The Hindu : Tamil Nadu News : Checklist for epilepsy treatment on the anvil

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Sunday, Jul 22, 2007
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Tamil Nadu

Tamil Nadu

Checklist for epilepsy treatment on the anvil

M. Dinesh Varma

The list will feature questions that all clinicians should ask their patients
It stems from evidence of a host of factors that leave a disabling impact on patients

CHENNAI: An international group of experts on epilepsy is working on a checklist that will help clinicians look beyond frequency of seizures to examine a set of quality of life issues that bother the patients.

The checklist, broadly modelled on the International Classification of Functioning, Disability and Health of the World Health Organisation (WHO), will feature a compendium of questions that all clinicians should necessarily ask the patients.

Involving the practical aspects of living with the illness, the attempt is to piece together a wholesome index of well-being. The checklist will help the experts, neurologists and even general practitioners assess patients against the social, psychological and vocational contexts. “The focus is to keep the checklist concise and workable across cultures, literally anywhere in the world,” said E. S. Krishnamoorthy, chairman, International Commission on Neuropsychiatric Aspects functioning under the International League Against Epilepsy (ILAE).

The checklist, which is limited to 10 essential questions—in view of the sparse time clinicians have to interact with patients—will also enshrine clinical practice guidelines. The list will be fine-tuned in order to tailor it for epilepsy, as the WHO classification module is generic and applies across disorders.

The initiative has stemmed from the accumulating evidence of a host of factors that leave a disabling effect on epilepsy patients. These could be a ban on going out—self-imposed or a family diktat—for fear of a bout of seizure, a chequered education, the stigma burden, high treatment costs or a broken marriage. These newer findings led the TS Srinivasan National Working Group of experts to propound the concept of ‘Disabling Epilepsy,’ or a condition characterised by ‘medical and psychosocial co-morbidity that impairs the physical, occupational, emotional and vocational functioning of an individual.

Pilot study

The draft checklist, along with clinical practice guidelines, will have to be put through a possibly multi-centric pilot study and is expected to be ready before the next consensus conclave scheduled in Chennai for February 2008.

The dossier will be put up for scrutiny before a forum of doyens in epilepsy care before it is readied for worldwide dissemination.

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