New Delhi: Annually observed in India on November 17, National Epilepsy Day is a national healthcare event that aims to create awareness about epilepsy conditions and their impact on individuals, families and communities, who are affected by this disease. Various government and private sector organisations join hands and conduct events, workshops and awareness programmes to create awareness about epilepsy.
History and Significance
First initiated by the Epilepsy Foundation of India (EFI), the National Epilepsy Day aims to reduce epilepsy conditions in India. A non-profit charitable organisation, Epilepsy Foundation of India was set up by Dr Nirmal Sury in 2009 in Mumbai.
The day highlights the importance of the detection and treatment of epilepsy at the initial stage. It also tries to clear myths surrounding epilepsy, which is a neurological condition characterised by irregular brain activity.
Epilepsy Foundation of India
With a vision to be a pioneer and leader in the field of patient care for those suffering from epilepsy, the Epilepsy Foundation of India strives to improve the quality of life of not just the poor and underprivileged epilepsy patients in remotest corners of India by providing expert consultation and treatment free of cost. It also imparts skill development to enable sustainable employment and living.
What is Epilepsy
Epilepsy is the second most prevalent and often-seen neurological disorder. It is a brain disease characterised by abnormal brain activity causing seizures or unusual behaviour, sensations and sometimes loss of awareness. It carries neurological, cognitive, psychological and social consequences and accounts for a significant proportion of the world’s burden of disease, affecting around 50 million people worldwide. The number of people with epilepsy is expected to increase further due to rising life expectancy worldwide and an increasing proportion of people surviving insults, which often lead to epilepsy, such as birth trauma, traumatic brain injury (TBI), infections of the brain and stroke.
Who Are Prone to Epilepsy
Epilepsy can affect men and women of all ages, ethnicities and cultural backgrounds. Some people with epilepsy stare impulsively for a small length of time during a seizure, while others shake their limbs or legs continuously. A single seizure does not always imply epilepsy. A diagnosis of epilepsy typically requires a minimum of two unprovoked seizures that happen at least 24 hours apart. Most epilepsy patients can manage their seizures with medication, while some may require surgical treatment.
WHO On Epilepsy
Around the world, people with epilepsy and their families suffer from stigma and discrimination, often facing serious difficulties in education, employment, marriage and reproduction. “Nearly 80% of people with epilepsy live in low- and middle-income countries (LMIC) where treatment gaps exceed 75% in most low-income countries and 50% in most middle-income countries. This is despite the effectiveness and low cost of anti seizure medicines,” the World Health Organisation (WHO) said.
Global Burden Of Epilepsy
Epilepsy accounts for over 13 million disability-adjusted life years (DALYs) and is responsible for more than 0.5% of the global burden of disease (GBD). It affects people of all ages, sexes, races, income groups and geographical locations. Around 7.6 per 1,000 persons have epilepsy during their lifetime. It has a bimodal distribution according to age with peaks in the youngest individuals and in those over 60 years of age. Epilepsy has a variety of causes, ranging from genetic, metabolic, infectious, structural, immune and unknown. There is a higher incidence of epilepsy in LMIC (139 per 100 000 person-years) compared with high-income countries (HIC) (48.9).
According to a 2018 study, over 1.2 crore Indians are affected with epilepsy, contributing about one-sixth of the worldwide epilepsy burden.
Comprehensive Health Care Response To Epilepsy
Health care for people with epilepsy involves providing health care and social services to decrease morbidity, premature mortality and adverse psychosocial outcomes associated with the condition. Providing quality epilepsy care is a challenge because of its complexity, chronicity and considerable comorbidity.
Prevention of epilepsy
According to WHO, an estimated 25% of epilepsy cases are potentially preventable. Preventing head injury, for example by reducing falls, traffic accidents and sports injuries, is the most effective way to prevent post-traumatic epilepsy. Adequate perinatal care can reduce new cases of epilepsy caused by birth injury.
The use of drugs and other methods to lower the body temperature of a feverish child can reduce the chance of febrile seizures. The prevention of epilepsy associated with stroke is focused on cardiovascular risk factor reduction, like measures to prevent or control high blood pressure, diabetes and obesity and the avoidance of tobacco and excessive alcohol use.
“Central nervous system infections are common causes of epilepsy in tropical areas where many low-and-middle-income countries are concentrated. Elimination of parasites in these environments and education on how to avoid infections can be effective ways to reduce epilepsy worldwide, for example, those cases due to neurocysticercosis,” the WHO said.
India’s Take On Epilepsy
In November 2020, the seventy-third World Health Assembly (WHA) adopted resolution WHA73.10 to develop an intersectoral global action plan on epilepsy and other neurological disorders in consultation with member states to ensure a comprehensive, coordinated response across multiple sectors. Towards the objectives of the International Global Action Plan for Epilepsy and other Neurological disorders (2022-2031), the Government of India and stakeholders across the country have been actively engaged in working towards raising policies and providing and implementing strategies for prevention, diagnosis and care of epilepsy and the other neurological disorders across the country.
The Government of India has actively pursued to incorporate epilepsy and other neurological disorders into existing healthcare programmes.
According to the Health Ministry, the National and District Mental Health Programmes have succeeded in prioritising care for neurological disorders such as epilepsy and dementia. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) focuses on strengthening infrastructure and care pathways for stroke, a major cause of disability, across the country.
Other programmes such as the National Programme on Healthcare for the Elderly (NPHCE), National Programme for Palliative Care (NPPC) and National Mental Health Programme (NMHP) are widening their scope of activities to improve intersectoral care for people with dementia.
