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Epilepsy causes and symptoms

Q: Why the mouth of patient sometimes bubbled during epilepsy and where the bubbles come from?

A: During a generalised seizure attack, majority of the patient will have salivation i.e. saliva will come out of the mouth. The causes if the salivation is not well known but presume as an autonomic respond to seizures. The bubbling is due to the over breathing during a seizure. The bubbling will stop once the over breathing stops. If there is tongue biting, there is blood in the saliva.

Q: When epilepsy occurs, how do you categorize Major Attack, Intermediate Attack, and Minor Attack?

A: There are many types of seizures that we are aware now. In general, seizure can be divided into focal seizure and generalised seizure. Generalised seizure is associated with loss of consciousness and simple seizure usually associated with preserved consciousness. Intermediate seizure is usually due to temporal lobe epilepsy. They usually have impaired conscious level and no proper communication between the patient and the surrounding people. Please visit the website for further detail

Q: One of my relative has been taking medicine since last 15years.As per information he suffered from this disease due to a injury. May I know that it will completely cure?

A: Epilepsy can occur because of brain injury from a motor vehicle accident. If the head injury is significant i.e. evidence of brain scarring (encephalomalacia) then the seizures are recurrent. The medication i.e. anti-epileptic drugs can only help to control the occurrence of seizures.

Q: A friend of mine just had a seizure attack a month ago and fell unto the ground. Until today, this friend of mind still suffering from a severe headache. Is there anything I can help? Face is pale. And I was told that none of the anti-epileptic meds suits....

A: A person can suffer from headache after an episode of seizure that can last several hours. However, if the headache persists for several days to a month, one has to look for other causes that includes post-traumatic headache. Other possible causes of headache include Intracerebral Haemorrhage.






Treatments and Medications

Q: My father is an epilepsy patient for more than 40 years. For the past few years, we have been noticing some changes in his personality. Is this called personality disorder? What can we do?

A: In Malaysia, there is health system. The more popular one is under the government or University Hospitals. The medications are given at a subsidised price. The second option is the private hospitals. I need to enquire about the price for each medication you have listed. Based on my previous experience the monthly expenses are about RM 200-300.

Q: My daughter has been diagnosed as having a variant of Sturge Weber syndrome. Currently she is on Epilim, Tegretol Crand started Keppra 500mg replacing Topamax. The seizures are reduced to 2 to 3 times a month compared to having 5-6seizures before on Keppra. The problem with Keppra is she feels scared most of the time. Why is it so? Another plus point is that she is more energetic and have a better appetite than before hence she is putting on weight - not very excessive about 53kg unlike when she was Onlamotrigene - 70kg.

A: Definitely she has "uncontrolled" epilepsy. Having to take 3 anti-epileptic drugs is quite a lot. Keppra is the best available medication now. If she can tolerate the side effect, please continue taking it.

Q: My mum, aged 78 had a seizure today that last a few minutes. The last time she had was 2 months again (recurrence after 2 years lapse). This time was not as severe as the previous times and she was able to respond immediately after the seizure. She refused to see doctor or be admitted to hospital. We discovered she took frizzy old drink before the attack i.e. immediately after the drink. Could it be her sugar level suddenly shot that trigger the seizure? She is on medication - Epilim and has never missed a single dose every day on top of other medicines for her hypertension, cholesterol. Will she has recurrence if she drinks frizzy coke again? Although she has been warned not to touch cold stuff like that. How to see difference between stroke and seizure?

A: Seizure and epilepsy do occur in all age group. The most common cost of epilepsy in the elderly is stroke. I do not think the frizzy coke do trigger seizures. The dose of Epilim needs to be increase if the seizure does recur. Seizure can occur after a stroke. For a new case of stroke, it can be differentiated from a seizure. Seizure only happens for a short duration while stroke has more prolonged signs.

Q: I noted that the type of epilepsy that not always attacked me sometimes will be complex partial seizures and sometimes is absence seizures. This 2 type of seizures already happen on me about 3 years after my high attack full recover, now I’m taking Epelim and Lamictal medicine. So I want to know that this 2 type of seizures will full recover by taking this 2 type of medicine. And after recover this 2 type of medicine will give me any side effect?

A: Based on your information, it is very unusual for complex partial seizure (CPS) to happen with absence seizures (AS). CPS is a partial or focal seizure and AS is s a generalised seizure. I suspect you are getting CPS. The most common type of CPS is from temporal lobe epilepsy (TLE). TLE is quite difficult to treat at times and may be need more than one medication. Please refer to any website on epilepsy for the side effect of the medications. In general, these medications are well tolerated. The most common side effect of Epilim is weight and drug allergy for Lamictal.

Q: About 1 year more my small problem of epilepsy didn’t happen on me but suddenly it happen again in last 3 month. So, doctor already add me more dose of medicine but until now the problem still happen in every month. When the problem comes, I feel so scared. Did the simple seizures also wont recover until I die?

A: If you have the feeling of fear or scared during the attacks, most likely you are suffering from Temporal Lobe Epilepsy (TLE). TLE is well known to be difficult to control or even cure. However, with good choice of medications, we can perhaps reduce or even stop the seizure from coming. Please refer this to your own doctor. If you need further evaluation, perhaps seeing a Neurologist will be helpful.


Q: I haven’t got the right medication although already had the illness for 20 years already. I took Epilim before and now taking Tegretol. But still get the fits almost more frequently. Attacks usually come while sleeping at night. Are there any better AEDs for my type of seizure?

A: We have more new medication for epilepsy for the past 10 years. This includes Lamictal, Topamax, Neurontin and Keppra. Usually in difficult cases we need at least to medications i.e. using the standard one e.g. Epilim, Tegretol or Dilantin in combination with the newer ones listed.

Coping with Epilepsy

Q: May I know if an epileptic person will get employment for a job in companies. Will they be rejected once they indicated they are epileptic or will they get fired once they get a seizure attack unknowingly?

A: Unfortunately, a person with epilepsy is still being discriminated. Any new employment in the private sector usually will not accept people having epilepsy to join their organisation. Therefore, if the seizures are well control with medication, it is advisable not to reveal your illness. As for the second question, it depends from company to company. Big companies will usually retain their staff that has epilepsy. If any problem arises during employment, please consult the staff organisation or union for proper handling of your case.

Q: My son having this symptoms and still treatment in HKL and I am worry about his future.

A: You need to ask your doctor who is treating your son the type of epilepsy he is suffering from. Epilepsy has many types and most of the types have a good prognosis.

Q: I would like to know is there any reference or resources that I can get in order for me to understand more on the epilepsy patient in getting a health insurance from insurance company? My spouse and me have been trying to get a health cover for my wife, but then 2 companies have rejected us. Is there any guidelines or information that we can use as a reference for this?

A: Each insurance company has their own policy with regards to the diseases covered as well as premium. Unfortunately, other organisation including the epilepsy society cannot interfere with their policy. Perhaps you can get a letter from your wife's doctor informing her condition