Dr Atma Ram Bansal
Epilepsy may not be as common as diabetes or hypertension but it is also not a rare disease. It affects more than 5/1000 people in the world. In India alone there might be more than 5million people suffering from epilepsy. Epilepsy can occur in any age group but is more common in children and young adults, particularly in villages.
Epilepsy is a disorder of repeated fits due to sudden excessive electrical activity in the brain that may produce jerks in the limbs, unresponsiveness and spells of unawareness. It occurs if the normal electrical activity increases and spreads to surrounding areas. When the electrical activity involves a small area of the brain, it produces minor seizure (partial). And if large area is involved a major seizure results (generalized).
Lack of knowledge about epilepsy leads to social stigma, loss of quality of life and social alienation. Children with epilepsy often deprived from schooling. Grown up youths and adult finds the going tough in matters of job and marriage. Though with a good control of seizures a person can achieve what anybody without epilepsy can but lack of awareness and self confidence is a big hindrance.
Majority of cases with epilepsy don’t get proper diagnosis and treatment especially in villages. This ‘treatment gap’ is responsible for inadequate control of seizures.
There are special issues with females having epilepsy. Though there are very high chances of healthy married life and kids, the getting married is a big issue for the family. It is always do to consult a doctor before her marriage and also when she is planning to become a mother. If there is proper treatment and if medicines are taken regularly as prescribed, delivery will be normal in majority of cases. Doctors can change the medicines during pregnancy so that the child is not affected in any manner. There are certain people who are prone for epilepsy that includes; Babies with slow development, infection and delayed cry after birth or with abnormal brain structures and brain infections, serious head trauma or use of cocaine and the like, stroke and brain tumors.
But it can occur without any obvious reasons also. With the advancement in treatment epilepsy can be treated easily in almost 80 per cent of the patients. With the discovery of new medicines for epilepsy it is very safe to use them even for long term use. Most of the patients require a single medicine though some may require more than one medicine also. The type of medicine a patient should take depends on the type of epilepsy afflicting the person. Duration of treatment is for a period of three to five years. Some may get relief within six months to one year. In what are known as juvenile myoclonic epilepsy cases, the treatment may last for a very long period.
There are about 20 to 30 per cent people with a history of poorly controlled epilepsy despite multiple medications. These cases can be considered for treatment by doing epilepsy surgery. In epilepsy surgery a small area of the brain responsible for seizures can be removed easily by microscopic surgery, which is very safe. It is possible to pin point the focus of origin of seizures by video-EEG and MRI.
(The author is Sr.Consultant-Institute of Neurosciences) at Medanta-The Medicity” Division of Neurology”.
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