Clinical and Demographic Profile of Person With Epilepsy in Tertiary Care Hospital of Bundelkhand Region, Central India

Abstract

BACKROUND Epilepsy is one of the most common neurological disorders in the world. It is seen that relative frequency of various clinically important characteristics are different in persons with epilepsy (PWE) living in different geographical area. The purpose of this study is to determine the clinical and demographic profile of epilepsy in Bundelkhand region of central India. MATERIALS AND METHODS This is a descriptive study. All persons with epilepsy attending epilepsy clinic of neurology department were enrolled in this study. Detailed clinical history and general physical examination were carried out. CT scan head, EEG and other relevant investigations were done to determine cause and type of epilepsy. Antiepileptic drug therapy and compliance to treatment was also recorded. RESULTS One hundred and seventy six patients were included in this study. Mean age of onset were 17.4 + 10.4 years. Two-third of persons were from poor socioeconomic strata and from rural background. Age of onset of epilepsy was less than 15 years in 44% patients. Ten percent of patients gave family history of epilepsy among first degree relatives. Most common seizure type was generalised tonic-clonic seizures (68%). Sleep deprivation was the most common precipitating factor. Cause of seizure was idiopathic in 64% patients. Neurocysticercosis was found in 14% of patients and was the most common cause of secondary epilepsy. Eighty five percent were treated with single antiepileptic drug. Noncompliance for drug therapy was seen in 28% patients, which underscore the need for continuous and effective public awareness programme towards this condition. CONCLUSION Understanding of clinical and demographic profile of patients with epilepsy is needed to develop appropriate strategies for be tter and effective health planning.

Perception of the general population on Epilepsy and Antiepileptic drugs: A questionnaire-based study

“…But most of our subjects muddled epilepsy with insanity and overstated the role of hereditary factors in epilepsy, in line with several other works 2,8,12,15,16,20 .Contrarily, developed countries had a greater understanding of the lack of connection between epilepsy and insanity or hereditary 21 . In comparison to earlier Indian studies, a considerably higher number of individuals in our study believed epilepsy was contagious, caused by supernatural powers, and the sins of ancestors or patients 2,5,8,12,14,16 . An Ethiopian and Jordanian study also misrepresented the contagious nature of the disease and its occurrence due to God's curse, respectively 22,23 .…”

“…In our current study also, a maximum number of participants had a positive attitude towards QOL, employment, marriage, giving birth, and revealing the epileptic history before marriage, congruent with other papers 2,10,20,21 .Unlike our analysis, most others discovered widespread negative attitudes about the aforementioned characteristics 5,8,10,[14][15][16]22,[26][27][28] .The dissimilarity shown by our answerers could be attributed to younger participants from urban and diverse locations, gradual public attitude change due to improved awareness, and sociocultural diversity. Our article suggests a potential link between agitated dancing to God and epilepsy.…”

“…The majority of our participants were aware of epilepsy, its symptoms, and its relation to brain disorders, similar to other studies 8,13,14 . But most of our subjects muddled epilepsy with insanity and overstated the role of hereditary factors in epilepsy, in line with several other works 2,8,12,15,16,20 .Contrarily, developed countries had a greater understanding of the lack of connection between epilepsy and insanity or hereditary 21 .…”

“…But in the same study only 33% and 34% felt that epileptic kids have an appropriate level of intelligence and the need to be sent to special schools respectively 12 . Our study's maximum number of respondents had no objection to playing with epileptic children, corresponding to other works 2,8,10,11,16 .But, Chaitra, Kankane (15-20%) and a rural Ethiopian study (39%) found a negative attitude towards playing with epileptic children 14,15,22 .Our respondent's positive attitude toward epileptic children may be linked to their urban background and higher literacy status.…”

“…Epilepsy is a chronic disorder of brain function characterized by the recurrent and unpredictable occurrence of seizures 1 .Around 1% of the world's population has epilepsy, which is the fourth most common neurologic disorder after migraine, stroke, and Alzheimer's disease 1 .The annual incidence of epilepsy in India is approximately 40 to 50 per 100,000 per year, and the disease burden is higher (80%) in developing countries 2 .Epilepsy significantly impacts the medical, psychological, economic, and social aspects of the affected individuals, their families, and the community 3,4 .Studies have shown that, despite advancements in educational and social parameters, including technology and communication, there has been no significant change in the deep-rooted stigmas, perceptions, and discrimination of epilepsy throughout India and other developing countries compared to the developed countries [4][5][6] .There is also a noteworthy treatment gap among epilepsy patients due to this lack of cognizance 2,7,8 . Improving disease awareness and comprehension can aid in epilepsy prevention and treatment 2 .Hence, understanding the public's perception, attitudes, and practices regarding epilepsy and antiepileptic drugs (AEDs) is critical, as misconceptions about the disease have a negative impact on sufferers' quality of life (QOL) 9 .Though there are some original research articles on this topic from different states of India, because of the differences in the population investigated as well as the questionnaires and procedures utilized, the results are not strictly comparable 2,5,6,8,[10][11][12][13][14][15][16][17][18][19] . Except for a few Knowledge, Attitude, and Practice (KAP) studies in rural northeastern Tamil Nadu (TN), explorations targeting the non-epileptic general population of TN are very limited; hence, this research may help to assess the extent of the problem and provide additional insight into public KAP 5,10 .…”