Treatment gap and social stigma, the biggest barriers for those with epilepsy

Treatment gap and social stigma, the biggest barriers for those with epilepsy 

Need to remove misconceptions and myths associated with the condition

New Delhi, 17^th November 2017: About 80% of those with epilepsy live in low and middle-income countries, as per reports by a global health body(WHO). Over 50 million people around the world suffer from this condition and about three-fourth of these live in low- and middle-income countries. The ‘treatment gap’ and the social stigma associated with the disorder in India further exacerbate conditions for people with epilepsy.

Epilepsy is a chronic disorder of brain characterized by recurrent ‘seizures’ or ‘fits’. The seizures are caused due to sudden, excessive electrical discharges in the neurons (brain cells). The condition can affect people at any age and each age group has unique concerns and problems.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The International League Against Epilepsy (ILAE) has expanded the definition of epilepsy to incorporate a single unprovoked seizure with a probability of future seizures. The new definition also specifies that epilepsy can be considered ‘resolved’ if a patient has been seizure-free for 10 years, with no seizure medicines for the last 5 years. The previous definition stipulated that a patient needs to have 2 unprovoked seizures more than 24 hours apart. Epilepsy is mostly treatable with medications. The critical thing about epilepsy is that treatment should not be delayed. Start the treatment as soon as it is diagnosed. This prevents further deterioration of the condition.”

Some causative factors for epilepsy include brain damage from prenatal and perinatal injury, congenital abnormalities, brain infections, stroke and brain tumors, head injury/accidents, and prolonged high fever during childhood.

Adding further, Dr Aggarwal, said, “A lot of progress has been made in the country for treating epilepsy and controlling the onset of seizures. Many effective new anti-epileptic drugs are available in the market today. India also many centres that offer treatment facility for this condition. Only mass awareness can dispel the associated myths with epilepsy. It is important to create awareness that those with epilepsy can lead a normal life, get married, have children, and even work. This is not a contagious condition and does not spread through contact.”

One of the major reasons for incomplete control of seizures is non-compliance. Some tips to prevent onset of seizures and the condition from getting worse are as follows:

• Adhere to the prescribed medication
• Following a regular sleep cycle to remain stress-free
• Keep yourself hydrated
• Eat a balanced diet
• Get regular medical checkups done

New AAN-AES guidelines on sudden unexpected death in epilepsy

New AAN-AES guidelines on sudden unexpected death in epilepsy The American Academy of Neurology (AAN) and the American Epilepsy Society (AES) have jointly developed a new guideline on SUDEP or sudden unexpected death in epilepsy. SUDEP is the term used when a patient with epilepsy, who is otherwise healthy, dies suddenly without any known cause. • SUDEP is rare in children, affecting just one in 4,500 children every year. It is also uncommon in adults, typically affecting one in 1,000 adults every year. • Generalized tonic-clonic seizures are a major risk factor for SUDEP. • SUDEP is more likely in patient with frequent generalized tonic-clonic seizures. People with ≥ 3 episodes of generalized tonic-clonic seizures in a year are 15 times more likely to die suddenly vs people who have ≤ 3 generalized tonic-clonic seizures per year. • The guidelines stress on education about the condition for both physicians and patients with epilepsy. Patients should be informed that controlling seizures, especially tonic-clonic seizures, may reduce the risk of SUDEP. They should be encouraged to take their medications on time, not miss a dose and to learn and manage their seizure triggers to reduce frequency of seizures. • The guideline shows that being free of seizures, particularly tonic-clonic seizures, is strongly associated with a decreased risk of SUDEP. These guidelines were presented at the ongoing 69th AAN Annual Meeting in Boston and simultaneously published online April 24, 2017 in the journal Neurology. (Source: AAN, Press Release, April 24, 2017) Dr KK Aggarwal National President IMA & HCFI