy. They often allow people to get a 2 or 3 month supply of medicine at once if prescribed by your provider.
DON'T take any over-the-counter (OTC) medicines without talking to your provider.
Look into ways to have food and other things you need delivered to you.
Stay in touch with family, friends or someone who can check on you if needed.
15.How do I protect myself from getting sick?
It is flu season and respiratory illnesses are common. Follow these common-sense tips
Make sure you’ve had a flu vaccine.
Wash your hands regularly to prevent the spread of germs.
Avoid close contact with people who are sick.
Avoid touching your eyes, nose and mouth.
Stay home if you are sick and call your health care provider first if you need an appointment.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Preparing for Any Emergency
Preparing for potential emergencies is part of life for all of us – whether that's for natural disasters, extreme weather conditions, or medical emergencies. This is no different. Here are a few tips to follow now and every day.
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