Epilepsy Prevention & Integrated Care Program
Epilepsy Prevention & Integrated Care Program is a one of its kind multidisciplinary program that is launched to spread awareness and combat Epilepsy. Epilepsy is the most common neurological disease globally with an estimated proportion of 4 to 10 per 1000 people suffering from it. In India, there are about 12 million people with epilepsy, making it to almost one sixth of the global burden. Incidence of epilepsy is more in children and young adults, and more in rural than urban India.
This program aims to identify & recruit epilepsy patients to the program using EPIC App and also plans to conduct camps periodically with the active involvement of local Rotary clubs. Through EPIC, the objective is to create awareness in the community and remove any fears about epilepsy through regular patient contact programmes. It is the club’s mission to improve the overall quality of life of persons with epilepsy.
Epilepsy is also called “fits or convulsions or mirgi. Epilepsy is a chronic disorder of the brain characterised by recurrent episodes of unprovoked seizures. Seizures are episodes of disturbed brain electrical activity that cause changes in attention or behaviour of an individual.
- Epilepsy may occur due to various causes and depends on the age of the individual.
- In infants and children, it may be due to birth injuries, hypoxic damage, brain infections like meningitis and encephalitis, genetic disorders and developmental malformations of the brain and brain tumors.
- A large percentage of children with epilepsy outgrow the problem with age.
- In adults seizures may occur due to head injury, scars in the brain, brain tumors, infections like tuberculosis and neurocysticercosis, developmental malformations of the brain and stroke.
- In elderly most common cause is stroke followed by tumors, encephalitis, head injury, medical problems like hyponatremia and hypoglycemia and degenerative disorders like Alzheimer’s disease.
- In about 50-60% of persons with epilepsy no cause can be identified (Cryptogenic).
Epilepsy in children is known to cause poor scholastic performances, significant behavioural changes to mental retardation.
In adults, it leads to social and cultural adverse effects on education, employment, marriage, and other essential social opportunities. Epilepsy also gives rise to a very high economic burden especially for treatment and travel costs required to find appropriate treatment centres. This vicious cycle of economic burden and poor disease outcome causes misunderstanding, fear, secrecy, stigmatization which indirectly leads to rejection & denial of education and social isolation.
With proper identification & medical intervention up to 70% of people with epilepsy could live seizure-free. About 10-15% of patients end up in intractable seizures which can be brought under control with surgical procedures.
- Lack of sleep
- Extreme fatigue
- Psychological stress
- Alcohol & drug abuse
- Noncompliance of medication
- Menstruation or other hormonal changes
- Low blood sugar
- Excess caffeine or other specific food
65-70% seizures are well controlled with single medication and curative in more than 70%. Others more than 2-3 medications required to control seizures. Several new medications available over the last decade have very few side effects. At present there are over 15 different medications available for the treatment of fits.
25% of seizures can be prevented
- It is recommended that all persons who have an unprovoked seizure seek emergency medical attention immediately following the initial seizure and then follow up with their primary care physician soon thereafter
- If seizures reoccur, person should be seen as soon as possible by a specialist who manages seizures and epilepsy (Epileptologist) to ensure precise and early diagnosis and initiation of appropriate therapy
Medications suppress seizures and keep the person seizure free, but they do not remove the tendency to seizures. A large percentage of patients outgrow the tendency to several episodes of seizures with age, and can eventually discontinue medications.
It is advisable to plan the treatment with a specialist doctor who treats epilepsy – a neurologist or an epilepsy expert. However, about 20-30% of people with epilepsy continue to have seizures despite medications. Some of these patients can benefit brain surgery. The decision of suitability for surgery depends testing called a “Presurgical Evaluation:. Technological advances like better neuroimaging and long term video EEG (electroencephalogram) evaluation have improved diagnostic accuracy. In rightly chosen patients, surgery is safe and can cure epilepsy. The person can be free of seizures, and may even be able to gradually stop all medications.