Epilepsy (Singapore): Case Studies and Medications

Choong Chew Thye, Michael Chee Wei Liang, Diana Koh Hwee Hoon, Sherman Goh Keng Hwee (Editors).(2013). Seizures in the city: a collection of writings on epilepsy. Singapore. Candid Creation Publishing for Epilepsy Care Group.

Perhaps the old me would have gone through the book like a train. But these are not just writings. These are peoples’ lives…

This post is split into two parts, it opens with treatment then it follows with a few life experiences.

Anticonvulsants

Professor Michael Chee Wei Liang at the time of writing was a neuroscientist (with the Duke-NUS Graduate Medical School) and was a former clinician (active medical doctor). He wrote the chapter on the development of epilepsy care. I shall focus on the medications specifically coined – anticonvulsants.

In Professor Chee’s analysis, an approximate 50% of epilepsy sufferers have well controlled epilepsy via medication. (With further research elsewhere or reading through the book, some undergo surgery as remedy.) To side track, some ‘psychogenic seizures’ may appear to be epilepsy but they are not so. (I do recall I hearing about this back when I attended a talk during my healthcare sector days.) Thus, this presents greater challenges for correct and accurate diagnosis.

[Do note that the year now is 2017. Things may have changed. Further, it is critical to seek qualified medical advice on the issue. If needed, seek a second or even a third opinion. The medication list below is not exhaustive. I have selectively highlighted some side effects and put them in italics. The trade/brand name of the drugs on the market most likely differ from the names provided.]

There are two groups categorised by age. The prior/elder generation of drugs include:

  • Phenytoin
  • Sodium Valproate
  • Phenobarbitone (risks of inducing sleepiness/has sedative effects)

The more recent/younger group comprise:

  • Lamotrigine (rashes)
  • Topiramate (cognitive decline in areas like word finding; falling weight)
  • Gabapentin (limited side effects but not very useful)

Resident Accounts and related issues

Tony Loh Kia Hiang – seizures hit him at age 35 (complicated by sleep apnea if my memory serves me right).

Fan Yew Meng – left store with unpaid merchandise: ‘did not have clarity of mind’; charged with theft and acquitted.

Tan Pek Ann – seizures from age 7 post severe fever; was able to get married; supportive work environment with colleagues who know ‘what simple steps should be taken when I have a seizure.’

Discrimination faced by some at work and in leisure because of their epileptic condition.

Epilepsy may intertwine with depression given the (potential) job losses; sense of helplessness; and relationship rejection. The flow on risk is suicide. Hence, carers and families or friends need to take precautions as required.

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