HYDERABAD: Approximately 50 million individuals are affected by epilepsy globally, according to the World Health Organisation (WHO). Due to a lack of knowledge, people often fail to take care of those with this condition. To address this, International Epilepsy Day is observed every year on the second Monday of February to raise awareness among people and to help manage epilepsy with greater effectiveness.
Epilepsy is a neurological disorder characterised by recurrent seizures. Its prevalence is higher in underdeveloped and developing nations like India compared to developed nations, with 3-12 people per 1000 population suffering from epilepsy in India. The estimated prevalence is slightly higher in rural populations than urban ones and more prevalent in males compared to females. The incidence of epilepsy is most common in the first decade of life followed by the geriatric population.
Uncontrollable jerking and shaking movements, loss of consciousness, temporary confusion, sudden falls, staring spells, and difficulty in speaking or understanding speech are some of the most common symptoms of epilepsy.
The common causes of epilepsy include genetic factors, brain injury or infection, abnormal brain development, brain tumours, stroke or other vascular diseases, and exposure to toxins or substances that affect the brain. The cause of epilepsy also depends on the age of onset of seizures. For example, perinatal injury, respiratory distress, hypoglycemia, hypocalcemia, brain infections, and haemorrhage are common causes in newborns, while febrile seizures are common in preschool children. Genetic generalised epilepsies are common causes in school-going children and adolescents. Parasitic infections like neurocysticercosis are also common in Indian children. Temporal lobe epilepsies are common in adolescents and younger adults, while strokes, head injuries, and brain tumours are important causes in the elderly.
Taking care of people with epilepsy
While there is no guaranteed way to prevent epilepsy, Dr Srinivas Botla, Senior Consultant Neurosurgeon at Yashoda Hospitals, suggests steps one can take to reduce the risk and manage the condition. These include reducing the risk of head injury by using seat belts, child passenger seats, and wearing helmets, preventing falls by installing grab bars in bathrooms, using non-slip mats, and avoiding walking on wet surfaces. “A balanced diet is required which includes plenty of fruits, vegetables, and whole grains can help reduce the risk of chronic diseases that can contribute to epilepsy, such as stroke and heart disease. Exercise can help improve overall health and well-being, reducing the risk of epilepsy. Sleep deprivation is a common trigger for seizures, so aiming for seven to eight hours of sleep per night is recommended. Stress can also trigger seizures, so managing stress through techniques such as yoga, meditation, and deep breathing is important. Alcohol and drugs lower the seizure threshold.”
Dr A Soumya Reddy, Consultant Neurologist at Renova Hospitals, emphasises the management of epilepsy, saying “It depends on the type of epilepsy, the frequency of seizures and subsequent disability. Management of epilepsy in pregnancy requires caution, with the safest medication chosen and periodic antenatal monitoring. Management of psychosocial issues is as important as treating epilepsy, and adequate neuropsychological counselling helps boost confidence in patients. Evaluation and treatment of anxiety, depression, and quality of life may require the involvement of psychiatrists and neuropsychologists.”
Additionally, Dr Soumya advises patients with frequent seizures to avoid dangerous activities like driving and swimming, working at heights, etc. They should strictly comply with their medication regimen and avoid skipping doses. In the event of a seizure at home, bystanders should remain calm and help the patient lie in a sideways position without tightly holding their limbs. Recording the seizure event on a mobile phone can be helpful for the treating physician. A patient experiencing a prolonged seizure lasting more than 5 minutes, termed status epilepticus, requires immediate hospitalisation in the ICU for stabilisation.
Dr Srinivas Botla concludes by highlighting the efficacy of the Ketogenic Diet (KD) - a high-fat, low-carbohydrate diet for seizure reduction, the Modified Atkins Diet (MAD) for improved compliance, and the Mediterranean Diet for potential benefits in epilepsy management. Furthermore, certain nutrients, like vitamin B6, are crucial for children with specific forms of epilepsy.