1.5 mn women of reproductive age in India affected by epilepsy: Experts

NEW DELHI: The staggering number of nearly 1.5 million women of reproductive age in India grappling with epilepsy highlights a critical need for tailored care and support, said experts on International Epilepsy Day on Monday.

World Epilepsy Day is observed every year on February 12 to raise awareness and timely intervention for people suffering from the neurological disorder characterised by recurrent seizures.

The disease affects approximately 50 million individuals worldwide, with a significant portion residing in India, where 10-12 million people are affected.

Social stigma and reluctance to seek medical intervention often hinder women from receiving the care they need. Concerns related to reproductive health are a significant issue within the community of women with epilepsy. But experts stated that proper treatment can help women lead a normal and healthy life.

“Despite the disease prevalence, there exists a considerable treatment gap in the management of epilepsy, particularly in low-resource settings like rural areas of India. With nearly 1.5 million affected women in India, special attention must be given to women of reproductive age with epilepsy, as pregnancy poses unique challenges. Issues such as teratogenic effects from antiepileptic drugs (AEDs) and increased infertility rates are significant concerns,’’ said Dr. Siby Gopinath, Epileptologist and Professor of Neurology at Amrita Hospital, Kochi.

Neuroinfections, head trauma, and metabolic abnormalities significantly contribute to the burden of epilepsy in India, especially among women of reproductive age.

Children also bear a substantial impact, with the highest incidence occurring in the first year of life and peaking between ages 1 to 12. Diagnosis in children poses challenges due to various seizure imitators, necessitating evaluation by trained paediatric neurologists.

The experts said that women with epilepsy can plan pregnancies if they have been seizure-free for two years or more. Collaboration between neurologists, gynaecologists, and paediatricians is essential to manage medications during pregnancy and address any seizures promptly.

"Women with epilepsy can lead a normal life with timely and proper treatment. It is crucial to address the unique challenges faced by women, including social stigma, to ensure they receive the necessary medical attention. Women with epilepsy should plan pregnancy so that anti-epileptic medications do not harm the baby as well as the mother," Dr. AK Sahani, Director and Chief of Neurology, Indian Spinal Injuries Centre (ISIC) New Delhi, told IANS.

However, the doctor said that the ongoing medication dose can be optimally minimised to reduce the risk to the baby and prevent epilepsy in the mother.

“Otherwise, drugs can be switched over to other safer drugs for pregnancy. Women with epilepsy can go safely for pregnancy under the supervision of a neurologist and they can have normal delivery,” Dr Sahani said.

The causes of epilepsy vary, including birth defects, oxygen deprivation or hypoxic sequelae, genetics, brain infections, head injury, stroke, and brain tumours.

“Diagnosis involves a comprehensive approach, including medical history, physical examination, and various investigations like blood investigations, bedsides EEG, video EEG, CT, MRI of the brain. These tests and investigations help in identifying potential causes and plan appropriate treatments. Treatment options include anti-seizure medications, with the caveat that finding the right medicine and dosage may take time,” said Dr. Amlan Mandal - Senior Consultant - Neurology, Narayana Hospital RN Tagore Hospital.

"Surgery is also considered to address underlying causes more so in drug resistant epilepsy such as removing brain tumours. Deep Brain Stimulation (DBS) may be required in cases where the origin of seizures is unclear," the doctor said.