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Resources inadequate to manage epileptics, says expert

PUDUCHERRY: About 22 to 61 per cent of patients with epilepsy do not return after their first visit to hospital owing to various reasons, including lack of efficacy and failure to achieve quick cure, former Head, Institute of Neurology of Madras Medical College A.V. Srinivasan has said.

Dr. Srinivasan, who is an Emeritus professor at Tamil Nadu Dr. MGR Medical University, was delivering a lecture on ‘Management of epilepsy in this millennium’ at a continuing medical education programme organised by the Pondicherry Association of Neuroscientists on Sunday.

“Epilepsy is a fascinating disorder affecting three functions of the brain – cognition, conation and affect,” he said.

About 50 million people the world over are affected by epilepsy. One fifth of the world’s epileptic patients are in India and the prevalence rate was five to 10 per 1,000, Dr. Srinivasan said.

Referring to inadequate resources for managing epileptics, he said, “In a country with a population of one billion, we have approximately 800 neurologists.” He outlined the importance of treatment and said that the objective was to prevent further seizure and chances of recurrence.

Talking about anti-epileptic drugs, he said that increased side effects were predominantly seen in men. “Using carbamazepine with phenytoin is the least useful in the treatment of epilepsy but practically used throughout the country,” Dr. Srinivasan said.

Overall risk of recurrence after one year varied between 16 per cent and 36 per cent among different studies and the risk was greatest in the first year of index seizure.

“The overall relapse rate is 20 to 36.5 per cent, while children have a lower relapse rate of 12 to 36.3 per cent,” he said. Speaking about women , he highlighted the need for seizure control, bone health, avoiding anaemia and cognitive impairment.

Director of Jawaharlal Institute of Postgraduate Medical Education and Research K.S.V.K. Subba Rao said that neuroscience is a fascinating subject in the field of medicine. But, unfortunately it had taken a long time to establish firm service of neurology in Puducherry. Four qualified M.Ch neuro surgeons had joined JIPMER, he added.

Medical Superintendent of JIPMER A.K. Das said that quality of life was greatly altered by epilepsy. “It is a traumatic disease because issues associated with it are deep, emotional, social and involve the community. Surgery has opened new vistas in the management of epilepsy,” he said.

Convener of the association Paranjothi spoke.

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