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  • decodeMR Team

Insights into Epilepsy Care: Q & A session with an expert




Episode summary


Welcome to the very first episode of decodeMR’s podcast journey!   


In this inaugural episode, we discuss one of the most prevalent neurological disorders, epilepsy- featuring an exclusive interview with Dr. N V Ramani, a distinguished neurologist at Raffles Neuroscience Centre Singapore. With epilepsy accounting for over 0.5% of the global burden of disease, as reported by the World Health Organization (WHO), Dr. Ramani provides valuable insights into its prevalence within his practice. He shares insights into the epidemiological patterns and discusses notable changes observed over the past five years. 


Dr. Ramani highlighted various advancements in epilepsy diagnosis, ranging from improved imaging techniques to portable epilepsy monitoring units. He also points out the importance of interdisciplinary collaboration with specialists from neurology, sleep medicine, and psychiatry to navigate the complexities of diagnosing epilepsy. 


As the conversation progresses, Dr. Ramani shares valuable insights into the promising therapies and the evolving landscape of epilepsy management. He provides crucial information on recognizable warning signs and first aid measures for individuals and caregivers dealing with epilepsy emergencies. 


Episode notes


  1. Prevalence and Changes Over Time (1:05) 


  • On an average, Dr. Ramani sees one epileptic patient every two weeks and a new case every two months, including both adults and older children.

  • Over the past five years, a noticeable increase in epilepsy cases among older individuals has been observed, attributed to factors like aging, stroke, and head injuries. 


2. Technological Advances in Diagnosis (3:01) 


  • CT scans, MRIs with varying Tesla field strengths, and portable epilepsy monitoring units have significantly enhanced the diagnostic process. 

  • Functional MRI provides insights into metabolic areas in the brain, aiding in epilepsy diagnosis and localization. 

3. Recognizable Warning Signs and First Aid (4:08) 


  • Dr. Ramani emphasizes the importance of recognizing triggers, auras, and implementing first aid during a seizure, including lying the patient down and ensuring a safe environment. 

  • Public awareness and education are crucial for effective response to epilepsy emergencies. 

4. Ongoing Research in Epilepsy Treatment (6:15)


  • Ongoing research focuses on better seizure corroboration through advanced imaging and EEG monitoring. 

  • Anticipated breakthroughs include more focused medications tailored to specific epilepsy subtypes, with improved efficacy and fewer side effects.


5. Guidelines and Patient-Centric Care (7:05) 


  • While guidelines provide general guidance, Dr. Ramani stresses the importance of adapting care plans to individual patient needs, considering factors like preferences, compliance, and cost. 

6. Long-Term Care and Follow-Up (8:00) 


  • Achieving seizure control is the primary goal, and long-term management involves collaboration between patients, doctors, and families. 

  • Education, prevention strategies, and gradual therapy discontinuation are key components of long-term care plans. 


Take home messages 


  1. Excessive alcohol consumption and lack of sleep are significant triggers for epilepsy, emphasizing the importance of lifestyle factors in managing the condition. 

  2. Collaborating with specialists from neurology, sleep medicine, and psychiatry are crucial to navigate the complexities of diagnosing epilepsy and related disorders. 

  3. Effective preparation for seizure emergencies involves raising awareness about epilepsy and its triggers, promoting medication compliance and ensuring individuals are educated on providing appropriate first aid. 

  4. Patients who are compliant with medication and undergo regular monitoring have the potential to lead a good quality of life, and in some cases, may even be able to discontinue treatment under careful medical supervision. 


About Dr. N V Ramani 


Dr. N V Ramani is a distinguished neurologist affiliated with Raffles Neuroscience Centre. He is actively engaged in postgraduate and undergraduate medical training and also takes on the role of educating allied healthcare workers and the general public. His commitment extends to membership in various local and international committees, and he serves as an editorial board member and reviewer for several peer-reviewed journals specializing in medicine, neurology, and stroke. Dr. Ramani's expertise encompasses a range of neurological areas, with specific interests in epilepsy, stroke, neurosonology, dementia, epidemiology, and clinical trials. 


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