Chennai: Epilepsy is a neurological condition that affects brain activity, causing seizures and loss of awareness in afflicted persons. India carries a burden of more than 50 lakh people with epilepsy (PWE), of which 10 lakh people are potential candidates for epilepsy surgery (ES). However, the number of people who are operated upon is not more than 500 a year.
Even after intensified awareness campaigns in private and government hospitals on epilepsy and available treatment for PWEs, neurologists say that surgical interventions remain most under-utilised option of epilepsy treatment.
The cause of epilepsy in younger people can commonly be traced back to improper prenatal care such as a lack of oxygen available to the baby during delivery. While in adults, it is due to injuries to the brain. Infections or trauma can also lead to epilepsy.
Dr Meenakshi Sundaram, senior neurologist at Apollo Hospitals, says, “Today epileptic patients can opt through detailed evaluation and classification of their seizures, appropriate rational combinations of different antiepileptic drugs, implantation of a device called vagal nerve stimulator or respective surgery to remove the epileptic focus.”
Commenting on the treatment options available, Dr Meenakshi Sundaram says, “The most under-utilised option of treatment considered by patients is ‘surgery’. With the help of an operating wand (an advanced technology) that adds to the accuracy and safety of the surgery and also the operating microscope, these benefits may open the door for more epilepsy patients to see surgery as a viable option.
“Good results can be achieved only if we are able to identify critical cases at the earliest. A patient can be reported as critical if the seizures exceed two per month, in spite of taking two or more anti-epileptic drugs, or who has limiting side effects due to medication,” he adds.
Medicos say that lack of awareness on epilepsy has led to its increasing occurrence and lack of utilisation of treatment facilities. Many eligible patients do not avail the advantage of epilepsy surgery because of illiteracy, ignorance, misconceptions, costs and complications of epilepsy surgery.
“Treatment strategies such as polytherapy for people with DRE, standardised non-invasive pre-surgical evaluation protocols and optimum utilisation of resources for invasive monitoring under the National Epilepsy Control Programme can help to provide surgical management of difficult and complex cases,” says neurologist Dr Satish Kumar.
