DNA
18 November 2008
by Sumitra Deb Roy
Mumbai, India

Experts say that patients prefer drugs over the scalpel
Research has shown that drugs can only control epilepsy but surgery can, in most cases, cure this neurological disorder that is believed to affect one in 100 people. And despite epilepsy surgery being practiced in India for about 15 years, it still isn’t widely accepted as a form of treatment.

It is estimated that Mumbai alone has more than 1,80,000 people living with epilepsy. In medical terms, epilepsy means seizures caused by periodic electrical storms inside the brain. While many are believed to be born with this condition, epilepsy can develop at any age due to trauma, tumour, and infection in the head or even a stroke.

The Epilepsy Care Centre at KEM hospital recently completed 100 cases of epilepsy surgeries, after starting the programme about seven years ago. Out of the 100 cases, only 40 were from Maharashtra. In epilepsy surgery, the abnormal tissue that sparks the seizure or fits is cut off.

“When it comes to epilepsy, very few think of surgery as an option even if it promises cure in about 80–85% cases,” said Dr Sangeeta Ravat, professor and head of neurology, KEM Hospital. Acceptability of surgery as a treatment for epilepsy is limited even in a city like Mumbai, she added.

Experts also believe that the acceptability of brain surgery is less since not all patients qualify for it. “Surgery can be done only on very selective patients when all other modes of treatment have failed,” said Dr Vinay Chauhan, consultant neurologist, Lilavati hospital. “Though the surgery is not very risky, accuracy is what we have to look for,” he added.

In about 70% of the cases, epilepsy can be controlled with drugs, but that would be a life long requirement. Ravat said that for 30% of the patients, who are forced to live with uncontrolled and recurrent seizures despite being on medication, surgery could be an answer.

“In certain kinds of epilepsy in children, it may not be able to cure, but it can definitely improve the quality of life,” she said.

Meanwhile, patients of epilepsy still face a lot of stigma and hence even educated families tend to keep the ailment under wraps.

“Even educated, urban people believe that smelling a shoe/chappal might stop a seizure,” said Dr Charulata Sankhla, neuro physician, Hinduja Hospital. “The situation is worse if it is a girl and of a marriageable age,” she said.