Epilepsy is the most common chronic neurological disorder that affects 1 in every 200 people in the community. It is estimated that in India, there are over five million people with epilepsy and one million with medically refractory epilepsy. There are nearly five hundred thousand people with focal epilepsies, and in a majority of them, surgery cures or controls epilepsy.
In urban India, the family practitioner, paediatrician, physician and neurologists are involved in epilepsy care. However, a large section of patients with active epilepsy especially in rural India go undiagnosed and untreated. This treatment gap in underdeveloped countries ranges from 70 to 94% with an estimated three million patients living in rural areas of India. The reasons are several: failure to identify persons with epilepsy; failure to deliver treatment to identified persons with epilepsy; knowledge, attitude and cultural practices of the people; and the cost of antiepileptic drugs.
What is Epilepsy?
Epilepsy is the tendency to have repeated spontaneous seizures (fits/convulsions). Seizures are episodes of disturbed brain electrical activity that cause changes in attention or behaviour.
What are the different types of fits?
The normal brain continuously has electrical currents in a controlled manner. Fits or seizures occur because of brief excessive currents in the brain. The symptoms of a seizure vary depending on the part of the brain that has abnormal current. Accordingly there are different types of fits or seizures.
- Grand Mal Seizure
The classical 'grand mal' seizure is a result of the current invading the entire brain. In this type of seizure the person falls to the ground and becomes stiff and then shakes all over. There may be frothing at the mouth, the person may lose urine control and also bite his tongue. These are commonly called 'convulsions'.
- Partial Seizures
These are seizures due to abnormal current in only some portion of the brain, the symptoms may vary with the location of the current.
- Simple Partial Seizure
The person is fully aware and has an unusual sensation or jerking of his limbs, and recollects this event later.
- Complex Partial Seizure
The person is not fully in his/her senses and has some irrelevant automatic behaviour. The person cannot recollect this event later. This is called a complex partial seizure.
What causes Epilepsy?
Epilepsy may occur due to
- Brain stroke
- Head injury due to an accident
- Brain damage at the time of birth
- Abnormalities in the function of the neurons without any brain damage
Epilepsy can start at any age, but it commonly starts at extremes of age, i.e., in small children and the elderly. A large percentage of children with epilepsy outgrow the problem with age.