生活指導

Lifestyle Guidance and Counselling for Patients with Epilepsy

Point

・患者の自立した生活と良好な社会参加のために，発作のリスクを減ずるための生活指導は重要である．

・てんかんはlife-long diseaseであり，患者や家族の生活に与える影響は長期に及ぶため，患者とその家族が診療に積極的に参加する雰囲気を醸成しなければならない．そのためには，主治医だけでなくメディカルスタッフも加えたチームによる対応が必要である．

　Apart from epilepsy specialists, neurosurgeons should also play an important role for epilepsy treatment in the Japanese healthcare structure. This review focuses on lifestyle guidance and counselling methods for general neurosurgeons to reduce risks of seizures in epilepsy patients, and to maximize patient independence. Reduction of seizure precipitants such as sleep deprivation, emotional stress, fatigue, and alcohol is key to epilepsy practice with appropriate anti-seizure medication. The modular service package epilepsy（MOSES）program may prove useful for patients by increasing awareness of their own seizure precipitants and empower them to manage their individual risks.

　This article also addresses the topics of practical guidance for counselling in（1）school life;（2）sports and physical activities;（3）pregnancy; and（4）eating habits. Multidimensional collaborations should be recommended to reduce the burden of hectic neurosurgeons.