[Psychosocial aspects of childhood epilepsy].
Epilepsy is without a doubt one of the most ancient and enigmatic conditions in the history of medicine, as it was already described in remote times. From the ancestral obscure understanding of epilepsy to the present, there have been important scientific advances in the knowledge of its diagnosis and treatment. The management of a child with epilepsy requires following a protocol that includes a detailed clinical and laboratory evaluation. All chronic diseases, and also epilepsy, are felt as a double aggression: 1) Internal, related to the changes that the disease causes, and 2) external, related to the tests, medications, excessive protection, and all the rules and prohibitions that are applied. The doctor (pediatrician, pediatric neurologist or epileptologist), when initiating a relationship with the child with epilepsy, is going to propose "a new code", often hard to accept. He is going to intervene far away from the crisis, or soon after it happened, in an environment characterized by significant anguish for the family. There is no question that the disease is difficult for the child, as it is also for the parents, who become responsible for a different type of care, are preoccupied daily about their son taking the medication regularly, and suffer awaiting for another crisis to happen. Epilepsy, more than other conditions, creates a high level of restlessness because of the spectacular, dramatic nature of its presentation and for the ancestral myths still attributed to it. For all these reasons, the diagnosis of epilepsy is frequently accompanied by three relevant reactions in the family: anxiety, guilt and aggressiveness. The intervention of the doctor in the treatment of childhood epilepsy must be "global". With mystic devotion, the doctor must embrace the true Hippocratic concept of patient care.
Sell Salazar
Fernando
F
Servicio de Neuropediatría, Hospital Cima, San José, Costa Rica. sellma@racsa.co.cr
D002648:Child; D002908:Chronic Disease; D004827:Epilepsy / Q000523:psychology* / Q000628:therapy; D005190:Family / Q000523:psychology; D006801:Humans; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations