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Lack of awareness thwarts early diagnosis: Expert
Nandita Vijay, Bangalore | Monday, June 25, 2007, 08:00 Hrs  [IST]

Neurocysticercosis is emerging to be a leading cause of epilepsy in India. At least 15 out of 100 people in a population suffer from this dreaded disease caused due to infection with the cystic larval form of the tapeworm Taenia solium. The intestinal dwelling tapeworm stage develops following the ingestion of raw or poorly cooked pork containing cystic larvae. The tapeworm releases infectious ova into the faces.

There is a serious lack of awareness in India about epilepsy which is not only just fits or seizure attacks but a condition of partial loss of consciousness. Epilepsy due to neurocysticercosis is the cause of adult-onset of epilepsy in the developing world which is serious, Dr AR Bhat, Sr Consultant Neurologist, Manipal Hospital told Pharmabiz during the Epilepsy week observed from June 17 to 23 across the world.

Epilepsy is a disorder of the central nervous system (CNS). Every 1 in 100 people in a population are known to suffer from epilepsy caused due to illness, brain damage, or abnormal development of the brain. There is also a condition of genetic juvenile epilepsy which is inherited. Medically it is referred as Juvenile Myoclonic Epilepsy (JME) which is an idiopathic generalized epileptic syndrome characterized by myoclonic jerks and represents about 5 percent of all epilepsies, stated Dr Bhat.

Around 5-10 per 1,000 population is known to have a seizure once in their lifetime. There is no preponderance for the disorder and it could affect any grown-up, man or woman, but causes could be different. Therefore, it is a challenge for neurologists to educate people that early diagnosis is the fastest way to be cured, averred Dr Bhat.

At least 50 per cent of the 1 per 100 patients can be cured with early detection. Therefore there is a need for immediate reporting to a medical expert who could start the treatment.

India is known to report a high incidence of epilepsy followed by South East Asian countries compared to the western world who have a high degree of awareness. In the rural areas epilepsy is considered a social stigma and a taboo.

"The patient will need to take only one drug for a period of two to three years depending upon his response to the treatment," he added.

The medical reasons for an epilepsy attack are attributed to low birth weight, poor delivery systems, ceberal plasy, malnutrition, blood clots and tumours in the brain.

The preferred first line therapy drugs are Gardinal and Phenytoin which are cost effective and efficacious. The latest drugs prescribed depending on patient affordability are Topamax, Lamictal, Depakote and Carbamazepine.

Latest systems for diagnosing epilepsy are MRI, video EEG and PET Scan. Although these are expensive yet it is a one-time cost for patient, stated Dr Bhat.

Apart from drugs, some patients need surgery for a condition known as 'refractory epilepsy which provides 10-20 percent relief. Surgery can benefits Mesial Temporal Sclerosis, which is the most common epilepsy syndrome in adults. Here the selection of patient is important as 80 to 90 per cent are diagnosed at an advanced stage.

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