Q: I had an attack of epilepsy by late 1996. When I was 30 years old. Later I came to know that it was epilepsy. I had no disease earlier. One day before I had the seizure I had taken alcohol. After that I discontinued taking alcohol. Eptoin was the tablets that I took. Still I got seizures (yearly two times). Doctor advised me to discontinue Eptoin and prescribed Tegrital (Feb 2001. By Nov 2001, I had another siezure. Nowadays I do not regain consciousness for about one hour. 1) Does epilepsy occurs at a later age? 2) Despite taking regular medicines, why is it not under control? 3) Does it occur because of alcohol?

A:Epilepsy is a state of recurrent seizures, which is not due to an identifiable metabolic cause. It results from intermittent, irregular, excessive electrical discharge in the brain cells. It may be caused by various brain disorders like birth trauma, head injury, brain infection or tumour etc. At times there may be no identifiable cause. There are many types of epilepsies and different seizure types. It can start at any age, though different types are more frequent at certain ages. Alcohol withdrawal can certainly precipitate a seizure. It is important to know the type of epilepsy before starting treatment. A detailed history and clinical examination assists in categorising the seizure type. Certain investigations, esp EEG and brain imaging are often helpful. About 70% of patients are seizure free with appropriate medicine in adequate doses. Other patients require a trial of different anti-epileptic medicines, at times in combinations. Certain newer drugs have been found to be quite useful in patients with uncontrolled seizures. It is important to avoid precipitating factors like lack of sleep, prolonged fasting, excessive alcohol ingestion and certain drugs like Ciprofloxacin as they may result in a seizure in a person who is otherwise seizure free. Driving, swimming, working on heavy machinery etc. should be avoided as loss of consciousness may result in an accident. It is important to be under regular supervision of a neurologist for long term management of epilepsy.