Epilepsy and disability: Unknown devil

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Nirmal Surya

Epilepsy Foundation, India

: Int J Ment Health Psychiatry

Abstract

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Epilepsy is a major public health concern affecting an estimated 50 million people worldwide. Developing countries are the one most affected by the consequences of epilepsy, with treatment gap of over 60%. The life time prevalence rate for epilepsy in developing countries varies from 1.5-14 per 1000 in Asia to 5.1-57.0 per 1000 in Latin America and 5.2-74.4 per 1000 in Sub-Saharan Africa. The increased occurrence of birth trauma, traumatic head injury and neuro-infection are responsible for higher prevalence of epilepsy. Approximately 30% patients with epilepsy have significant neurological co-morbidity ID, CP, autism, ADHD, stroke, head injury and encephalitis. In developing world epilepsy is associated with many disability particularly in children, in children with epilepsy 30-40% have ID and 7-42% with autism. In population-based study 38% of children with CP have epilepsy. ADHD, ASD are more common with epilepsy. The more serious the neurological co-morbidity, higher the incidence of epilepsy, each disability needs to be addressed separately besides the disability related to epilepsy itself. Epilepsy is often misunderstood, leading to fear, stigmatization and the risk of social discrimination. In some patients, social stigma can pose a greater challenge than the epilepsy itself. People with epilepsy have an increased risk of poor self-esteem, depression and suicide. Many people with epilepsy live in fear that they will have another seizure. Our experience of epilepsy and disability during the epilepsy camp in Maharashtra with NHM Government of Maharashtra as follows in 69 camps from 2011-2018 the total no. of patients with epilepsy are 26606, number of patients evaluated by the physiotherapist: 1724, speech therapist: 2574, occupational therapist: 2724 and clinical psychologist: 1896.

Biography

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Nirmal Surya is currently working as a Consultant Neurologist at Bombay Hospital and Research Center, Saifee Hospital, Mumbai. He is also the Chairman of Surya Neuro Center, Mumbai. He is the Founder Trustee and Chairman of Epilepsy Foundation, India. He has been at various posts for neurological societies in India, Founder President of Indian Federation of Neurorehabilitation, Past President (2013-14) of Bombay Neuroscience Association (BNA), Treasurer (2014-2020) Indian Academy of Neurology (IAN), Founder Secretary (2005-10) Maharashtra Association of Neurology (MAN). He is also the Regional Vice President of World Federation for Neuro Rehabilitation (Since 2006) Chairperson, developing world Forum, SIG, WFNR.

E-mail: nirmal_surya@yahoo.com