IDEAL PARENTING STYLE

IDEAL PARENTING STYLE= Parents are a huge part of a child's life. However they act, whatever they say, anything that they do largely impacts a child's development from the moment they are born. According to research there are four types of parenting styles (Parenting Styles in Psychology, Brittany Olivarez). Through naturalistic observation, parenting interviews, and other research methods there are following four parenting styles: 1.Authoritative: democratic style of parenting, parents are attentive, forgiving, teach their offspring proper behavior, have a set of rules, and if child fails to follow their is punishment, if followed their is reward/reinforcement 2.Authoritarian: strict parenting style, involves high expectations from parents but have little communication between child and parents. Parents don't provide logical reasoning for rules and limits, and are prone to harsh punishments 3.Permissive: parents take on the role of "friends" rather than parents, do not have any expectations of child, they allow the child to make their own decisions 4.Uninvolved: parents neglect their child by putting their own life before the child's. They do provide for the child's basic needs but they show little interaction with the child Each of these different parenting styles impacts and influences the development of child. The most ideal and balanced style that leads to the child being mature, independent, and socially responsible is the Authoritative style (Parenting Styles in Psychology,Olivarez) The style commonly leads to children becoming delinquents is the Uninvolved style because of the lack of parenting, affection, and care from the parent leads the child to act out badly for attention (Parenting Styles in Psychology, Olivarez). Parenting is a large impact in a child's life and development. Most families have a blend of two or more of these parenting types because the mother and father tend to differ when it comes to parenting a child. What we know is that a healthy development leads a child to succeed not only in developing as a person but building a stronger bond to their parents.

WHAT IS STRESS?

WHAT IS STRESS? Stress is a primal, innate response to fear and it's a factor in all of our lives. It also affects other species of animals. The technical definition of stress is the physical pressure, pull, or other force exerted on one thing by another; strain. It is a common disease which may at some point affect you, your organization, and also any of the people within it. So you can not afford to ignore it or just give up. Stress is something that you feel when you are afraid of a situation, threatened by something, or simply find a situation that you are in to be annoying. What is actually happening is that your body is triggering it's "fight or flight" response due to the fear that is in the situation. The reason that stress can wear you out is because your body tends to be more alert, focused, and prepared for any threats or dangers. This uses considerable more energy. When you are stressed all day long, fatigue will take over making you more irritable to others around you since you are so worn out. The body is not designed to deal with these types of situations forever. Over time there are a wide variety of health Problems that can be formed by having stress. SIGNS OF STRESS The mental symptoms ofstress include Tension Irritability Inability to concentrate Feeling excessively tired Trouble sleeping The physical symptoms of stress include: Dry mouth A pounding heart Difficulty breathing Stomach upset Frequent urination Sweating palms Tight muscles that may cause pain and trembling. Mental and emotional changes are often the first signs that stress is taking its toll. Stress takes away from the memory when too much is applied. It also decreases our abilities to think clearly. Stress eventually leads to mood changes and can cause mental illnesses like depression and anxiety. It also causes us to age quicker which in turn leads to our bodies and minds not being able to deal with it like we were once able to. We become tired and more easily exhausted than we once were. Some people cannot even function properly when they are under too much stress. What is so sad is that it is completely normal for people to break down, especially if they are not taking care of themselves in the process. Stress can come from many sources. One of the biggest and most obvious in the world today is finances. We always seem to worry about money and worrying about money is a never ending thing. People will always have bills to pay, and as long as the economy is down and out like it currently is, people are going to continue to lose jobs. It is actually very depressing. But, we cannot let ourselves get beat down. Other sources of stress come from losing loved ones or experiencing a divorce. These things can also lead to some serious depression. Emotionally, stress can cause us to lose all of our coping skills. Sufferes of stress should worth remember the following points: •Suffering from stress could not be considerd as a weakness •Stress is infectious.It is stressful to live and work with people who suffering from stress. •There is no solution guaranteeing a stress free life,but there are techniques for minimizing stress. •Stress is produced from high demands in life combined with highconstraints and little support fromcolleagues and family. •Stress can be killer.The Japanese have an officially recognized condition called Karoshi ,death from stress caused from too much work. Regardless of what situation you are in realize that you do have a choice. If it's a stressful job, relationship, or other situation, realize that you do have a choice to stay in them or be there to try to fix the situation. When you feel that your life is out of control, generally that is where much of the stress comes from. Find things in your life that you can do to get rid of stress. You need to get rid of the stress else you will have problems that you will face in the future.

15 interesting facts about dreams

Here are 15 interesting facts about dreams – enjoy and what’s most important, don’t forget to share your dream stories in the comment section! 1. You Forget 90% of Your Dreams=Within 5 minutes of waking half of your Dream is forgotten. Within 10, 90% is gone. 2. Blind People also Dream=People who became blind after birth can see images in their Dream. People who are born blind do not see any images, but have Dreams equally vivid involving their other senses of sound, smell, touch and emotion. 3.Everybody Dreams=Every human being Dreams(except in cases of extreme psychological disorder). If you think you are not dreaming – you just forget your dreams. 4. In Our Dreams We Only See Faces That We already Know=Our mind is not inventing faces – in our Dreams we see real faces of real people that we have seen during our life but may not know or remember. We have all seen hundreds of thousands of faces throughout our lives, so we have an endless supply of characters for our brain to utilize during our dreams. 5. Not Everybody Dreams in Color=A full 12% of sighted people Dreams exclusively in black and white. The remaining number dream in full color. Studies from 1915 through to the 1950s maintained that the majority of dreams were in black and white, but these results began to change in the 1960s. Today only 4.4% of the dreams of under-25 year-olds are in black and white. Recent research has suggested that those changing results may be linked to the switch from black-and-white film and TV to color media. 6. Dreams are Symbolic=If you Dream about some particular subject it is not often that the dream is about that. Dreams speak in a deeply symbolic language. Whatever symbol your dream picks on it is most unlikely to be a symbol for itself. 7. Emotions=The most common emotion experienced in dreams is anxiety. Negative emotions are more common than positive ones. 8. You can have four to seven dreams in one night.=On average you can Dream anywhere from one or two hours every night. 9. Animals Dream Too=Studies have been done on many different animals, and they all show the same brain waves during dreaming sleep as humans. Watch a dog sleeping sometime. The paws move like they are running and they make yipping sounds as if they are chasing something in a dream. 10. Body Paralysis=Rapid eye movement (REM) sleep is a normal stage of sleep characterized by rapid movements of the eyes. REM sleep in adult humans typically occupies 20-25% of total sleep, about 90-120 minutes of a night’s sleep. During REM sleep the body is paralyzed by a mechanism in the brain in order to prevent the movements which occur in the dream from causing the physical body to move. However, it is possible for this mechanism to be triggered before, during, or after normal sleep while the brain awakens. 11. Dream Incorporation=Our mind interprets the external stimuli that our senses are bombarded with when we are asleep and make them a part of our Dreams. This means that sometimes in our dreams we hear a sound from reality and incorporate it in a way. For example you may be dreaming that you are in a concert while your brother is playing a guitar during your sleep. 12. Men and Women Dream Differently=Men tend to dream more about other men. Around 70% of the characters in a man’s dream are other men. On the other hand, a woman’s dream contains almost an equal number of men and women. Aside from that, men generally have more aggressive emotions in their dreams than the female lot. 13. Precognitive Dreams=Results of several surveys across large population sets indicate that between 18% and 38% of people have experienced at least one precognitive dream and 70% have experienced déjà vu. The percentage of persons that believe precognitive dreaming is possible is even higher – ranging from 63% to 98%. *Precognition, also called future sight, refers to perception that involves the acquisition of future information that cannot be deduced from presently available and normally acquired sense-based information. 14. If you are snoring, then you cannot be dreaming.=This fact is repeated all over the Internet, but I’m a bit suspicious whether it’s really true as I haven’t found any scientific evidence to support it. 15.You can experience an ORGASM in your dream=You can not only have sex as pleasurable as in your real life while Dreaming , but also experience an orgasm as strong as a real one without any wet results. The sensations felt while lucid dreaming (touch, pleasure and etc..) can be as pleasurable and strong (or I believe even stronger) as the sensations experienced in the real world.

કામવાસના અને તમારૂ બાળક.

કામવાસના અને તમારૂ બાળક. માતાપિતાનુ કામવાસના વિષેનુ જ્ઞાન ખાસ કરીને તેના બાળકોના સંબંધ માટે મહત્વનુ છે. જ્યારે બાળક મોટુ થતુ હોય ત્યારે માતાપિતાએ તેના બાળકનુ કામવાસના વિષેના જ્ઞાન ઉપર ઘણુ ધ્યાન રાખવુ જોઇએ. કોઇકવાર ઘણા બધા માતાપિતાને તેમના બાળકો સાથે કામવાસના વિષય ઉપર વાત કરતા બહુ બેઢબ અને શરમજનક લાગે છે. માતાપિતાએ આ બેઢબ વાતોની બહાર આવવુ જોઇએ. અભ્યાસ બતાવે છે કે જુવાન લોકોના માતાપિતા સાથે કામવાસના વિષે વાત કરવાથી તેઓ પહેલો સંભોગ કરતા પહેલા લાંબા સમય સુધી રાહ જુએ છે. તેઓએ પણ ઘણી સાવધાની અને જન્મ નિયંત્રણ પદ્ધતીનો ઉપયોગ કરવાની સંભાવના છે અને તેઓને તેનાથી વગોવાઈ જવાની જાણકારી છે જ્યારે તેઓ એકવાર યોન સબંધ રાખે છે. કેટલાક સંકેતો માતાપિતાને મદદ કરવા તેમના બાળકોને શીખવા માટે : •તમારા છોકરાની/તમારી છોકરીની વિચારપંરપરા જુઓ કે તે એવા મંચ ઉપર પહોચી ગયો/ગઈ છે કે તેની સાથે કામવાસના વિષે વાતો કરવી જરૂરી છે. •માતાપિતા માટે એ વાત કરવી મહત્વની છે કે તેઓ છોકરાઓ પાસે પહોચી જાય અને કહે કે તેઓ ત્યાં છે. તેઓને આરામની અને વિશ્વાસની જરૂર છે કે જેથી તેઓ માતાપિતાને પહોચી શકે. એટલે માતાપિતાનો આરામ કરવાનો વિષય બહુ મહત્વપુર્ણ છે. માતાપિતાએ હંમેશા ઇમાનદારીથી અને ન શરમાતા જવાબો આપવા જોઇએ. •બાળકની આજુબાજુમાં કોઇ દિવસ બાલીશ શબ્દોનો ઉપયોગ ન કરો કે જેનાથી તેમની બુદ્ધીને ઠેસ પહોચે. તમારી/તમારા પત્ની/પતિ અથવા મિત્રો સાથે વાતો કરવાથી તમારા બાળક્ને મદદ થશે જ્યારે તમે તેની સાથે વાતો કરો. કામવાસના એક ભાવનાઓને વ્યક્ત કરવાની રીતો, વિચારો અને લાગણીઓ છે. આ જ વસ્તુ છે જે એક માણસને પરિપક્વ સમજવાળો બનાવે છે. જ્યારે આ વિષય ઉપર આવે ત્યારે કોઇએ થરથરવાની અથવા શરમાવાની જરૂર નથી. આપણી લૈંગિકતા આપણો એક ભાગ છે અને કોઇ દિવસ શરમાવવા અથવા તેની અવગણના ન કરવી જોઇએ. એક વ્યક્તિની પસંદગી પોતાનુ પ્રતિબિંબ છે - ચલો તેમ બધાય સૌથી પહેલા જાગરૂકતામાં રહો.

જાતિય નીરસતા/ઉદાસિનતા

જાતિય નીરસતા/ઉદાસિનતા નીરસતા - બાંધાઓના "ઠંડા" માધ્યમથી તોડીને "એક સ્ત્રી એક વાર લગ્ન કરે પછી તેની જીંદગી અદભુત છે. જે હુફ અને પ્રેમ તેણીને તેના પતિ તરફથી મળે છે તે કોઇપણ આપી શકતુ નથી. તે હવે પુર્ણપણે એક સ્ત્રી છે." આવા શબ્દો જ્યારથી આપણે આપણા લગ્ન વિષે મગજમાં ઠસાવ્યા છે, ત્યારથી લગ્નની વિચારધારાને સમજી શક્યા છીએ. કામવાસના, તેનો વિચાર અને તેનો અભ્યાસ એક taboo છે અથવા કાનુની લગ્નની છાપ પાછળ છેતરવાની યુક્તિ છે. હંમેશા ગમે તે રીતે એ વાતને સંબંધિત કરશે કે એક સ્ત્રી હંમેશા શારિરીક રીતે સંતુષ્ટ છે, ભલે પછી તેની પાસે બીજી સમસ્યાઓ હોય. આ વિષયની સાચી વાત કાઈક જુદી જ છે. સ્ત્રીઓ બીજા કરતા શારિરીક સબંધોમાં વધુ વાર અસમાધાન રહે છે અથવા લૈંગિક સબંધો રાખવામાં અસંતુષ્ટ છે અથવા તેના વિચારો પણ એકદમ બંધ કરી દીધા છે. શબ્દ નીરસતા/ઉદાસિનતા શબ્દકોષમાં "બહુ ઠંડા" અને "લાગણીની હુફ વીનાના" બતાવવામાં આવ્યા છે. આ સવિસ્તર મુસાફરીમાં શબ્દ એક બહુ મુશ્કેલ સવાલ બની ગયો છે, જે હવે ધંધાદારી ખેલાડીઓએ તેનો અભ્યાસ કરવા લીધો છે, જે આજે સ્ત્રીઓમાં એક વર્ચસ્વવાળો મુશ્કેલ સવાલ બની ગયો છે. ઉદાસિન શબ્દ ફક્ત સ્ત્રીઓને સબંધિત છે અને તે લૈંગિક વિકારોની યાદીમાં વર્ગીકૃત થાય છે. લૈંગિક વિકારો માનસિક રીતે વર્ચસ્વ ધરાવે છે અને નીરસતા/ઉદાસિનતા તેમાંનુ એક છે જેના માટે માનસિક રોગના ચીકિત્સાના ઉપચાર પદ્ધતીની જરૂર છે. ઉદાસિનતા ઘણીબધી પરિસ્થિતીમાં આવી શકે છે, જેમાંથી કેટલીક છે : લૈંગિક સબંધ વિષે ઓછુ જ્ઞાન, સાચી વાત સમજવામાં ભ્રમ, લૈંગિક સંબંધોમાં અસંતોષ, ઓછો આત્મ વિશ્વાસ, થાક અને પોતાના રોજના કામમાં એકરસતા. "લૈંગિક આવેગો એ લાગણીની અભિવ્યક્તિ છે." એમ ડૉ.સુપર્ણા તેલંગ કહે છે અને તેણી ખુલાસો કરે છે કે લાગણીઓ જેવી કે હુંફ, પ્રેમ અને લાગણી કેવી રીતે માનસિક વિકારોને પ્રેરક કરવામાં ખોટ લાવે છે. તેલંગ પાસે એક ઇતિહાસનો દાખલો કહેવા માટે છે. મીના અને સુરેશ એક સંપુર્ણરીતે સંબંધ માણી રહ્યા છે અને તેઓ એક ખુશ, સંતુષ્ટ અને ભાવનાત્મક રીતે સંતુલન જોડી છે. ત્યા એક દિવસ જ્યારે સુરેશ તેના કુંટુંબને મળે છે અને કહે છે કે તેને હવે પછીથી તેની પત્ની સાથે રહેવુ નથી. ઘણીવાર સુધી ખુશામત કરી અને મીઠી મીઠી વાતો કરીને છેવટે તેણે સ્વીકાર કર્યો કે તે બે બાળકોનો પિતા થયો હોવા છતા, દરેક વખતે તે જ્યારે તેની પત્ની સાથે સંબંધ રાખવા કોશિશ કરે છે, ત્યારે તેણી તેનુ મોઢુ ઓશીકાથી ઢાકી દયે છે અને પીડામાં મોટેથી ચીસો પાડે છે. તે લગભગ ૧૧ વર્ષો સુધી દરદી રહ્યો અને હવે તેણી અથવા તે આ યાતનામાં રહેવા નથી માંગતા. એક કુંટુંબ આ જોડી માટે એક ઉપચાર પદ્ધતી સુચવે છે, જ્યારે ચિકીત્સક આ ઇતિહાસના કિસ્સાની તપાસ કરે છે, ત્યારે તે વ્યાકુળ થઈ જાય છે કારણકે સુરેશ કહે છે કે મીના બહુ જલ્દી પ્રતિક્રીયા કરે છે અને તે પ્રણય ક્રીડા શરૂ કરે છે. પણ ફક્ત તેટલુ જ, જ્યારે પરિપૂર્ણતાનો સમય આવે છે, ત્યારે તેણી એકદમ બદલાય જાય છે અને ચીસો પાડવાનુ ચાલુ કરે છે. આવા ઘણા બધા દાખલાઓ સ્ત્રીઓના છે. તેમાંથી ઘણી બધીને તેના મિત્રો અને સાથીદારો કહે છે કે પુરૂષનો સ્પર્શ બહુ અદભુત અને રોમાંચક હોય છે અને તે વાત તેઓ માને છે. પણ જ્યારે તેઓ વયસ્કર લોકો સાથે વાતો કરે છે, ત્યારે તેઓ કહે છે કે સ્ત્રીની જીંદગી બહુ દુખદાયક છે અને તેઓએ હંમેશા પુરૂષની ઇચ્છા સામે વશ થઈ જવુ પડે છે, જે કેટલીક વાર અસહ્ય વેદના આપે છે. જુવાન સ્ત્રીઓ આ વાતને બહુ માને છે. હવે તેનુ મન આ બેવડા સંદેશા જે સાંસ્કૃતિક લિપીથી લખાઈ ગયુ છે પણ છેવટે તેણીને સમજાય છે કે સ્પર્શથી તેને સારૂ લાગે છે અને જાગૃત કરીને ઉત્તેજીત કરે છે, પણ તેનો સંપર્ક બહુ દર્દનાક અસહ્ય વેદના આપે છે, એટલે તેને હવે નીરસતા આવે છે જે ગુંચવણોનો એક ભાગ છે, જે લૈંગિકતાની સચ્ચાઈને સમજાવે છે. ભારતમાં લગ્ન વિચ્છેદ કરવા માટે નીરસતા એક કારણ તરીકે વપરાય છે. આ કાયદો બતાવે છે કે જો પુરૂષ અથવા સ્ત્રી તેના લગ્ન થયા પછી લૈંગિક સબંધો રાખવામાં જો અસંતુષ્ટ થાય તો લગ્ન વિચ્છેદ એક નક્કર પાયો છે. આવી રીતે એ લોકોએ કહ્યુ કે નપુંસકતા અને નીરસતા તેમના સંબંધિત ભાગીદારોના લૈંગિક અસંતોષની પરિસ્થિતી છે. તે છતા નીરસતા કાયમી અને લાઈલાજ પરિસ્થિતી નથી. આ માનસિક વિકાર હોવાથી તે ઉપચાર પદ્ધતીથી સારો કરી શકાય છે. ચિકીત્સકો ઘણા રસ્તા બતાવે છે, જેનાથી સંબંધિત ભાગીદારો મદદ કરે છે, વાત કરીને, સ્પર્શથી અને કોમળતાથી ઉત્તેજીત કરીને, તેમની પત્નીને કહીને કે તેઓ હજી ઇચ્છનીય છે, તેમના શરીરને જાણ કરીને વિશ્વાસ આપે છે કે તેઓ સંપુર્ણ રીતે સારા છે અને તેમને હવે લૈંગિક સબંધો રાખવાની ઇચ્છા નથી. "સ્ત્રીઓને સમજવા માટે મદદ કરશે કે તેમની લાગણીઓનો સમાવેશ છે, જે બહુ મહત્વની છે અને લૈંગિકતા એક લાગણી છે. તેમના મગજમાંથી લૈંગિકતાના મુદ્દાનુ મહત્વ અને તેનુ દબાણ ખલાસ કરી નાખશે. એ પણ સાચી વાત આગળ લાવશે કે પુરૂષો સંવેદનશીલ છે અને બેફિકર નથી" એમ તેલંગ કહે છે. CALPAGEAFUX એ ઉદાસિનતાની ચરમ સ્થિતી છે, આવી સ્થિતીમાં સ્ત્રીઓ ઘણુ બધુ પ્રવાહી બહાર કાઢે છે કે એક પુરૂષ અંદર ધકેલી શકતો નથી અને એટલે સ્ત્રીને લાગે છે કે તેઓએ પરિપૂર્ણતા પામી નથી. પ્રવાહી જે બહાર આવે છે તે એક રક્ષાની કાર્યપદ્ધતી છે તે સ્ત્રીને તેને થતા તીવ્ર દુખાવાને દુર કરવા મદદ કરે છે. આનો ઇલાજ લૈંગિક જાગરૂકતામાં છે. એક સ્ત્રી માટે વધારે જાણકારી કે લૈંગિકતાનો ઇલાજ આ ચર્ચાના વિષય લૈંગિકતાના જેને એક taboo કહીને પ્રક્રીયા ન કરી શકાય અને સ્ત્રી અને પુરૂષની વચમાં એક પ્રાકૃતિક ભાવના સમજી શકાય, તે પોતાની લૈંગિકતાની ઓળખની ભાન કરવા ભરોસેપાત્ર છે અને તેની જવાબદારીનુ તેને ભાન થાય છે જે તેનો દુરઊપયોગ નહી કરવો જોઇએ. આ બધી કુદરતી લાગણીઓ મેળવી શકાય જો પતિ પત્ની વચ્ચે સારો સબંધ હોય, જે પછી તેમના છોકરાઓ ઉપાડી શક્શે. તેના બદલામાં કુંટુંબનુ સ્વસ્થ વલણમાં બદલાઈ જશે જે આગળ જઈને સમાજમાં પ્રસરાશે.

શું થાય છે : લૈંગિક સંબંધ રાખતા પહેલા, દરમ્યાન અને પછી?

શું થાય છે : લૈંગિક સંબંધ રાખતા પહેલા, દરમ્યાન અને પછી? આ કદાચ બતાવવાથી સ્પષ્ટ થશે અને બતાવશે કે મુખ્ય રૂપમાં તે એક લૈંગિક ખુશી છે જે મુખ્યત્વે એક માણસને લૈંગિક સંબંધ રાખવા ધકેલે છે. એ અહીયા નોંધ લેવુ સાર્થક હશે કે સ્ત્રી અને પુરૂષમાં સંભોગ કરતા પહેલા, કરતી વખતે અને કર્યા પછી કેવુ પરિવર્તન આવે છે, આમાં જનેનન્દ્રિયોમાં થતો બદલાવ સામિલ છે અને સાથોસાથ શરીરના બીજા ભાગોમાં પણ. બંને લિંગોમાં લૈંગિક પ્રતિક્રીયાઓનુ ચક્ર ચાર તબક્કામાં વહેચાયેલ છે. એક સુરક્ષિત અને અસરકારક સંભોગ કરવા માટે અને એક જે ઇંડાને (રજ:પિંડ) ગર્ભાધાન કરવા માટે દોરે છે. તે નીચે બતાવેલ છે : ઉત્તેજનાનો તબક્કો. અવધિ. આ ફક્ત થોડી મિનીટોથી કલાકો સુધી ચાલતો સમય છે જે કદાચ બદલાય છે. તે અપનાવેલ કલાકૌશલ્ય ઉપર આધારિત છે અને બીજા બહારના કારકો જેવા કે વ્યગ્રતાની ખામી. પુરૂષોમાં કામુત્તકાની ભાવનામાં લોહી ત્રણ નાળકાર આકારના પોચા પેશીજાલના પોટલામાં શિશ્નમાંથી ખેચે છે. આ શિશ્નને અક્કડ અને ટટ્ટાર બનાવે છે અને એ પ્રમાણે એક ખુણા ઉપર ઉભો રહે છે. અંડકોષની થેલી ધીરેથી ઉપર ચડાવે છે જેના લીધે સ્નાયુઓ સંકોચાય છે અને testes ઉપર આવે છે. સ્ત્રીઓમાં યોનીની દિવાલો ખેંચાય છે અને પ્રવાહીને ઉંજવીને છુપાવે છે. ગર્ભાશય (ઉત્પત્તિસ્થાન) બસ્તિના ભાગ ઉપર આવે છે. The labia majora (યોનીના બહારના આવરણો) થોડાક ખુલી જાય છે. The labia minora (યોનીના અંદરના આવરણો) જાડા થાય છે. ભગ્નશિશ્ન આકારમાં મોટુ થાય છે, સોજી જાય છે અને કડક થઈ જાય છે. પઠારનો તબક્કો તબક્કાનો અવધિ પઠારનો તબક્કો સાધારણપણે સંક્ષિપ્તમાં તીવ્ર છે. પુરૂષોમાં શિશ્નનો ભાગ થોડો મોટો થાય છે. શિશ્નનુ માથુ (glans નુ શિશ્ન) લાલ અને ચમકદાર થાય છે. ચીકણા પ્રવાહી (લાળ)ના થોડા ટીપા ટોચ (મુખ)માંથી ઉઘડીને બહાર આવે છે. testes આગળ વધીને તૈયાર કરાય છે. સ્ત્રીઓમાં યોનીનો બહારનો ભાગ ફુલાય છે અને તેમાં વધારે પડતુ લોહી જાય છે. યોનીનો બહારનો સોજોલો ભાગ અને labia minora (આંતરીક હોઠ) લાંબા ઉંચાઈ ભર્યા જેને કામોવેશનાની પરાકાષ્ઠાનો મંચ પણ કહેવાય છે. આની પાછળ ટોપી પહેરાવેલ ભગ્નશિશ્ન છુપાય છે. કામવાસનાની પરાકાષ્ઠાનો તબક્કો. તબક્કાનો અવધિ કામવાસનાની પરાકાષ્ઠાનો અવધિ સૌથી ઓછો છે. તે ફક્ત થોડી સેકંડ ચાલે છે. testes માં ઇચ્છાવિના તાલબદ્ધની માળા સંકોચાય છે અને તેનુ શિશ્ન તેના વીર્યને ઝડપથી અચાનક બહાર કાઢે છે. આ પુરૂષને લૈંગિક સંબંધોમાં બહુ સંતોષ આપે છે. આ શિશ્નમાંથી વિર્યને બહાર કાઢવાની પદ્ધતીને શુક્ર બહાર ફેકવાની ક્રીયા કહેવાય છે. સ્ત્રીઓમાં કામવાસનાની પરાકાષ્ઠાનો મંચ તાલબદ્ધતાથી નાનો થાય છે જે ૩ થી ૧૫ વારની વચ્ચે ટુકા સમયનો ગાળો જે ૦.૮ સેકંડ છે. આ તાલબદ્ધતાનુ સંકુચન કામવાસનાની પરાકાષ્ઠાના મંચ ઉપર બસ્તિપ્રદેશના બંધારણ સાથે સ્ત્રીને તીવ્ર લૈંગિકતાનો આનંદ આપે છે. પૃથક્કરણનો તબક્કો. તબક્કાનો અવધિ ફક્ત ૧૦ સેકંડ જેટલો, એટલો જ. પુરૂષોમાં આ તબક્કો બે માધ્યમમાંથી જાય છે. પહેલા તબક્કામાં તેનુ શિશ્ન સંપુર્ણ ટટ્ટાર રહેવાના માપ કરતા અડધુ નાનુ થઈ જાય છે. બીજામાં તેના અડધા ટટ્ટાર મંચ ઉપરથી નિયમિત નિર્બળ માપમાં પાછુ આવે છે. બીજો તબક્કો પહેલા કરતા થોડો વધારે સમય લ્યે છે. જે રીતે શિશ્ન નાનુ થાય છે, તે પ્રમાણે અંડકોષ ઢીલુ થાય છે અને testes નીચે આવે છે. સ્ત્રીઓમાં યોની માર્ગના ૧૦ સેકંડ સંકોચાયા પછી, ભગ્નશિશ્ન પાછુ તેની સામાન્ય સ્થિતીમાં આવે છે. આખી યોની તેનો સામાન્ય રંગ અને સ્થિતીમાં ૧૫ મિનીટમાં આવે છે. ગર્ભાશય ધીમેથી તેની સામાન્ય સ્થિતીમાં પાછુ આવે છે, જેને લગભગ ૨૦ મિનીટ થતા લાગે છે. યોનીના અંદરના અને બહારના આવરણો તેના પહેલાના રંગમાં અને આકારમાં આવે છે. શરીરના બીજા ભાગોમાં પરિવર્તન. પેટ, ગળુ અને સ્તન ઉપર લાલાશ જેવા ધબ્બા જેને લૈંગિક ઉમળકો કહેવાય છે તે દેખાય છે. તે સંભોગ કર્યા પછી લગભગ ૫ મિનીટમાં દેખાતા બંધ થાય છે. સ્નાયુઓનો તણાવ થાય છે જેને લીધે ડીટીઓ ટટ્ટાર થાય છે સાથળ તંગ થાય છે, વાસો તોરણકાર થાય છે, નસકોરા બળવા મંડે છે વગેરે. આ બધુ સંભોગ કર્યા પછી પાંચ મિનીટમાં દેખાતુ બંધ થઈ જાય છે. એક પાતળુ પરસેવાનુ આવરણ ઘણી બધી વાર આખા શરીરને સંભોગ કર્યા પછી આવરી લ્યે છે. હદયના ધબકારા, શ્વાસોશ્વાસ અને લોહીનુ દબાણ બંને લિંગોમાં ઉત્તેજના, પઠાર અને કામવાસનાની પરાકાષ્ઠાના તબક્કાઓ દરમ્યાન ઉપર ચડે છે. સંભોગ કર્યા પછી તે તરત જ સામાન્ય સ્થિતીમાં આવે છે.

લૈંગિક આવેગો અને લૈંગિકતા એટલે શું? જાતિય અને જાતિયતા

લૈંગિક આવેગો અને લૈંગિકતા એટલે શું? જાતિય અને જાતિયતા શબ્દ "લૈંગિક આવેગો" હંમેશા ઘણા આંખોના ભવાને ઉંચે લઈ જાય છે. આ વિષય ખુલ્લી રીતે બોલી શકાતો નથી. અમે અમારા લૈંગિક આવેગો અને લૈંગિકતાના ભાગમાં એવી જાણકારી આપીયે છીએ જે તમારા શરીરને અને મનને તંદુરસ્ત રાખવા વિષે જ્ઞાન આપે છે અને જે લૈંગિક આવેગોના ક્ષેત્રમાં રહે છે. પુરૂષ અને સ્ત્રીને જ્યારે લૈંગિક આવેગ બાબત પુછવામાં આવ્યુ કે તમને તમારા મગજમાં શું વિચાર આવે છે જ્યારે તમને આ વિષય ઉપર પુછાય છે. પુરૂષ - મજા, આનંદી, ભાવાવેશ, ઉષ્ણ, સ્વંયસ્ફુર્ત અને ખુબ નાજુક. સ્ત્રી - ગંભીર વ્યવસાય. તે બે બહુ જ જાતજાતના અતિશયોક્તીવાળા જવાબો છે, જે શબ્દોમાં જણાવી જ શકાય, છતા પણ તે બંને લિંગની મગજની પરિસ્થિતી બહાર લાવે છે. તે ચરમ સીમાથી ખબર પડે છે કે તેમની લિંગની વ્યાખ્યા શું છે. સ્ત્રી લૈંગિક આવેગોને ગંભીર વ્યવસાયના રૂપમાં જુએ છે અને તેનો આનંદ અને સુખની ઉણપ બતાવે છે. તેમ છતા પુરૂષ તેને આવેશવાળુ અને અત્યાનંદનુ સમજે છે, જેમાં તેની જવાબદારીની ખોટ દર્શાય છે અને નિકટતાના અનુભવને આદર આપતો નથી. તેમ છતા આ અગાવથી ધારેલા લૈંગિક આવેગોના વિચારોને આપણુ મગજ શું વિચારે છે તે જ છે. આપણને આપણા વિચારો વિવિધ પ્રકારના માધ્યમમાંથી મળે છે, જેવા કે ટીવી, સિનેમા ચિત્રપટ, સંગીત, વિનોદી ચુટકાઓ, મિત્રો અને કુંટુંબ તરફથી અને પછી આપણે તેને ભેગા કરી બનાવીએ છીએ, જેને આપણે સાચા માનીએ છીએ અને તેના ઉપરથી આપણે પોતાની ખોટી માન્યતાઓ ઘડીએ છીએ. તેમ છતા એક એ તેની સચ્ચાઈ શું છે અને તેની પરંપરા શ્રવણનો ઉકેલ કરવો જોઇએ. લૈંગિક આવેગોની ઉપચાર પદ્ધતી એક માધ્યમ અને અભ્યાસ છે, જે લોકોને તેમની લૈંગિકતાને સ્વીકારવા, તેનો આનંદ લેવા અને તેને વધારવા માટે મદદ કરે છે. તે કલ્પના ઉપર આધારીત છે કે લૈંગિક આવેગો સામાન્ય અને સારા છે, જે આપણા સંબધોને અર્થવાહી બનાવે છે અને લૈંગિક નિકટતાને સામાન્ય લક્ષ સમજે છે. તે તમને તમારા જ્ઞાન માટે એક મજબુત હથિયાર આપશે જે એવી રીતે સુસજ્જિત છે કે પુર્ણ રીતે તમારી જીંદગી અને સંતોષથી જીવવા દોરાવશે. લૈંગિકશાસ્ત્ર એક ચર્ચા કરવાનુ અને નૈતિક, સાંસ્કૃતિક, માનસિક, સામાજીક અને રાજનીતિક જાહેર સ્થાન છે અને રાજકીય સવાલોને સંબધિત, લૈંગિક સંબધોને અને લૈંગિક વર્તનોના સંબધિત સવાલો છે. એક વ્યક્તિગત લૈંગિક અનુસ્થાપન તે સમલિંગકામી છે અથવા વિષયલિંગકામી છે તે તેના લૈંગિક આરોગ્ય અને વ્યક્તિત્વનો એક જરૂરી ભાગ છે જે દૃઢપણે દરેક વ્યક્તિના અધિકારને ટેકો આપે છે, જેને સ્વીકારવા, માન્ય કરવા અને તેણીના/તેના નિર્ધારણ પ્રમાણે જીવવા આધાર આપે છે. લૈંગિક અનુસ્થાપન એકનુ કામોદીપક, રોમાંચક અને લાગણીવશ તેના સમાન લિંગનુ, બીજા સામેના લિંગનુ અથવા બંનેનુ આકર્ષણ છે. એક વ્યક્તિ પછી ભલે તે પુરૂષ હોય કે સ્ત્રી બંનેને તેમના લૈંગિક અનુસ્થાપનને પસંદ કરવાનો અને તેના તરફ એક સ્પષ્ટ લૈંગિકતા જાહેર કરવાનો હક્ક છે. કોઇકવાર તમારો સાથીદાર તમને લૈંગિક આવેશો સક્રિય કરવા ધકેલશે. તમારા જીવનના સિદ્ધાંતો જાણીને આ પરિસ્થિતીમાં શું કરવુ જે નક્કી કરવા મદદ કરશે. એ વાત તમારે જાણવી કે જો કોઇ તેની સાથે નિરોધ રાખતુ હોય તો તે એનો અર્થ એ નહી કે તે શાંત છે અથવા ક્રિયા કરવાની અપેક્ષા રાખે છે. તેનો કેવળ એક જ મતલબ છે કે તે વ્યક્તિ સુરક્ષિત રહેવા તૈયાર છે, જો તમે/તેણી સાથે લૈંગિક સંભોગ કરવા માટે તૈયાર હો. સાચી વાત એ છે કે તમને સલાહ અપાય છે કે તે તમારે સાથે લઈ જવુ જોઇએ અને અસુરક્ષિત યૌન સંબધથી દુર રહેવુ જોઇએ. લૈંગિક આવેગો લાગણીથી, વિચારોથી અને ભાવનાઓથી વ્યક્ત કરવાની રીત છે. એક પુર્ણ વિકાસ પામેલી સમજણ જે વ્યક્તિને પરિપક્વ બનાવે છે. આ કરવા માટે એકને જરૂરી નથી કે આ વિષય ઉપર આવે ત્યારે તે કાંપે અથવા વ્યાકુળ થાય. આપણી લૈંગિકતા આપણો એક ભાગ છે જેને કોઇ દિવસ દબાવવો અથવા નજર અંદાજ ન કરવો જોઇએ. એક વ્યક્તિગત પસંદગી માણસને પોતાનુ પ્રતિબિંબ બતાવશે જે તમારી જાગરૂકતાને સૌથી પહેલી લાવશે

માનસશાસ્ત્ર

માનસશાસ્ત્ર માનવી અને પ્રાણીઓના વર્તન વિષે શાસ્ત્રીય અભ્યાસ એટલે ’માનસશાસ્ત્ર’. મનુષ્યપ્રાણીના સ્વભાવને જાણવું, તેમના વર્તન વિશેષ અંદાજ કાઢવો. તેનું વર્તણૂક બદલવા માટે વિવિધ પધ્ધતિઓને વિકસીત કરવો અને ઉપચારની પધ્ધતિને ઠરવવા માટે માનસશાસ્ત્ર જુદા-જુદા શાસ્ત્રીય પધ્ધતિનો ઉપયોગ કરે છે. સંશોધન પ્રયોગશાળામાં જ કરવામાં આવે છે, જેથી જે બાબતોનો અભ્યાસ કરવાનો છે તેના સંબંધિત વર્તનનું નિયંત્રણ કરી શકાય છે, અથવા ત્યાં પ્રત્યક્ષ જીવનના સ્વભાવનો અભ્યાસ કરી શકાય છે. માનસશાસ્ત્રમાં વિવિધ વિભાગો આવેલા છે અને પ્રત્યેક વિભાગ ’ વર્તનના’ જુદા-જુદા દૃષ્ટીકોણથી વિશ્લેણ કરતાં હોય છે. સમાજ માનસશાસ્ત્ર એ માનવના વર્તન પર થનાર વિવિધ સામાજિક પરિસ્થિતીનો અભ્યાસ કરે છે. વ્યક્તિમત્તવના તત્ત્વ વિચારકો માનવીના વર્તન પર અબ્યાસ કરે છે. વિકાસ માનસશાસ્ત્રીઓ આયુષ્યમાં કાયમી સ્વરુપે બદલાવ લાવવા માટે આવશ્યક સિંધ્દાતો (પધ્ધતિ) અને તત્ત્વોનો અભ્યાસ કરે છે. તુલનાત્મક માનસશાસ્ત્રીઓ પ્રાણીઓમાં વિવિધ જાતીઓનો અભ્યાસ કરીને તેઓના વર્તનનો અભ્યાસ કરે છે. ઇંદ્રિયવિજ્ઞાન માનસશાસ્ત્ર એ વર્તનના જીવનશાસ્ત્રથી સંબંધિત હોય છે. જ્ઞાનવિષયક માનસશાસ્ત્ર એ સ્મરણશક્તિ શોધે છે, વિચાર ,સમસ્યા નિવારણ અને શીખવાની માનસશાસ્ત્રીય પાંસાનું અભ્યાસ કરે છે. ચિકિત્સાવિષયક માનસશાસ્ત્રીઓ વ્યક્તિમાં અથવા સમૂહમાં તેના વર્તનમાં બદલાવ લાવી આપવા માટે વિવિધ પધ્ધતિથી અભ્યાસ કરે છે. શારિરીક તથા સમાજિક ઘટકો વ્યક્તિના કાર્યની જગ્યા/ વાતાવરણ પર થનારા પરિણામો તથા તેને લીધે ઉત્પાદન ક્ષમતા પર થનારા પરિણામો અભ્યાસ ઔધોગિક/ સંગઠિત સંસ્થાના માનસશાસ્ત્રીઓ કરે છે. સમાજ માનસશાસ્ત્રીઓ વિવિધ શાસ્ત્રીય પધ્ધતિનો ઉપયોગ સામાજિક સમસ્યાનો અભ્યાસ તથા તેનાથી છૂટકારો મેળવવા માટે કરતાં હોય છે.

Treatment of Epilepsy

Treatment of Epilepsy Treatment of Epilepsy The neurology team will design a treatment plan according to medical condition, state of health and individual needs. They may also refer to additional doctors or other medical professionals. Most medical treatments can involve some risks or complications. The neurologist will explain any possible risks or complications involved. Don’t be afraid to ask the doctors, nurses or therapists about your treatment. Drug Therapy Medication In many cases, seizures can be successfully prevented with medications. The type of medication you will receive depends on many factors. Your neurologist will explain how the medication should be taken and the side effects that may occur. Over a period of time medication regimen may be changed. It is very important that you take the medication exactly as directed. Call your neurologist if you have any questions about the medications or you experience some unexpected side effects. Some patients do not respond to medications and continue having seizures. In these cases, other treatments may be recommended. The standard treatment for epilepsy is the regular use of one or more chemical substances called anti–epileptic or anti–convulsant drugs. The ideal situation is when a person takes as little medication as possible while maintaining seizure control. Anti–epileptic drugs like phenytoin sodium, phenobarbitone, benzodiazepines are commonly used to control epilepsy. However the blood levels of these medicines need to be closely monitored so that adequate levels are constantly maintained. The most commonly used treatments are probably Dilantin, or Eptoin, Carbamazepine or Tegreto, and Phenobarbital, an older medication. The 1st two drugs are, in general well tolerated. Dilantin, is very effective as it is long acting and needs to be taken only once a day, the side effects are mostly cognitive and can cause problems with thought and memory, can lead people to tire easily and cause a kind of rash. Since it has been around for a long time it has been well researched and we are aware of its uses and limitations. The most common medication worldwide for seizures is Tegreto or carbamazepine. Chemically, it is very similarly to Dilantin but taken twice a day. But it is a different drug. The side effects are a bit different. If the dose is too high it can cause sedation and double vision. Drug options Over the past decade there have been a number of developments, with new more specific drugs becoming available. This is not to say that the older drugs have become obsolete. In fact, the newer preparations may not be at all suitable for some people. Each drug has two names, the generic, or chemical name (for example carbamazepine) and the trade name (for example Tegretol), given by the manufacturer. It is helpful for a person to know the generic names of his/her drugs, especially when travelling abroad. Team work Co–operation between you and your doctor is essential in establishing optimum control of your epilepsy. The more accurately you, or a family member, can describe your seizures and the effects of the medication, the more precise the doctor’s prescription can be. It is important that drugs are taken exactly as prescribed. Compliance is a major factor in the overall results that can be achieved. Your pharmacist is also able to assist with information and advice about your medication. Side–effects Like all drugs, anti–convulsants may have some side–effects. The appearance of these depends on each person’s individual response to the drug as well as how much of it he or she is taking. With only a few exceptions, side–effects associated with anti–convulsants drugs are mild and usually occur at the beginning of therapy, usually disappearing as the person becomes used to the drug. If side–effects do occur, they should be reported. Depending on the type of drug involved, the most frequent side–effects are drowsiness, irritability, nausea, rash, thickening of facial features, increase in body hair, physical clumsiness, overgrowth of gum tissue, and hyperactivity in children. Some drugs may produce emotional changes; occasionally a drug will actually increase rather than decrease the number of seizures a person experiences. However, many people are able to take the medication for years without experiencing any of these effects. Ketogenic Diet Special high–fat, low–protein, no–carbohydrate diet has been recommended for people with epilepsy who do not respond to medications. The diet mimics certain effects of starvation, which helps to prevent seizures. Dietician can help you to incorporate this diet into your family’s lifestyle. Strict adherence to the diet is essential for the treatment to be successful. Surgery for Epilepsy If seizures are confined to a part of the brain or if they are due to growths, surgical resection may cure the condition. Surgery helps lessen seizures after they’ve been on a couple of medications. Medications just suppress epilepsy, while surgery can be a cure. The best cases for surgery are patients with temporal lobe epilepsy. The temporal lobe lies next to the ear and can be removed without any effects that we are aware of. Conclusive testing is required before the person goes for surgery, as to define the exact area in the brain that is causing the seizures and that area is not important for other functions. Many of the patients don’t need to take anti–epileptic medications after surgery What are the surgical treatments for Epilepsy? Standard surgical procedures If drug therapy fails to control seizures, particularly partial, over a two or three year period, surgery may be appropriate. Children and young adults are the preferred candidates, because older people have more difficulty with rehabilitation. Tests for Surgical Decision Making. Advances in imaging and monitoring, new surgical techniques, and a better understanding of the brain and epilepsy in infants as well as in older individuals have made surgery a more viable option than in previous decades. The general approach is first to locate the brain tissue that triggers the epileptic event using long term EEG monitoring, usually with added information from imaging techniques, such as MRI or PET scans. If such tests detect a specific area in the brain as the location for the seizure, then surgery is possible. The physician then tries to determine if the offending nerve cells perform vital functions usually with the use of advanced MRI techniques. The surgeon’s goal is to remove just enough damaged tissue and no more in order to prevent seizures and limit brain injury. If the diagnostic tests indicate that more than one site is involved or they have conflicting results, then more invasive monitoring of the brain is required. Surgical procedures may be considered to prevent seizures. These procedures include: Disconnection procedures – These procedured disrupt abnormal electrical activity that occurs in the brain and triggers epileptic seizures. Two types of disconnection operations are: Corpus callostomy – Used to stop atonic and tonic seizures. Multiple subpial transections – Used when seizures are caused by parts of the brain that can’t be removed. Focal resections – Focal resections are the most common surgical approach for treating epilepsy and provide the best chance for patients to gain complete seizure control. These procedures involve the removal of a small area of the brain where seizures originate. New brain monitoring techniques allow doctors to better pinpoint brain tissue causing seizures. {jumi usermod/ads/ads.php}{/jumi} Types of resections include • Temporal lobectomy – A portion of the temporal lobe is removed to control seizures. • Lobar resection – A portion of a seizure, producing lobe, frontal, parietal or occipital lobe – is removed, if it can be done without damaging vital functions. • Hemispherectomy – One sphere of the brain is removed or disabled. The remaining half of the brain takes over many of the functions of the half that was removed. This procedure is used to treat severe conditions that have not responded to other treatments. • Gamma Knife radiosurgery – The Gamma Knife delivers a finely focused, high dose of radiation to remove tissue without damaging surrounding tissue. Some types of seizures, such as gelastic seizures which are accompanied by brief, sudden bursts of emotion, can be treated with this technology. • Vagus nerve stimulation – This procedure involves minor surgery and is a relatively new treatment that helps prevent or lessen the severity of seizures. An electrical stimulator is implanted that sends regular electrical pulses through the vagus nerve to the brain to reduce the onset or frequency of seizes. If a seizure occurs between doses of current, you or your child can pass a magnet over the device to trigger an additional dose. A child with a vagus nerve stimulator continues to take medication but sometimes can reduce the amount or number of medications. This procedure can treat a wide variety of seizure disorders when surgery isn’t an option. Prevention and Follow–Up To help cope with epilepsy and reduce your chance of injury from seizures, doctors recommend the following • Patient should carry identification, that indicates he or she has epilepsy. In an emergency, this information can ensure that you receive the right care. • Explain to your family, friends, teachers, relatives and sports coaches how to care for you if he or she has a seizure. • If you get regular or even occasional seizures, make sure he or she avoids dangerous situations and activities. Eg. Be careful when playing sports and should not swim unattended. • Should never stop taking seizure medication or change the amount taken without discussing it with a doctor first. • Always consult your doctor or pharmacist before taking other medications in addition to seizure drugs Medication for Epilepsy Epilepsy cannot be ‘Cured’ with medication. However, various medicines can control the seizures by stabilising the electrical activity of the brain. The success in controlling seizures by medication varies depending on the type of epilepsy. If there is no underlying cause for your seizures – Idiopathic epilepsy, you have a good chance that medication can fully control your seizures. Seizures caused by a core brain problem may be more difficult to control. Your physician will take into account various conditions, such as your age, type of epilepsy, other medicines you may be taking, possible side–effects, if you are pregnant, etc while choosing your medication. There are some popular medicines for each type of epilepsy and if one does not suit you, another may be better. Doctors usually start at the lowest possible dose to control seizures. The dose is usually increased if you have further seizures. Medicines are available as tablets, soluble tablets, capsules, or liquids. Side–effects of Epilepsy Medications Most medicines have probable side–effects, not everyone is effected. The listed of side–effects are found in the which comes in the medicine box. You should read this even though it may appear alarming. Many of the side–effects listed, are rare. When you start medication, don’t forget to ask your doctor about any problems that may arise for that particular medicine. Do not stop taking a medicine suddenly, if you notice a side–effect, but consult your doctor for advice. One of the common side–effect is sleepiness but eases or goes once the body gets used to the medicine. Side–effects which are rare, but you still need to be aware of are rashes or bruising whilst taking certain medicines. Re–occurring Seizures In some cases, seizures are not controlled immediately in spite of taking medicine. This could be because the dosage or timing of the medication needs re–assessing. A common cause of seizures is taking medication incorrectly. If you have taken a medicine correctly up to its maximum allowed dose, but it has not worked well, you may be advised to switch to a different medicine. If that does not work alone, taking two medicines together may be advised. It is quite uncommon that seizures are not controlled with two medicines. Importance of correct medication It is important to take your medicine as prescribed. Try to get into a daily routine. Forgetting an occasional dose is not a problem for some people, but for others would lead to breakthrough seizures. One of the reasons why seizures recur is due to not taking medication properly. Duration of Epilepsy Medication The chance of seizures recurring is higher for some types of epilepsy than others, only your doctor will be able to advise you, so follow his instructions religiously. You may be able to stop medication if your seizures have been well controlled for two or more years. Since there are many different types of epilepsy, some of which are age dependent may not need medication for long, but there are others that will need medication for life. Your life circumstances may influence the decision about stopping medication. If a decision is made to stop medication, it is best done gradually, reducing the dose over a period of several weeks or months. Follow the advice given by a doctor. How effective is Medication used for Epilepsy? The success in controlling seizures by medication varies depending on the type of epilepsy. For example, if no underlying cause can be found for your seizures you have a good chance that medication can fully control your seizures. Seizures caused by some underlying brain problems may be more difficult to control. The following figures are based on studies of people with epilepsy which looked back over a five year period. These figures are based on grouping people with all types of epilepsy together which gives an overall picture. 1. About 5 in 10 people with epilepsy will have no seizures at all over a five year period. Many of these people will be taking medication to control seizures. Some will have stopped treatment having had two or more years without a seizure whilst taking medication. 2. About 3 in 10 people with epilepsy will have some seizures in this five year period, but far fewer than if they had not taken medication. 3. In total, with medication about 8 in 10 people with epilepsy are well controlled with either no, or few, seizures. 4. The remaining 2 in 10 people experience seizures, despite medication. Which Medicine is the most Suitable? A doctor will take into account various things when choosing a medicine to prescribe. These include: your type of epilepsy, age, other medicines that you take, possible side–effects, pregnancy, etc. There are popular medicines for each type of epilepsy. However, if one medicine does not suit, another may be better. A low dose is usually started. The aim is to control seizures at the lowest dose possible. If you have further seizures, the dose is usually increased. There is a maximum dose allowed for each medicine. In about 7 in 10 cases, one medicine can control all, or most, seizures. Medicines may come as tablets, soluble tablets, capsules, or liquids to suit all ages. What if Seizures still occur? In some seizures are not controlled despite taking one medicine. This may be because the dosage or timing of the medication needs re–assessing. A common reason why seizures continue to occur is because medication is not taken correctly. If in doubt, your doctor or pharmacist can offer advice. If you have taken a medicine correctly up to its maximum allowed dose, but it has not worked well, you may be advised to try a different medicine. If that does not work alone, taking two medicines together may be advised. However, in about 2 in 10 cases, seizures are not well controlled even with two medicines. When is Medication Started? The decision when to start medication may be difficult. A first seizure may not mean that you have ongoing epilepsy. A second seizure may never happen, or occur years after the first. For many people, it is difficult to predict if seizures will recur. Another factor to consider is how severe seizures are. If the first seizure was severe, you may opt to start medication immediately. In contrast, some people have seizures with relatively mild symptoms. Even if the seizures occur quite often, they might not cause much problem, and some people in this situation opt not to take any medication. The decision to start medication should be made by weighing up all the pros and cons of starting, or not starting, treatment. A popular option is to ‘wait and see’ after a first seizure. If you have a second seizure within a few months, more are likely. Medication is commonly started after a second seizure that occurs within 12 months of the first. However, there are no definite rules and the decision to start medication should be made after a full discussion with your doctor. What about side–effects? All medicines have possible side–effects that affect some people. All known possible side–effects are listed in the leaflet which comes in the medicine packet. If you read this it may appear alarming. However, in practice, most people have few or no side–effects, or just minor ones. Many side–effects listed are rare. Each medicine has it’s own set of possible side–effects. Therefore, if you are troubled with a side–effect, a change of medication may resolve the problem. When you start a medicine, ask your doctor about any problems which may arise for your particular medicine. Two groups of problems may be mentioned. 1. Side–effects which are relatively common, but are not usually serious. For example, sleepiness is a common side–effect of some medicines. This tends to be worse when first started. This problem often eases or goes once the body gets used to the medicine. Other minor side–effects may settle down after a few weeks of treatment. If you become unsteady, it may indicate the dose is too high. 2. Side–effects which are serious, but rare. Your doctor may advise what to look out for. For example, it is important to report any rashes or bruising whilst taking some types of medicine. Do not stop taking a medicine suddenly. If you notice a side–effect, ask your doctor for advice. Taking your Medication Correctly It is important to take your medicine as prescribed. Try to get into a daily routine. Forgetting an occasional dose is not a problem for some people, but for others would lead to breakthrough seizures. One of the reasons why seizures recur is due to not taking medication properly. A pharmacist is a good source of advice if you have any queries about medication. Some medicines taken for other conditions may interfere with medication for epilepsy. If you are prescribed or buy another medicine, always remind your doctor or pharmacist that you take medication for epilepsy. Even things such as indigestion medicines may interact with your epilepsy medication, which may increase your chance of having a seizure. Some epilepsy treatments interfere with the contraceptive pill. You may need a higher dose pill for effective contraception. Your Family Planning doctor will be able to advise you about this. What about Epilepsy Medication and Pregnancy? Being pregnant does not usually make epilepsy any better or worse. However, there is a small chance that the unborn child may be affected by some medicines used to treat epilepsy. Before becoming pregnant it is best to seek advice from a doctor, epilepsy nurse, or counsellor. The potential risks can be discussed. One important point is that you should take extra folic acid before becoming pregnant, and throughout the pregnancy. This may reduce the chance of certain abnormalities occurring. If you have an unplanned pregnancy, do not stop epilepsy medication which may risk a seizure occurring. See a doctor as soon as possible. How long do I need to take Medication for? You may wish to consider stopping medication if you have not had any seizures for two or more years. It is important to discuss this with a doctor. The chance of seizures recurring is higher for some types of epilepsy than others. Overall, if you have not had any seizures for 2–3 years and you then stop medication: • About 6 in 10 people will remain free of seizures two years after stopping medication. If seizures do not return within two years after stopping medication, the long–term outlook is good. However, there is still a small chance of a recurrence in the future. • About 4 in 10 people will have a recurrence within two years. There are many different types of epilepsy, some of which are age dependent, but some that will need medication for life. Your epilepsy specialist should be able to offer you more advice about the long–term outlook for your particular type of epilepsy. Your life circumstances may influence the decision about stopping medication. If a decision is made to stop medication, it is best done gradually, reducing the dose over a period of several weeks or months. Follow the advice given by a doctor. Are there any other Treatments for Epilepsy? Surgery to remove a cause of seizures in the brain is an option in a small number of cases. It may be considered when medication fails to prevent seizures. It is only possible for certain causes in certain areas of the brain. Therefore, only a small number of people are suitable for surgery. Also, there is risk involved in brain surgery. However, techniques continue to improve and surgery may become an option for more and more people in the future. The ketogenic diet, a diet that needs to be supervised by an experienced dietician, is useful for some children and adults with particular types of epilepsy. Vagal nerve stimulation is another treatment that is occasionally used in some cases. Complementary therapies such as aromatherapy may help with relaxation and relieve stress, but have no proven effect on preventing seizures. Counseling – Some people with epilepsy become anxious or depressed about their condition. A doctor may be able to arrange counseling with the aim of overcoming such feelings. Genetic counseling may be appropriate if the type of epilepsy is thought to have a hereditary pattern. It may be an option to consider before starting a family. Book

Diagnosing a case of epilepsy

Diagnosing a case of epilepsy A patient’s detailed medical history is of utmost importance in diagnosing epilepsy. Many times family members who witness the seizure activity might be asked to keep a record of the time of the seizures, how long each seizure lasts, any aggravating factors like emotional stress, certain foods, smells or sounds etc.. This information can be crucial in the diagnosis of the type of epilepsy. Usually, a neurologist would look into a case of epilepsy, although general physicians can also treat a person with seizures. The laboratory that would be required for epilepsy are: •Primary care investigations Chest X–ray to rule out malignancy. Blood tests (eg. full blood count, erythrocyte sedimentation rate, electrolytes, renal function, liver function, calcium, and glucose) could show an underlying disorder or metabolic disturbance. •Secondary care investigations Such as electroencephalography, neuroimaging, and metabolic screening in children, may aid seizure classification and help to determine the aetiology but they have limitations. •Magnetic resonance imaging (MRI) Can better define the structures of the brain in three dimensions and can look at discrete areas of brain activation. •Computed axial tomography (CAT) Has a role in the urgent assessment of seizures or when MRI is contraindicated, but it is less effective in detecting lesions. •Electroencephalography (EEG) The EEG is not foolproof. It can only measure abnormal electrical activity that occurs during the test period and should not be performed to ‘Exclude’ a diagnosis of epilepsy but should be used to support the classification of epileptic seizures and epilepsy syndromes when there is clinical doubt. •Positron emission tomography (PET) Scanning is a highly specialized, expensive and largely unavailable technique that detects cerebral blood flow and metabolism. •Single proton emission computerized tomography (SPECT) scanning is much cheaper and technically simpler than PET scanning it shows the areas where blood flows through your brain.

Signs and Symptoms of Epilepsy

Signs and Symptoms of Epilepsy Epileptic seizures can take a very wide variety of forms but are broadly divided into generalized and focal or partial seizures. Partial or focal seizures affect part or a whole limb and may or may not become generalized. If there is no alteration in consciousness it is known as simple partial or Jacksonian seizures and if consciousness is altered or lost it is known as complex partial seizures, commonly known as psychomotor or temporal lobe epilepsy. Generalised seizures affect the whole body and consciousness is lost. However, by far the most common is Generalised seizures (involving the whole brain) commonly known as “Grand Mal” or “Tonic Clonic” seizures or major seizures. People with epilepsy experience more than one type of seizure. The two categories of seizures are called generalized and partial. A) Generalized Seizures Generalized seizures result from electrical impulses arising from the entire brain. They typically occur without warning. There are six types of generalized seizures. • Absence seizure – You will lose awareness and stare blankly for a few seconds. Usually, there are no other symptoms. These seizures may occur several times a day. • Atonic seizure – During this kind of seizure, your muscles will relax, particularly in the arms and legs, which can cause you to suddenly fall and often injure themselves. • Clonic seizure – Both sides of your body jerk rhythmically at the same time. • Myoclonic seizure – Your body may jerk, as if being shocked by electricity. The jerks can range from a single muscle jerking to involvement of the entire body. • Tonic-clonic – You will lose consciousness and may also collapse. Your body becomes stiff and begins jerking. Finally, your child will fall into a deep sleep. Injuries such as tongue-biting can occur, as well as a loss of bladder control. • Tonic seizure – Your child’s muscles suddenly become very stiff. B) Partial Seizures Partial seizures originate from activity in a smaller part of the brain. They are divided into simple and complex.The difference between simple and complex seizures is that during simple partial seizures, your child will retain awareness. During complex partial seizures, your child will lose awareness. • Simple partial seizure – Your child may experience movements such as jerking or stiffening, various sensations. Full consciousness is retained. • Complex partial seizure This is the same as a simple partial seizure except that your child’s awareness is impaired. He or she may appear to be “Out of touch” or “Spaced out.” Your child also may involuntarily chew, walk, fidget or perform other repetitive movements or simple actions. Although the symptoms listed below are not necessarily indicators of epilepsy, it is wise to consult a doctor if you or a member of your family experiences one or more of these symptoms: • “Blackouts” or periods of unclear memory. • Episodes of staring or unexplained periods of unresponsiveness. • Involuntary movement of arms and legs. • “Fainting spells” with involuntary urination or defecation followed by excessive fatigue. or • “Hearing of odd sounds”, distorted perceptions, feelings of fear or emotional distress that cannot be explained. Seizures can be Generalized (‘Grand Mal’) or Partial (‘Petit Mal’ or ‘Absence’) or of a type that affects only a localized area of the brain (‘Partial seizures’). Generalized seizures manifest as episodes of involuntary twitching of the extremities, uncontrolled head movement, frothing at the mouth, rapid eye movement, usually followed by a period of unconsciousness. For a varying period of time after an epileptic seizure, the patient may be confused & unresponsive. Seizures are partial when the abnormal electrical activity is limited to one part of the brain. Such partial seizures can cause periods of “Repetitive behavior” and altered consciousness. This is characterized by behavior, such as buttoning or unbuttoning a shirt. Such behavior, however, is unconscious, may be repetitive, and is usually not remembered.

Genesis of Epilepsy

Genesis of Epilepsy • The brain is the control center for the body, like a computer of the highest generation. It is made up of millions of tiny nerve cells or neurons and supporting glial cells. Each neuron is connected to thousands of other neurons and in turn to the different parts of the body via nerves. Each neuron has electrical voltage difference across the parts of the body via nerves and across the cell membrane. (This inherent electrical activity can actually be detected, measured and recorded by the electrencephalogram – EEG). A seizure occurs when there is a sudden "Surge" or "Excess" or "Chaos" in the normal electrical activity in groups of neurons (epileptic focus) possibly due to change in metabolism. This abnormal electrical discharge spreads to the other areas of the brain and soon there is total disruption of the normal function of the brain. This chaotic state of excessive excitability is ultimately brought under control by inherent inhibitory influences. • The abnormal discharges may involve a small part of the brain only manifesting as partial or focal seizure or a much more extensive area in both cerebral hemispheres manifesting as generalized seizures. The presence or absence of a warning or an aura and a typical sequence of events during an attack reflect the point in the brain from where the attack begins. • The abnormal discharges may vary in site, extent and severity and this explains the wide diversity of clinical forms that a seizure might take.

Epilepsy and Pregnancy

Epilepsy and Pregnancy Patient Information Epilepsy is a neurological condition, which affects the nervous system, and is also known as a seizure disorder. The seizures in epilepsy may be related to a brain injury or a family tendency, but most of the time the cause is unknown. The word “Epilepsy” does not indicate anything about the cause of the person’s seizures, what type they are, or how severe they are. A seizure is a sudden surge of electrical activity in the brain that usually affects how a person feels or acts for a short time. About half of the people who have one seizure without a clear cause will have another one, usually within 6 months. You are twice as likely to have another seizure if you have a known brain injury or other type of brain abnormality. If you do have two seizures, there’s about an 80% chance that you’ll have more. If your first seizure occurred at the time of an injury or infection in the brain, you are more likely to develop epilepsy.More seizures are also likely if your doctor finds abnormalities on a neurological examination; a set of tests of the functioning of your nervous system that is performed in the doctor’s office. Another thing that can help your doctor predict whether you will have more seizures is an EEG, electroencephalogram, a test in which wires attached to your scalp record your brain waves. Certain patterns on the EEG are typical of epilepsy. If your brain waves show patterns of that type, you are about twice as likely to develop epilepsy as someone who does not have those patterns. When an individual is aware of the beginning, it may be thought of as a warning or aura. On the other hand, an individual may not be aware of the beginning and therefore have no warning. Sometimes, the warning or aura is not followed by any other symptoms. It may be considered a simple partial seizure by the doctor. The middle of the seizure may take several different forms. For people who have warnings, the aura may simply continue or it may turn into a complex partial seizure or a convulsion. For those who do not have a warning, the seizure may continue as a complex partial seizure or it may evolve into a convulsion. The end to a seizure represents a transition from the seizure back to the individual’s normal state. This period is referred to as the “Post–ictal period” (an ictus is a seizure) and signifies the recovery period for the brain. It may last from seconds to minutes to hours, depending on several factors including which part(s) of the brain were affected by the seizure and whether the individual was on anti–seizure medication. If a person has a complex partial seizure or a convulsion, their level of awareness gradually improves during the post–ictal period, much like a person waking up from anesthesia after an operation. Epilepsy can develop in any person at any age. 0.5% to 2% of people will develop epilepsy during their lifetime. People with certain conditions may be at greater risk. More men than women have epilepsy. Bookmark Pregnant Women with Epilepsy Pregnancy is a very important event especially so in the life of women with epilepsy. The main concern in the patient and her relatives mind is whether any thing would happen to the baby is it safe to carry on with the pregnancy. The health of the mother (patient) is also a concern, though to a lesser extent. During pregnancy, various things to be considered are • Risks of baby being born physically or mentally deformed . • Risk of epilepsy in the offspring. • Risks to mother or baby during delivery. Risk to the baby does exist, and this would be partly due to the anti epileptic medications and partly due to the seizures themselves, which if frequent, could lead to lack of oxygen to the baby. The risk from medicines is about double (5-6%) when compared to women not on anti epileptic medicines. These take the form of neural tube defects (improper development of brain and /or spinal cord), or facial deformities. Thus though there is a risk of improper development, this is not too great and most pregnancies pass of uneventfully. Certain medicines like evaporate are known to cause a greater proportion of defects and if possible these need to be changed to some other drug. This has to be done prior to the pregnancy as the risk of fetal defects is highest in first 3 months. Most of the other routinely used medicines have more or less equal risk so there is nothing much to choose between them. Some gynecologists have their individual preferences, as do neurologists, so this decision needs to be taken jointly. As opposed to risk to baby due to medicines, there are risks of seizures also, and seizures need to be well controlled prior to planning pregnancy. Each seizure causes temporary reduction in oxygen supply to the baby and this may lead to poor growth, or in occasional cases abortions or fetal deaths. The decision about anti epileptic medicines in pregnancy should be taken before the patient gets pregnant, and pre-pregnancy counseling is an important aspect, which is most often lacking, partly because of the doctors who are not thinking too far ahead and partly due to patients who are too shy to discuss this with their neurologists and prefer to approach the doctor only after pregnancy is confirmed. Prior to considering pregnancy, the patient’s fits must be controlled and ideally patient should be 6-12 months fit free. This is sometimes a problem because of our society and hence extra counseling is necessary. If the patient is well controlled and on multiple medicines then the doctors try and keep only one of these and reduce the others If patients are on valproate, then this should be changed to one of the other medicines, always ensuring that the seizure control is not affected. This process may take 3-6 moths. Certain types of fits do not respond to other medicines and there may be no option but to continue valproate. In such cases the doctor tries to keep the dose as low as possible, and the risk of Mal development must be discussed in detail with the patient and husband. Other measures to be taken during pregnancy are ensuring proper food timings, and sleep; reducing stress. Occasionally the level of the medicines would have to be checked and if too low then dose would be increased accordingly. Folic acid supplements are now routinely used and the help prevent neural tube defects in baby. Period ultrasound examinations also help to detect fetal problems. {jumi usermod/ads/ads.php}{/jumi} During last month of pregnancy there is substantial weight gain and this may lead to the medicine getting diluted. Drug level monitoring often helps to readjust doses, which would continue till delivery. During delivery (normal or caesarian) the same doses have to be continued. Breast feeding is by and large safe and babies are not affected by most drugs unless the dose is quite high. This needs to be discussed with the doctors. Risk to the mother is negligible, unless patient develops uncontrolled seizures. Or she develops eclampsia (high BP, Swelling of feet, Kidney Involvement). Lastly, about 5-10% of epilepsies are inherited so that is the risk of baby developing seizures later in life. Epilepsies have many different types and only a few of these are genetic in origin. In any case, treatment of the sits is no different from the non genetic varieties. Even so, it would not mean that the child would be mentally handicapped, and hence this aspect should not be a barrier to considering pregnancy. All said, pregnancy in an epileptic mother needs careful monitoring and assessment. Though there are increased risks, these are not prohibitive and can be minimized to some extent and most pregnancies pass off uneventfully.

Questions to Ask a Doctor about Epilepsy

Questions to Ask a Doctor about Epilepsy Doctor/patient Discussion Points If they’re diagnosed with epilepsy, one of the first thing we want to know is, what was the cause and what are the remedies and the chances of recurrence. When you have questions about epilepsy, write them down on a list as you think of them and ask your doctor. Use your doctor as a clearinghouse for information and support groups. Good medical care is based on a partnership between the doctor and the patient. Always tell your doctor about any reaction to the medication or, if the treatment isn’t working. Let the doctor know what is important to you and what concerns you have. It’s important for the doctor to know about any “Black–outs”, spells, auras or small seizures that you have experienced. Most patients with epilepsy see a neurologist for their epilepsy. Sometimes, the relationship between patient and doctor doesn’t “Click”, or the patient likes the doctor but their seizures remain uncontrolled. A change of doctor or a second opinion are reasonable options open to you as a patient. Epilepsy can be an agonizing condition to live through, and without a doctor you have complete trust in, the condition can become almost unbearable. Some of the questions to ask your doctor: • Could brain surgery be effective in stopping my seizures? • Can medication prevent seizures? • What would the side–effects be? • What is sodium valproate? • What is the difference between Lamotrigine and Carbamazepine? • What other medication can be used? • What about contraception pills? • Can I take other drugs while taking medicine for epilepsy? • What if I become pregnant whilst taking medication for seizures? What are the symptoms of Epilepsy? Fits are of many types. The symptoms found in most of the cases are: • Sudden fainting & falling on ground. • Face turning to one side. • Eyes becoming glossy. • Clenching of fists. • Bending of neck to one side. • Foaming in the mouth. • Feeling of giddiness for a second. • Fainting with oh’–oh’/go’–go’ sound or even headache with giddiness. • Seizures during Menstrual period in women. What Causes Epilepsy? Epilepsy is a disorder with many possible causes. Anything that interrupts the brain’s normal activity can lead to seizures. Epilepsy can be inherited, or it can result from a birth defect, birth or head injury, brain tumor, or an infection in the brain. In some cases, epilepsy may develop due to abnormal nerve connections that form as the brain heals after a head injury, stroke, or other problem. In about 70 percent of people with epilepsy, the exact cause cannot be determined. When the exact cause of epilepsy is not known, it is referred to as idiopathic epilepsy. What is a seizure? A sudden, excessive discharge of nervous–system electrical activity that usually causes a change in behavior. Closeis a sudden surge of electrical activity in the brain that usually affects how a person feels or acts for a short time. Seizures are not a disease in themselves. Instead, they are a symptom of many different disorders that can affect the brain. Some seizures can hardly be noticed, while others are totally disabling. The seizures in Epilepsy. A disorder characterized by transient but recurrent disturbances of brain function that may or may not be associated with impairment or loss of consciousness and abnormal movements or behavior. Closemay be related to a brain injury or a family tendency, but often the cause is completely unknown. The word “Epilepsy” does not indicate anything about the cause or severity of the person’s seizures. How is epilepsy treated? Before a person begins treatment, the first step is to ensure that the diagnosis of epilepsy is correct and to determine, if possible, the type of epilepsy and whether there are any underlying conditions that also need treatment. This will require a careful review of the person’s medical history and a neurological examination. Other tests may be recommended as well, usually including an electroencephalogram (EEG) and often a brain scan; such as a computed tomography (CT) or magnetic resonance imaging (MRI). The medical decision about how best to treat the epilepsy is based on this evaluation. • Antiepileptic drugs are the mainstay of treatment for most people. There are now many drugs available, and a doctor may recommend one or more of these based on several individual patient factors such as the type of epilepsy, the frequency and severity of the seizures, age, and related health conditions. After starting a medication, close monitoring is required for awhile to assess the effectiveness of the drug as well as possible side effects. Early in treatment, dosage adjustments in dosage are often required. Sometimes, because of continued seizures or significant side effects, it is necessary to change to a different drug. For about two-thirds or more of people with epilepsy receiving optimum treatment, drugs are successful in fully controlling seizures. For the remainder, although drugs may have a partial benefit, some seizures continue to occur. For some of these people, other treatment options may be considered. • Surgery. With certain types of partial epilepsy, especially when it can be determined that seizures consistently arise from a single area of the brain called the seizure focus, surgery to remove that focus may be effective in stopping future seizures or making them much easier to control with medication. Epilepsy surgery is most commonly performed when a seizure focus is located within the temporal lobe of the brain. This may need further advanced tests from an epileptologist -such as special sequence MRI scan even if previous simple screening MRI has been done, video EEG , SPECT or PET SCAN and neuropsychological evaluation or a functional MRI scan as required. • Surgery for epilepsy is available at few specialized epilepsy centres in India and abroad and is useful in carefully evaluated persons with epilepsy by a dedicated epileptologist and his team in a comprehensive manner. When this happens 5-10 % of resitiatn or difficult to treat epilepsy with focal brain disturbance , if not in an important brain area, can be surgically treated with good results for seizures reduction or total stoppage and improved quality of life. • Other options. Other supplemental treatments are sometimes beneficial when medications alone are inadequate and surgery is not possible. These include vagus nerve stimulation, where an electrical device is implanted to intermittently stimulate a large nerve in the neck, Alternative treatment such as specialized Yoga techniques and the ketogenic diet, a high fat, low carbohydrate diet with restricted calories. At what age does epilepsy start? Is it hereditary? Epilepsy primarily affects children and young adults, although anyone can get epilepsy at anytime. 20% of cases develop before the age of five, and 50% develop before the age of 25. However, epilepsy is also increasingly associated with the elderly, and there are as many cases in those 60 years of age and older as in children 10 years of age and under. Heredity usually is not a direct factor in epilepsy. But some kinds of brain wave patterns associated with seizures do tend to run in families. How can I help someone who is having a seizure? Stay calm don’t try to restrain or revive the person. If the person is seated, help ease him/her to the floor. Remove hazards such as hard or sharp objects that could cause injury if the person falls or knocks against them. Don’t move the person unless the area is clearly dangerous, such as a busy street. Loosen tight clothing and remove glasses. Protect airways by gently turning the person on one side so any fluid in the mouth can drain safely. Never try to force something into the person’s mouth! Don’t call an ambulance unless the seizure lasts more than five minutes, or is immediately followed by another one, or if the person is pregnant, ill, or injured. When the seizure ends, let the person rest or sleep. Be calm and reassuring because the person may feel disoriented or embarrassed. How do the doctors know that a person has epilepsy? A range of tests can be carried out at specialist centres to identify possible causes of epilepsy but these cannot always provide a definite diagnosis. The patient’s medical history and an eye–witness account are what doctors mainly use to decide the diagnosis. Epilepsy is a very difficult condition to diagnose correctly so it is important to see someone who has a specialist knowledge in this field as soon as possible. How long is treatment necessary for epilepsy? There is no easy answer to this question. Some people will need to take antiepileptic drugs all their lives. Others may only need medication for a limited time. If no seizures have happened for two to three years, then consult a doctor first about the possibility of withdrawing from the drugs don’t decide just to stop! Seizures may return or become severe and life threatening Is Epilepsy related to mental illness? Epilepsy is not related to mental illness. Because of the involvement Of the brain, Epilepsy has been mistakenly associated with psychiatric disorders. Epilepsy differs from psychiatric disorders in that seizures last for very brief periods and begin and end abruptly. Further, when not having seizures, people with Epilepsy need not have any changes in their mood or behavior and are normal persons able to carry out all activities of daily living and continue their studies or work. Can Epilepsy affect intelligence? Seizures can affect intelligence, so prompt diagnosis and rapid control of seizures is important. There is also a risk if seizures are prolonged and there is a significant reduction in oxygen in the brain during seizures. However, these are extremely rare occurrences. In the case of developmentally delayed persons with Epilepsy, it is most likely that the cause of the developmental delay is also the cause of the seizures. In most cases, people with Epilepsy have normal intelligence. Why epilepsy happens? The brain consists of millions of nerve cells, or neurones, and their supporting structure. Each neurone maintains itself in an electrically charged state. It receives electrical signals from other neurones, and passes them on to others. What actually happens is that a tiny quantity of a special neurotransmitter substance is released from the terminals of one neurone. This chemical excites an electrical response in the neurone next in the chain, and so the signal moves onward. All the functions of the brain, including feeling, seeing, thinking and moving muscles depend on electrical signals being passed from one neurone to the next, the message being modified as required. The normal brain is constantly generating electrical rhythms in an orderly way. There is a cancellation of unwanted signals which does not allow the excitation to spread to unwanted parts of the brain for the activity under consideration. When this does not happen excitation of larger portion of neurones occur causing interference with brain function seen as epileptic manifestations. In epilepsy this order is disrupted by some neurone discharging signals inappropriately. There may be a kind of brief electrical "storm" arising from neurones that are inherently unstable because of a genetic defect (as in the various types of inherited epilepsy), or from neurones made unstable by metabolic abnormalities such as low blood glucose, or alcohol. Alternatively, the abnormal discharge may come from a localized area of the brain (this is the situation in patients with epilepsy caused by localized structural changes such as head injury, or brain tumor or abnormal brain development). Who can have epilepsy? Practically, anyone can have excessive excitation of the brain cells leading to a seizure if there are precipitating conditions that reduce the threshold for electrical excitation such as fever, lack of sleep, alcohol, chemicals/drugs etc. In addition brain injury, strike, poisoning, metabolic disturbance in body’s chemical environment (such as heat or sun stroke) can cause seizures. When unprovoked and repetitive we call it epilepsy. A single seizure may occur commonly in many persons and we do not cal it epilepsy but it is necessary to investigate even a single seizure Epilepsy is seen most commonly in childhood below the age of 10 years (50% of all onset of seizures), then becomes less in adolescent (70 % of all seizures have begun by 20 yrs), rare in adulthood and again is seen to rise after the age of 50 years. How is epilepsy diagnosed? Only a neurologist can diagnose epilepsy. To make a diagnosis, the neurologist may order a neurological exam, blood tests, an electroencephalogram (EEG), and other tests like a CT or MRI scan. What types of doctors treat epilepsy? In many cases, a person’s initial diagnosis of epilepsy is made by their primary care provider, family doctor, or an emergency department physician. To get the type of specialized care a complex condition like epilepsy requires, you should see a specialist. A variety of specialists treat epilepsy. These include adult and pediatric epileptologists, physicians who specialize in the diagnosis and treatment of epilepsy, and adult and pediatric neurologists, physicians who specialize in diagnosing and treating disorders of the nervous system, including epilepsy. Epilepsy treatment is often provided in a specialized Epilepsy Center, where a treatment team of specialists in multiple fields offer a full range of treatment options. The ultimate goal of epilepsy treatment: seizure freedom with minimal side effects. The most common treatment is with antiepileptic drugs (AEDs). Your neurologist may prescribe one or many AEDs to find the best treatment option for you. Other treatment options include ketogenic diet, Vagal Nerve Stimulator (VNS), and surgery. Can epilepsy be fatal? Most people with epilepsy live a full life span. Nevertheless, the risk of premature death is increased for some, depending on several factors: • Sometimes epilepsy is a symptom of a more serious underlying condition; such as a stroke or a tumor that carries an increased risk of death. • People with some types of epilepsy who continue to have major seizures can experience injuries during a seizure from falling or hurting their head that may occasionally be life-threatening. • Very prolonged seizures or seizures in rapid succession, a condition called status epilepticus, can also be life-threatening. Status epilepticus can sometimes occur when seizure medication use is stopped suddenly. • Rarely, people with epilepsy can experience sudden death (SUDEP). These events are not well understood, although they are suspected sometimes to be due to heart rhythm disturbances during a seizure. Sudden death due to heart rhythm disturbances can also occur in the general population. The risk of sudden death is not increased for all types of epilepsy, but occurs more among people with major seizures, especially generalized tonic-clonic seizures that are not well controlled. Is epilepsy a disease? Epilepsy is not a disease. It is a symptom of a neurological disorder–a physical condition–which causes a malfunction of the electrical signals which control the operation of the brain. It is characterized by sudden, brief seizures whose nature and intensity varies from person to person. How does our nervous system work? Nerves throughout the body act like telephone lines, allowing the brain to communicate with the rest of the body via signals. This is our nervous system.From the moment we are born to the moment we die, this communications network controls our every thought, our every emotion, every step we take, every impression we get. Without it we could not plan, feel, move a muscle, nor distinguish between pleasure and pain. What is a seizure threshold? A seizure threshold is the level of stimulation at which your brain will have a seizure. A very high fever, for instance, can sufficiently excite anyone’s brain to produce a seizure. People with epilepsy have a lower–than–normal seizure threshold, meaning that only slightly increased excitement will cause them to have a seizure. Your seizure threshold is mostly genetically inherited, but other factors can affect this level. Young age and high fever are two factors that may lower one’s threshold, making a child more likely to have a seizure. Is epilepsy genetically inherited? Some forms of epilepsy have now been linked to specific genes. In addition, scientists believe that everyone inherits a seizure threshold which determines how susceptible you are to seizures. In fact, in most cases epilepsy develops without any family history of the condition. Basically, unless both parents have a strong family history of epilepsy, the chances that any of their children will inherit the tendency to have seizures are quite low. Is Epilepsy Contagious? Epilepsy is in no way contagious. No one can get the disorder by talking to, kissing, or touching somebody with Epilepsy. Epilepsy can only be transmitted through hereditary transfer. Epilepsy that runs in families suggests an underlying metabolic or genetic etiology, and this is the least common of all Epilepsy causes. Who has epilepsy? Epilepsy most often starts in childhood or else late in life, but anyone can develop epilepsy at any time. Epilepsy affects people of all ages, all nations, and all races. Next to migraine headaches, it is the most common neurological disorder. What is an EEG? The electroencephalograph or EEG directly measures electrical activity in the brain–brain waves–through the skin. In this harmless test, small sensors called electrodes are attached to the patient’s scalp. The electrical activity picked up by each sensor is graphed onto an EEG printout. Tests done on people with epilepsy commonly show uneven activity or large changes in the voltage of brain waves . Different patterns of activity from different spots on the scalp point to different kinds of epilepsy. How accurate is the EEG test? The EEG is not foolproof. It can only measure abnormal electrical activity that occurs during the test period. Sometimes, the brain of the person with epilepsy functions perfectly normally during the test. Or the electric patterns that the device is looking for happen too deep in the brain to be picked up by the scalp electrodes of the EEG. When the EEG doesn’t find anything unusual, it is common for the patient to get a continuous, 24–hour EEG monitoring in hospital. About 20% of people with epilepsy have normal EEGs, and a small percentage who don’t have epilepsy have abnormal ones! What other tests are sometimes used? Neuroimaging tests are often recommended, even in cases of long–standing epilepsy, when its cause is unknown. A. CAT or CT scan stands for computerized axial tomography, which uses computer processing and x–rays to make a computer image of the brain in three dimensions. B. The Magnetic Resonance Imager (MRI) can better define the structures of the brain in three dimensions. All electric currents make magnetic fields, and the MRI measures the strength of these fields. C. MRS (Magnetic Resonance Spectroscopy) provides information about the brain’s functioning and biochemistry which can be used in conjunction with structural MRI or CT images. D. Functional MRI (fMRI) can look at discrete areas of brain activation. E. PET (Positron emission tomography) scanning is a highly specialized, expensive and largely unavailable technique that detects cerebral blood flow and metabolism. F. SPECT scanning is much cheaper and technically simpler than PET scanning for determining cerebral blood flow. Does having epilepsy affect sex? Epilepsy can have effects on sex, and sex has effects on epilepsy. Many people with well controlled epilepsy have a comfortable, satisfying sex life. Having a supportive partner who provides emotional closeness, as well as sexual intimacy, is perhaps the greatest asset in helping people with epilepsy feel positive about themselves, which in turn improves seizure control. Anxiety and stress are known seizure “Triggers”. Sex can release stress, and help relax people, thereby reducing seizure frequency. People living with epilepsy frequently encounter sexual difficulties. These can be due to the epilepsy itself, the medications used to treat the illness, or due to reactions of partners. Can epilepsy lower my sexual desire? One of the commonest sexual effects of epilepsy is the decrease or loss of desire. This is variable depending on the type of epilepsy a person is dealing with. Erectile dysfunction is also a common problem for men with epilepsy. Desire changes appear similar for women. Sexual difficulties are found to be more significant in people whose epilepsy started before adolescence. Epilepsy can affect a person’s self–confidence, body image, and mood, both of which are important when relating with others. What effects do anti–seizure medications have on sex? Drugs used to treat epilepsy have common side–effects than can depress sexual responsiveness, desire, arousal (erection problems for men, and lubrication problems for women), as well as orgasmic difficulties. Finding the right balance of seizure control and side–effect reduction can be challenging. Stopping drugs due to frustrating side–effects might feel like a good solution in the short term, but doesn’t help reduce seizures and can be dangerous. Who can I talk to about sex and epilepsy? Discussing sexual side–effects can feel embarrassing, but most doctors should be able to deal with them appropriately. As more and more drugs become available for epilepsy, as well as other diseases, quality of life issues are becoming significant factors in medication choices. When should I tell someone new that I have epilepsy? Potential partners are often scared of the unknown, which leads them to avoid someone with epilepsy. At times people with epilepsy will hide their illness from someone new. It is appropriate to know someone a bit before divulging such private information. At times this leads to increased anxiety. Partners have fears regarding the myths and realities of what epilepsy actually is. Could having sex trigger a seizure? It is rare than sex will trigger a seizure, although it does occasionally happen. An intimate partner needs to be taught how to deal with seizures in general. What can I do if I’m encountering problems with sex? Talk to your partner, which is the best solution for it. By talking with doctors, family physicians, neurologists, and others about your sexual concerns, they can change medications or other treatments accordingly. For example, treatments exist for erectile dysfunction; lubricants can help for dry vaginas. Love can be the best medicine for a couple living with epilepsy. Is there a cure for epilepsy? There is currently no cure for epilepsy, but there are ways to keep seizures under control. Do anti–epileptic medications have side effects? All anti–epileptic drugs can have side effects. These vary from drug to drug and only affect some people. In general, however, it is common for people on anti–epileptic medication to experience drowsiness, fatigue, weight change, upset stomach and difficulties with concentration and memory. Is surgery used to treat epilepsy? Yes, brain surgery for epilepsy is performed, but only in a small percentage of cases, and only when all other treatments fail to adequately control seizures. The area of the brain with abnormally discharging neurons is surgically removed, if it is possible to identify this area and remove it safely. Or, in certain patients without a well–defined epilepsy focus, surgically disconnecting or isolating the abnormal area so that seizures no longer spread to the neighbouring normal brain can help. As with any operation, there are risks to epilepsy surgery. In patients with an identified seizure focus, the success rate of surgery is up to 80%. Is diet used to treat epilepsy? The Ketogenic Diet is used to treat a small number of children with intractable epilepsy who do not respond to standard therapies. It is an extreme, multi–year, high–fat diet that is challenging to administer and maintain. There is no way to predict whether it will be successful, but a significant percentage of children who are placed on the Ketogenic Diet achieve significant reduction in intensity and frequency of seizures. At present, the diet is not considered helpful for adults. What is vagus nerve stimulation therapy for epilepsy? The vagus nerve stimulator has been approved to treat to control seizures.The device is an small, pacemaker–like generator which is surgically implanted near the collarbone to deliver small bursts of electrical energy to the brain via the vagus nerve in the neck. So far, research has shown that vagus nerve stimulation may reduce seizures by at least 50% What alternative therapies are used for epilepsy? Unconventional or non–medical therapies that focus on the integration of the body, mind and spirit have not yet been well researched for epilepsy. Some people who have tried alternative therapies like relaxation, yoga, acupuncture, aromatherapy, biofeedback, nutrition and behaviour therapy have felt that these have helped their epilepsy and improved their quality of life. Is epilepsy related to other neurological problems? Epilepsy is not necessarily associated with other neurological problems or learning disabilities. Occasionally, the source of the seizures may be reflected in other neurological deficits. People with Epilepsy have the same range of intelligence as the general population. Is there a link between memory loss and Epilepsy? Some people with Epilepsy do experience a difficulty in recalling distant and recent events. Often, this is caused by the medications used to treat Epilepsy, or by regular seizure activity. Can seizures be triggered by flashing lights? “Photosensitive Epilepsy” is the name given to a form of the disorder where seizures are triggered by flickering or flashing lights. Though it occurs more frequently in girls aged 6–12, it can occur at any age and regardless of gender. When is surgery used to treat Epilepsy? Surgery is used only when medication fails and only in a small percentage of cases where the injured brain tissue causing the seizures is confined to one area of the brain and can be safely removed without damaging personality or functions. Are there any diseases that persons with Epilepsy more prone to? People with Epilepsy who are on medications may experience side effects that makes them more susceptible to other diseases and disorders. One common condition is Hyperplaxia, an over–growth of the gums caused by the drug Dilantin. Other common problems are liver dysfunction and depression. Can epilepsy cause emotional problems? People with Epilepsy may develop depression for both biological and social reasons. Some longstanding poorly controlled seizure disorders may be associated with chronic personality changes. Some patients may have emotional “Swings” or other thinking difficulties. Anger, fear, and depression are also common. However, with information and support, people with Epilepsy can understand the condition and develop positive coping strategies. Is there a special diet for people with Epilepsy? Good nutritional habits and a healthy life style may assist in the maintenance of optimum seizure control. Experiencing a drastic weight change may mean that either a chemical or metabolic imbalance is occurring, and you should consult your physician. What if my child has a seizure during his sleep? Children are usually awakened by seizures that occur while they sleep. Thus, a parent of a child with a known seizure disorder is usually aware when their child has seizures during the night. Only in those rare cases where a child vomits or experiences other problems during a seizure is there a need to worry. Does alcohol affect seizures? Alcohol can raise and then lower the seizure threshold, and thus increases the tendency to have a seizure. More important are interactions between alcohol and seizure medicines. Also, some drugs of abuse, especially cocaine and amphetamines, can cause seizures. Some prescription medications when taken in large doses can also bring on seizures. Can low blood sugar trigger seizures? Hypoglycemia (low blood sugar) can induce epileptic–type seizures. This condition can be caused by diet or by drugs such as insulin. This is not really Epilepsy since it is not recurrent seizures that are due to abnormal brain activity. Here the seizures are directly caused by the blood sugar levels. Can lack of sleep cause seizures? Excessive sleep deprivation can lower seizure thresholds and possibly result in a seizure. Lack of sleep is known to be an important precipitating factor in causing seizures. Other factors that can lower seizure thresholds are high fever, increased excitement, and changes in body chemistry. It is important for people with Epilepsy to learn what kinds of events can trigger seizures for them. How long do the seizures last? Depending on the type of seizure, they can last anywhere from a few seconds to several minutes. In rare cases, seizures can last many hours. For example, a tonic–clonic seizure typically lasts 1–7 minutes. Absence seizures may only last a few seconds, while complex partial seizures range from 30 seconds to 2–3 minutes. “Status Epilepticus” refers to prolonged seizures that can last for many hours, and this can be a serious medical condition. In most cases, however, seizures are fairly short and little first aid is required. Can seizures occur if a person does not have Epilepsy? Epilepsy is a chronic condition of recurrent unprovoked seizures. Isolated seizures and provoked seizures (e.g., drug or alcohol induced) are not Epilepsy even though the events are real seizures. There are many types of non–epileptic seizures. Non–epileptic seizures differ from epileptic seizures in that there is usually no evidence of abnormal electrical activity in the brain after the seizure, and they do not occur repeatedly. Some of the more common causes of non–epileptic seizures are: low blood sugar, fainting, heart disease, stroke, migraine headaches, kinked blood vessels, narcolepsy, withdrawal, and extreme stress or anxiety. What are pseudoseizures? Psuedoseizures (or psychogenic seizures) are quite common and can occur in people who have, or do not have, Epilepsy. The attacks are triggered by a conscious or unconscious desire for more care and attention. The seizures start with rapid breathing, triggered by mental stress, anxiety, or pain. As the person breaths rapidly, they build up carbon dioxide in their body and change their chemistry. This can cause symptoms very much like Epileptic seizures: prickling in the face, hands, and feet, stiffening, trembling, etc. The appropriate treatment for pseudoseizures is to calm the person and start them breathing at a normal rate. Treatment should also involve investigating the mental and emotional factors that led to the psuedoseizure. How do you distinguish epileptic seizures from pseudoseizures? Epileptic seizures and pseudoseizures are distinguishable both by their nature and symptoms, but the diagnosis can be difficult. Epileptic seizures are caused by a change in how the brain cells send electrical signals to each other, while pseudoseizures are triggered by a conscious or unconscious desire for more care and attention. Thus, measuring brain activity with an EEG and video telmetry is important for distinguishing epileptic and pseudoseizures. Also, pseudoseizures often lack the exhaustion, confusion, and nausea that is associated with epileptic seizures. What are “Status” seizures? Status epilepticus is the term used to describe recurrent seizures without recovery of consciousness between attacks. This is a medical emergency and can be life threatening, or cause brain damage. Immediate action to get the necessary medical care should be taken. What is an Aura? Before the onset of a seizure some people experience a sensation or warning called an “Aura”. The aura may occur far enough in advance to give the person time to avoid possible injury. The type of aura experienced varies from person to person. Some people feel a change in body temperature, others experience a feeling of tension or anxiety. In some cases, the epileptic aura will be apparent to the person as a musical sound, a strange taste, or even a particular curious odour. If the person is able to give the physician a good description of this aura, it may provide a clue to the part of the brain where the initial discharges originate. An aura could occur without being followed by a seizure, and in some cases can by itself be called a type of simple partial seizure.

Myths Surrounding Epilepsy

Myths Surrounding Epilepsy Sometimes having epilepsy is not as difficult as facing the problems associated with the stigma of epilepsy. Some common misconceptions about epilepsy include: • Only kids get epilepsy. Although epilepsy is more common in children and young adults, epilepsy happens quite often to adults. People with a history of stroke, heart disease, or Alzheimer’s disease are more prone to develop late onset epilepsy. • Epilepsy is contagious. Epilepsy cannot be "Caught" from being in contact with a person with epilepsy. • People with epilepsy cannot/should not be employed. People with epilepsy are employed and successful in all types of professions. Even today people with epilepsy often do not discuss their medical disorder with coworkers for fear of being ostracized. • People with epilepsy are physically limited in what they can do. In most cases epilepsy is not a barrier to physical achievement. An excellent case example is South African cricketer Jonty Rhodes who has overcome epilepsy to emerge as on of the fittest & finest players of the game in the world today. In some circumstances, when seizures are not being well controlled, persons with epilepsy may be advised to refrain from certain activities like driving an automobile. • You should force something into the mouth of someone having a seizure so that they do not swallow their tongue. It is impossible to swallow your tongue. However, a cloth may be placed between the teeth to prevent tongue biting. • Epilepsy is no longer a problem since there are medications to treat it. Unfortunately treatment does not prevent seizures for everyone. Researchers continue to look for new ways to combat this disorder. • You can’t die from epilepsy. Epilepsy can become a life threatening medical condition when seizures cannot be stopped (a condition termed status epileptics).

Epilepsy should not be a barrier to success

Epilepsy should not be a barrier to success • Epilepsy is perfectly compatible with a normal, happy, and full life. The person’s quality of life, however, may be affected by the frequency and severity of the seizures, the effects of medications, reactions of onlookers to seizures, and other disorders that are often associated with or caused by epilepsy. • Some types of epilepsy are harder to control than others. Living successfully with epilepsy requires a positive outlook, a supportive environment, and good medical care. Coping with the reaction of other people to the disorder can be the most difficult part of living with epilepsy. • Acquiring a positive outlook may be easier said than done, especially for those who have grown up with insecurity and fear. Instilling a strong sense of self–esteem in children is important. Many children with long–term, ongoingic illnesses—not only epilepsy but also disorders such as asthma or diabetes—have low self–esteem. This may be caused in part by the reactions of others and in part by parental concern that fosters dependence and insecurity. Children develop strong self–esteem and independence through praise for their accomplishments and emphasis on their potential abilities

Sudden Unexplained Death in Epilepsy (SUDEP)

Sudden Unexplained Death in Epilepsy (SUDEP) What about Sudden Unexplained Death in Epilepsy (SUDEP)? SUDEP is a rare condition in which people with epilepsy die without a clear cause. It accounts for less than 2% of deaths among people with epilepsy. The risk is about 1 in 3,000 per year for all people with epilepsy. It can be as high as 1 in 300 for those who have frequent, uncontrollable seizures and take high doses of seizure medicines. SUDEP is extremely rare in children. The person is often found dead in bed and doesn’t appear to have had a convulsive seizure. About a third of them do show evidence of a seizure close to the time of death. They are often found lying face down. No one is sure about the cause of death in SUDEP. Some researchers think that a seizure causes an irregular heart rhythm. More recent studies have suggested that the person may suffocate from impaired breathing, fluid in the lungs, and being face down on the bedding. Safety Precautions The best known way to lessen the risk of SUDEP is to control seizures. Therefore • Take all seizure medicines regularly, as prescribed. • Avoid heavy alcohol use and recreational drugs. • Get regular sleep and avoid fatigue.