【Common Diseases】Epilepsy

⚡ Epilepsy Guide (Hong Kong Edition)

Epilepsy is a chronic neurological disorder characterized by abnormal discharges of nerve cells (neurons) in the brain, leading to recurring seizures. According to the Hong Kong Hospital Authority and the World Health Organization (WHO), approximately 50 million people worldwide suffer from epilepsy, with an estimated 40,000–50,000 patients in Hong Kong.

I once spoke with a young epilepsy patient. He said his biggest fear wasn't the seizures themselves, but rather the misunderstanding and discrimination he faced. Some people believe epilepsy is contagious, and others are hesitant to help after witnessing an attack. In reality, with proper treatment, most epilepsy patients can manage their condition and lead normal lives.

1️⃣ Causes and types

Causes

Epilepsy has many causes, and sometimes no clear cause can be found (idiopathic). Common causes include:

  • Genetic factors (some epilepsy is related to genetic abnormalities)
  • Brain trauma (traffic accidents, falls and impacts)
  • Cerebrovascular disease (post-stroke epilepsy)
  • brain tumors
  • Brain infections (meningitis, encephalitis)
  • Neonatal hypoxia or complications of prematurity

type

  • Focal seizures
    • Abnormal discharges are limited to a certain area of the brain and may occur consciously or unconsciously
  • Generalized seizures
    • Abnormal electrical discharges affecting the entire brain, including absence seizures, petit mal seizures, and grand mal seizures
  • Hybrid
    • Focal seizures spread to generalized seizures

2️⃣ Main symptoms

Symptoms of epileptic seizures vary depending on the type, such as:

  • Generalized tonic-clonic seizures (also known as grand mal seizures)
    • Sudden loss of consciousness, body stiffness → convulsions → fatigue during recovery
  • absence seizures
    • Briefly "freeze", stop moving, and recover after a few seconds
  • focal seizures
    • Twitching of a part of the body, abnormal sensations, hallucinations, and phantom tastes and sounds
  • Confusion, headache, and muscle aches may follow an attack

3️⃣ Hong Kong First Aid (What witnesses should and should not do)

Should do✅

  • Protect patients from collisions and remove surrounding dangerous objects
  • Place soft padding under the patient's head
  • Record the duration of the attack (if > 5 minutes, call an ambulance immediately)
  • After an attack, place the patient in the recovery position (side-lying) to maintain an open airway

Don't do ❌

  • Do not forcefully hold the patient's limbs
  • Do not put objects in your mouth (to prevent aspiration or tooth injury)
  • Do not move the patient (unless the situation is dangerous)

4️⃣ Medical treatment methods (commonly used in Hong Kong)

💊 Medication (anti-epileptic drugs (AEDs))

  • Commonly used first-line drugs :
    • Carbamazepine
    • Valproate (sodium valproate)
    • Lamotrigine
    • Levetiracetam
  • in principle :
    • Doctors will choose medication based on epilepsy type, age, gender, and side effects
    • Most patients can control seizures with a single drug
    • Take medication regularly and avoid stopping medication on your own

🔪 Surgical treatment

  • Suitable for focal epilepsy that cannot be controlled by drugs and has a clear source of seizures
  • Common surgeries : temporal lobectomy, lesion resection
  • Some large hospitals in Hong Kong (such as Queen Mary Hospital) have neurosurgery teams to handle

⚡ Neuromodulation Therapy

  • Vagus Nerve Stimulation (VNS)
    • A device is implanted in the chest to stimulate the vagus nerve with electrical current, reducing the frequency of seizures.
  • Responsive Neurostimulation (RNS) (a new international technology, less common in Hong Kong)

🍽 Ketogenic Diet

  • A high-fat, low-carbohydrate diet alters brain energy metabolism
  • Particularly effective for refractory epilepsy in children
  • Needs monitoring by a nutritionist to avoid side effects

5️⃣ Hong Kong medical resources and follow-up

  • Hospital Authority Neurology Specialist Clinic (Public Hospital Referral)
  • Private neurology clinics (shorter waiting times but higher fees)
  • Epilepsy Foundation Hong Kong
    • Providing patient support and educational resources
  • Community Rehabilitation Centre (with occupational therapy and psychological counselling)

6️⃣ Daily Management and Editor’s Tips

  • Take medication regularly : Do not stop or reduce the dosage on your own
  • Adequate sleep : Lack of sleep can easily trigger attacks
  • Avoid triggers : excessive drinking, flashing lights, excessive stress
  • Safety measures : Avoid swimming alone, working at heights, and driving (subject to doctor's evaluation)
  • Healthy living : balanced diet and moderate exercise
  • Medical records : Use a diary or app to record the attack, so that the doctor can adjust the treatment

7️⃣ Common myths among Hong Kong patients

  • Is epilepsy contagious?
    Epilepsy is a neurological disease and is not contagious at all.
  • "Do I need to put a spoon in my mouth during an attack?" ❌
    This practice is dangerous and may cause injury to the patient's teeth or respiratory tract.
  • "Can I stop taking medication after a few years without experiencing an attack?" ❌
    Whether to stop the medication should be evaluated by a doctor, otherwise the risk of recurrence is high.

8️⃣ Editor’s Summary

Epilepsy does not necessarily mean incapacity. With proper treatment, most patients can return to work, go to school, get married, and have children. Hong Kong has a comprehensive range of medications, surgical options, and support organizations. Early diagnosis, ongoing follow-up, and adherence to medical advice are key. We recommend that both patients and their families learn the correct first aid knowledge to reduce panic and misunderstandings, allowing those with epilepsy to live a peaceful life.

Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.

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