India accounts for a large number of epilepsy patients and like in any other developing country nearly 90 per cent of the patients in some areas do not receive treatment for many reasons, which calls for a need to devise alternative strategies to provide service at the peripheral, regional, and apex levels, said a senior neurophysician K. Venkateswarlu on the occasion of the National Epilepsy Day on Saturday.
Lack of awareness, social stigma, unavailability of medicines, and patients not able to afford them are some reasons for the gap in treatment.
In a country such as India, which is a land of contrasts, treatment for epilepsy is provided by a variety of trained and untrained personnel that include neurologists, neurosurgeons, psychiatrists, physicians, paediatricians, and a large number of health and non–health care personnel, Dr. Venkateswarlu said.
The existing number of about 1,000 trained neurologists and 1,500 trained neurosurgeons is inadequate to take care of the large number of patients in the country.
“There is an urgent need to devise alternative strategies to organise services at the peripheral, regional, and apex levels. Any programme to be financially viable should be integrated with existing infrastructure. The idea that epilepsy control programme should be combined with mental health care may not be a good option because of the stigma attached to mental illness which will defeat the purpose”.
Training
He suggested that community health workers be trained to identify people with epilepsy and also convince them about the need to seek treatment while medical officers at the Primary Health Centres, Community Health Centres and District Headquarters Hospitals have to be given training in basic principles of diagnosis treatment of epilepsy.
Neurologists from the State medical colleges and tertiary care centres will act as nodal neurologists, who train the doctors at periphery and help them to maintain simple record.
Epilepsy is not just seizures suffered by an individual and its immediate effects on his/her family. Fear, misunderstanding, and the resulting social stigma and discrimination often force people with this disorder ‘into shadows’, he said.
General public must be explained that epilepsy can be prevented and cured, the treatment is beneficial and their myths and misconceptions about epilepsy must be dispelled.
A free and uninterrupted supply of regularly used antiepileptic medication should be ensured at selected centres and the teaching hospitals of medical colleges and tertiary care hospitals should be strengthened with adequate facilities such as CT scan MRI, and EEG to investigate the referred patients, Dr. Venkateswarlu said.
