Dr Kola Tytler MBBS CertHE MBA MSt MRCGPClinical Lead • iatroX
To effectively counsel patients with temporal lobe epilepsy regarding lifestyle modifications to reduce seizure frequency, focus on key areas that directly impact seizure control and overall well-being. It is crucial to develop an individualised treatment strategy that considers personal circumstances, including alcohol use and travel NICE NG217.
- Medication Adherence: Strongly support patients to take their antiseizure medications as prescribed to reduce seizures NICE NG217. Explain that uncontrolled seizures, particularly generalised tonic-clonic seizures or focal to bilateral tonic-clonic seizures, increase the risk of epilepsy-related death NICE NG217. Discuss adherence strategies and coping mechanisms for side effects NICE NG217.
- Avoidance of Alcohol and Drug Misuse: Counsel patients that alcohol and drug misuse are potentially modifiable risk factors for sudden unexpected death in epilepsy (SUDEP) and can impact seizure control NICE NG217.
- Safety and Supervision: Discuss the possibility of introducing or increasing night-time supervision, for example, using a night monitor for individuals with seizures during sleep who are at higher risk of epilepsy-related death NICE NG217. Provide information on minimising risks, including taking medication as prescribed NICE NG217.
- Driving Regulations: Inform patients about Driver and Vehicle Licensing Agency (DVLA) regulations related to epilepsy NICE NG217.
- Mental Health and Well-being: Be aware that people with epilepsy have a higher prevalence of mental health difficulties, such as depression and anxiety NICE NG217. Addressing emotional health and psychological well-being can indirectly support overall seizure management NICE NG217.
- Reproductive Health: Provide support and information on contraception and pregnancy to enable informed decision-making, including potential interactions with antiseizure medications and pre-conception planning NICE NG217.
- Emergency Planning: Agree on an individualised emergency management plan with the person if they experience repeated, cluster, or prolonged seizures and there is concern about recurrence NICE NG217.