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. Despite medical advancements, these demographic faces significant challenges, including teratogenic effects of antiepileptic drugs and heightened infertility rates, say experts.
On National Epilepsy Day, celebrated each year on the 2nd Monday of February, neurologists from Amrita Hospital Kochi emphasized the urgent need for heightened awareness regarding the early detection and treatment of epileptic seizures in young women. They expressed deep concern over the insufficient attention given to women with epilepsy, influenced by cultural beliefs, social stigma, and inadequate healthcare infrastructure.
Dr. Siby Gopinath, epileptologist and professor of Neurology at Amrita Hospital, Kochi, stated, ‘’Epilepsy, a neurological disorder characterized by recurrent seizures, affects approximately 50 million individuals worldwide, with a significant portion residing in India, where 10–12 million people are affected. Despite its 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.’’
Understanding the diverse causes of epilepsy, including structural changes in the brain and metabolic disturbances, is crucial for effective management. 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 pediatric neurologists.
Accurate diagnosis relies on comprehensive neurological examinations and advanced neuroimaging studies such as electroencephalogram (EEG) and brain scans. Preventive measures targeting fall and injury prevention, improved perinatal care, and addressing modifiable risk factors play a crucial role in reducing epilepsy burdens among women and children alike.
Treatment options encompass pharmacotherapy, surgical interventions, brain-stimulating therapies, and dietary modifications such as ketogenic diets. However, challenges like drug-refractory cases underline the necessity for alternative therapies and precision medicine approaches tailored to individual patients.
Tragically, individuals with epilepsy face a heightened risk of premature death, reducing life expectancy by 2–10 years on average. Mortality causes include injuries, sudden unexpected death in epilepsy (SUDEP), status epilepticus, infections, drug toxicity, and suicide, emphasizing the need for comprehensive epilepsy care beyond seizure control.
Dr. Ashok Pillai, clinical professor, Advanced Centre for Robotic Surgery, Surgical Oncology, Neurosurgery, Amrita Advanced Centre for Epilepsy, Amrita Hospital, Kochi emphasized, “Screening for epilepsy is vital for early detection and timely intervention. Implementing healthcare practices, careful childbirth management, and essential vaccination protocols are crucial steps in preventing epilepsy. Early detection and awareness contribute to timely intervention, enhancing overall well-being for women and children affected by epilepsy.”
