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Second Monday of February is recognized as International
Epilepsy Day, which was established with the goal of promoting the right
laws to ensure that the human rights of people suffering from epilepsy are
protected and to empower such people to have the best quality of life possible.
The World Health Organization (WHO) estimates that 50 million Trusted
Source people worldwide have epilepsy, making it one of the most widespread
neurological conditions in the world.
In the United States, 3.4 million Trusted Source people or 1.2
percent of the population live with the condition whereas in India almost 10
million people are diagnosed with Epilepsy. In which only 65% of epilepsy
patients can manage their symptoms with medication in the world. Even
though it is treatable, about 40% of individuals from wealthier countries still
do not receive the right treatment.
Currently, surgically removing the lesion in the brain
responsible for the condition is the only radical cure for epilepsy. Still,
many patients have to take medication for the rest of their life to deal with
their seizures. In 75 per cent of cases, patients have a very good response to
the medications. And in the end, surgery is a reliable option.
“Almost two third of epilepsy patients can be cured with simple
medications. For the remainder of the one-third clinical localized history has
been understood along with MRI and video ECG investigations followed by
interventions." explained, former AIIMS Bhopal head of department of
neurology and currently senior neurologist at Neurocity Centre, Dr Nirendra
Rai.
How Epilepsy can be identified?
Epilepsy is a neurological condition involving the brain that
makes people more susceptible to having recurrent seizures. It is one of the
most common disorders of the nervous system and affects people of all ages,
races, and ethnic backgrounds. Epilepsy is characterized by a range
of symptoms from mild episodes of "getting stuck" to severe ones that
include shaking of the whole body.
Anything that interrupts the normal connections between nerve
cells in the brain can cause a seizure. This includes a high fever, low blood
sugar, high blood sugar, alcohol or drug withdrawal, or a brain concussion.
Under these circumstances, anyone can have one or more seizures. However, when
a person has two or more seizures, he or she is considered to have epilepsy.
There are many possible causes of epilepsy, including an imbalance of
nerve-signaling chemicals called neurotransmitters, tumors, strokes, and brain
damage from illness or injury, or some combination of these.
Though in most cases the cause for epilepsy may not be
identified. Still, one of the major known causes of epilepsy is an injury to
the brain. People at risk for epilepsy include head trauma, trauma at birth,
developmental malformation of the brain, brain tumour, stroke, multiple family
members having epilepsy, meningitis or encephalitis infection.
At what age can epilepsy develop?
Dr. Atma Ram Bansal, Associate Director – Epilepsy Programme,
Institute of Neurosciences at Medanta Hospital said "between 5 to 15 years
of age and then post 70 to 80 years, an individual is most likely to develop
epilepsy. This neuro condition is of many types – some do not need any
treatment at all, in this case, patients get fits only while sleeping with mild
jerks, and it may not be treated with medications.
Normally, 60-70% of epilepsy cases are treatable with the help
of medicines. The patient must take medicine for 2-3 years depending upon the
type of epilepsy. In some patients, we need to give medicines for a lifetime.
And in some cases, when the patient doesn’t respond to medications, we may have
to perform surgery.""
Is there a cure for Epilepsy?
At the moment there is no definite cure for most types of
epilepsy, however treatment options which range from medication to surgery are
effective at managing the condition and in most cases can stop the seizures
from reoccurring. With the right treatment, most people, about 75% people with
epilepsy can lead a normal seizure-free life and 20-30% of persons with
epilepsy PWE have spontaneous remission of seizures without treatment. Only
about 30% of epilepsy patients experience drug-resistant epilepsy where the
seizures continue to occur in spite of appropriate medications.
What are the signs and symptoms of Epilepsy?
Recurrent seizures are the major symptom of epilepsy. However,
depending on the kind of seizure, the symptoms may be different for each
person. In case you observe any of the following symptoms in a person, particularly
if they continue to occur, it is a must to see a doctor. These are as follows:
-Sudden twitching (uncontrollable jerking motions of the arms
and legs).
-Loss of consciousness .
-Tingling sensation (feeling of pricking pins or needles) in
arms or legs.
-Stiffness in muscles of arms or legs or face-Convulsions which
are not accompanied by a change in temperature or development of fever.
-Blackout episodes, sudden unexplainable gaps in memory or
confusion.
-Frequent episodes of fainting which come with involuntary
urination or bowel expulsion.
-Patient is unable to comprehend what is happening and does not
respond to questions or instructions for some time.
-Patient's body becomes stiff without any cause.
-Psychological symptoms such as fear or anxiety - the patient
may suffer a panic or anger attack.
-Unexplainable change in sense perceptions for example a
different perception in smell, sound or touch.
-Arms and legs moving involuntarily, in jerking movements.
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How Epilepsy can be managed?
-If you witness an attack, take careful notes because an
accurate description prevents incorrect diagnosis. Now with the availability of
smart phones one could video the event which would be a very important tool for
diagnosis and treatment.
-Early treatment is critical
-The prescribed medications must be taken on a regular basis. Do
not skip any doses
-The duration of treatment varies with each individual
-There are only a few restrictions for someone suffering from
epilepsy. Make sure you get enough sleep. Patients can study, work, and live
their lives
-Epileptic women can marry and have children
-Folate supplementation should be encouraged in all women of
childbearing age who are taking any seizure medications.
-Treat epilepsy the same way you would treat other diseases like
diabetes or hypertension. Do not overprotect or isolate.
-International Epilepsy Day was established with the goal of
promoting the right laws to ensure that the human rights of people suffering
from epilepsy are protected and to empower such people to have the best quality
of life possible.
What is the treatment gap for epilepsy in India?
Prof Gagandeep Singh, Professor, Dayanand Medical College said,
“Epilepsy is a common neurological disorder in India. Nation has a
large magnitude of treatment gap, ranging from about 22% in the urban middle
class population and more so in villages, about 90%.This is because of National
health systems suffer from a huge financial burden because of this lack of
treatment besides that inadequate access to or awareness of anti-epilepsy
medications, low income, stigma and cultural beliefs associated with epilepsy,
insufficient health infrastructure and a shortage of professionals trained in
epileptology, inequitable distributions of available resources in rural areas
and high cost of treatment."
"While the prevalence of epilepsy has increased over the
past three decades, it is gratifying to note that India has made some gains in
reducing premature deaths and morbidity of people with epilepsy over this
period by reducing treatment gaps. There is however a need to scale up treatment
coverage of epilepsy in government schemes such as the Rashtriya Bal Swasthya
Karyakram and Ayushman Bharat." he concludes.
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