Newer medications with fewer side effects have displaced the
century-old 'Gardinal' containing the active ingredient Phenobarbitone
to treat epilepsy. The brain disorder which affects two percent of the
Indian population is now gaining considerable importance among
neurologists who are advocating early diagnosis.
"We have come a
long way in developing drugs with minimal side effects and
complications, especially in those who require long-term medications to
control the disorder that is caused due to certain disturbances of
electrical signalling in the brain. Some of the new drugs are
Levetiracetam, Lamotrigine, Topiramate. The companies offering the drugs
are Novartis, Sun and Lupin among others, Dr Chandran Gnanamuthu,
Senior Consultant Neurologist, Fortis Hospital, Bangalore and former
Professor & Head, Department of Neurological Sciences, Christian
Medical College & Hospital, Vellore, told Pharmabiz during an email
interaction.
The cost of these drugs could vary from Rs.800 to Rs.6,000 a month depending on which medications the patient is on, he added.
The
brain is a highly complex electrical system, powered by around 80
pulses of energy per second. These pulses move back and forth between
nerve cells to produce thoughts, feelings, and memories. An epileptic
seizure occurs when the energy pulses come in much more rapidly which
is as many as 500 per second for a short time caused due to an
electrical abnormality in the brain. The brief electrical surge can
happen in just a small area of the brain or it could affect the whole
brain. Depending on the part of the brain that is affected, the surge of
electrical energy results in the person's sensations or state of
consciousness. It also results in uncontrolled movements of certain
parts of the body. On the World Epilepsy day observed on November 17
annually, neurologists are calling for early diagnosis of the disorder .
Around
5 per cent of patients do not respond well to medications. They
continue to get several attacks a day, often injuring themselves.
These patients would need to be considered for surgery. Even after
surgery they would need some medications to be continued, though the
intensity and frequency of attacks would have come down, stated Dr
Gnanamuthu.
Going by the availability of large patient pool
and medical expertise, India is now a hub for clinical trials and there
are several human studies going on for the newer anti-epileptic
drugs. However Fortis Hospitals, is not a part of any of these clinical
trials, he said.
Among the visible trends in the treatment of
epilepsy are 'vagal nerve stimulation' which is is designed to prevent
seizures by sending regular, mild pulses of electrical energy to the
brain via the vagus nerve. These pulses are supplied by a device similar
to a pacemaker. Another emerging concept in treatment is the brain
cortical mapping which is done to precisely locate the epileptic foci,
during surgery, for ablation of these foci.
There are challenges
before neurologists to treat epilepsy patients because there are many
conditions that look like epilepsy. This is where precise diagnosis
and classification of the disease is essential, stated Dr Gnanamuthu.