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SCMP Reporter

IMAGINE waking up each day and not knowing if, without warning, your life will be disrupted. It could happen in a business meeting, while you're pouring your coffee or walking down the street.

  This is what life is like for someone with epilepsy. While treatment helps 60 per cent, the remaining 40 per cent may only respond partially, or not at all, to therapy.

   Epileptics are often shunned, and have been neglected by the medical profession, according to a Danish consultant neurologist Professor Mogens Dam who visited Hongkong recently.

 However, this trend could change with the development of new drugs for the treatment of epilepsy.

   These drugs will help epileptics who are resistant to existing medication, Professor Dam said. But, researchers warn, they may not work for everybody.

    The recent advances in anti-epileptic medication centre around modifying neuro-transmitters in the brain. A major advantage over current treatment is fewer adverse side-effects.

  Epileptic seizures can take various forms. A person might be talking intelligently, suddenly look vacant, and then come back with: ''I'm sorry, what did you say?''   In a child this lapse of consciousness might be mistaken as inattentiveness in the classroom and means that the child misses what is going on.

  In more severe seizures, an epileptic might experience muscle spasms for hours or could stiffen and crash to the ground, resulting in physical injury.

  Two per cent of the population will have an epileptic seizure at some time in their lives.

  It is estimated that 20 to 25 per cent of epileptics are never diagnosed or treated, while 15 per cent of those said to have the condition do not actually have it.

  There has been a tendency for epileptics to hide themselves away because of the social stigma attached to the condition. This affects schooling, employment and social relationships; poor self image and daily living difficulties also take their toll.

  Developed countries have patient associations which act as self-support groups and help to disseminate information. These do not attract as much support as they should, according to Professor Dam.

  In Hongkong no association has yet been formed, although local paediatrician Dr Virginia Wong is determined to change this.

  She is currently looking for funding to set up an epilepsy centre and has already initiated a parent support group.

  ''About 10 per cent of children suffer from mild to moderate disabilities related to neuro-development disorders.

  ''Among neurological disorders in children, epilepsy ranks first both as an isolated problem and associated with other handicaps such as mental retardation and cerebral palsy,'' said Dr Wong, a senior lecturer in the department of paediatrics at the University of Hongkong.

  There is a lack of pre-schools and schools catering for epileptics in Hongkong. Many children are treated by their general practitioner and only the more difficult cases are referred to specialists.

  ''Unfortunately, there are no resources for co-ordination of all-round rehabilitation of these epileptic children, adolescents and adults in Hongkong. Similarly, no such centre is available in China or Southeast Asia. A National Centre for epilepsy was proposed in Singapore in 1990, but the main emphasis was on the medical side.''   Dr Wong proposes that the Hongkong centre would provide assessment, treatment, care, education and work-training so that epileptics can return to a home environment.

  ''Normal'' education would be provided for children with normal or below average intelligence who have been rejected by the ordinary education system due to associated behavioural, psychological or psychiatric problems.

  Dr Wong says the project would be expensive to setup and run, but would be economic given the cost of epilepsy in terms of health care and underemployment.

  Both Professor Dam and Dr Wong said the knowledge of most GPs needed to be updated. Most have little experience with epilepsy.

  People with epilepsy and their relatives needed to be educated about the condition so they could demand more from their doctors.



Opening up lonely world of epileptics