Epilepsy Burden: Nearly 15,000 children are with epilepsy in Nagpur

Infants are 3 times more prone to having epilepsy than adolescents, says Dr. Vinit Wankhede, Consultant Neurologist and Epileptologist

Epilepsy is a disease of the brain characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized). The seizures are sometimes accompanied by loss of consciousness and control of bowel or bladder function.

According to Dr. J. Karankumar, Associate Director, Medical Affairs, Abbott Specialty Care, “Early and accurate identification of types of seizures, epilepsy and any associated conditions can help get the patient the right kind of medication.”

He further opines, “Education on the disease is crucial pertaining to myths and misconceptions prevalent in most of our communities about the medical nature of epilepsy amongst patients and their families, its characteristics, causes and prognosis.”

Dr. Vinit Wankhede, Consultant Neurologist and Epileptologist, Child Hospital, said, “There are approximately 15,000 children with epilepsy in Nagpur. Infants are 3 times more prone to having epilepsy than adolescents. In my experience, 80% of children with epilepsy remain seizure-free while taking medications for 1-2 years, and medication can be withdrawn in 70% of children after 2-5 years of successful treatment and being seizure free. However, one must always consult their doctor before modifying or stopping any medication. Timely diagnosis and treatment at an early stage aids in better management of the condition.”

According to Dr. Neeraj Baheti, Consultant Neurologist and Epileptologist, CIIMS, “There are around 30,000 patients with epilepsy in Nagpur, out of which 47% of epilepsy patients are women and within them 52% of women with epilepsy are in the reproductive age group of 15-49 years. If their condition is managed properly, most women with epilepsy remain seizure-free throughout their pregnancy and go through a healthy pregnancy and complication free delivery.”

Characteristics of seizures vary and depend on where the disturbance first starts in the brain, and how far it spreads. Temporary symptoms occur, such as loss of awareness or consciousness and sensation (including vision, hearing and taste), lack in coordination or other cognitive functions. People with seizures tend to have more physical problems (such as fractures and bruising from injuries related to seizures), as well as higher rates of psychological conditions, including anxiety and depression. Similarly, the risk of premature death in people with epilepsy is up to 3 times higher than the general population 1.

With 70 million people worldwide affected by epilepsy, it is one of the most common neurological diseases globally.  The chronic non-communicable disorder of the brain affects people of all ages and is known to be more prevalent among the rural (1.9%) compared to urban population (0.6%) with nearly 80% of the people with epilepsy (PWE) living in low-and middle-income countries.

There is broad agreement between studies that females have a marginally lower incidence of epilepsy and unprovoked seizures than males3. However, being a woman with epilepsy (WWE) is not the same as being a man with epilepsy. Epilepsy affects sexual development, menstrual cycle, aspects of contraception, fertility, and reproduction.

Oestrogen is known to increase the risk of seizures, while progesterone has an inhibitory effect.
In a study conducted in India, more than half of WWE concealed their history of epilepsy prior to their wedding, fearing social stigma and breakdown of the marriage negotiations.

It is estimated that there are about 2.73 million WWE in India and 52% of them are in the reproductive (15-49 years) age group 4.

Management of epilepsy in women requires not only knowledge of epilepsy, but also recognition of the various roles and priorities women have in their lives (education, career development, child rearing, the role as carer within the extended family), and attention to gender-specific issues and their impact on patients’ well being throughout life.