National Epilepsy Day: Epilepsy treatable like other diseases: Dr Sushil Razdan

On National Epilepsy Day, acclaimed and celebrated neurologist Dr Sushil Razdan in an exclusive talk with Greater Kashmir Correspondent, Zehru Nissa sheds light on what it’s really like to live with epilepsy, why early diagnosis is crucial, and how we can break down the stigma surrounding this condition.

What causes epilepsy, and how is it treated?

The causes of epilepsy can vary a lot. Some cases are genetic, others are the result of injuries, infections, or even brain damage at birth. Certain forms of epilepsy are preventable, especially those linked to poor birth care or childhood injuries. Treatment isn’t a one-size-fits-all scenario—some people may need medication for a lifetime, while others only for a short period, particularly if their epilepsy is due to a specific cause like a tumour or head injury.

Interestingly, diagnosis still relies heavily on a patient's history and eyewitness reports, despite all the technological advancements. Tests can help in evaluating the condition, but they aren’t always conclusive.

Why seek medical help early?

Anyone who experiences a seizure should see a doctor right away. Getting an early diagnosis doesn’t mean you will necessarily be on medication forever, but ignoring epilepsy can lead to dangerous situations, especially if a seizure happens in an unsafe location. A general physician or paediatrician is often fully capable of managing epilepsy, not just neurologists. More awareness and treatment facilities in district hospitals would make a huge difference, reserving referrals to neurologists for the most complex cases.

Is normal life possible for women with epilepsy?

Women with epilepsy face their own set of challenges, from potential weight gain to menstrual changes caused by anticonvulsants. Despite this, women with epilepsy can have a full life and healthy children. Genetic studies can help determine if certain types of epilepsy might be passed down, offering more clarity for those planning a family.

How can stigma be dispelled and patients empowered?

A major barrier to proper treatment, in many places including Kashmir, is the stigma tied to epilepsy. A groundbreaking study from 1988 in Kashmir’s Shangus area revealed that 2.47 out of every 1000 people had epilepsy, conforming to the incidence in other parts of the world. Despite these numbers, many avoid seeking treatment because of the stigma. Epilepsy is not contagious, and it’s certainly not a sign of possession. People with epilepsy are part of our families and communities. They deserve understanding, not exclusion.

With effective management, individuals with epilepsy can pursue any career they choose. Yes, they can drive, work, and live fully – as long as they follow medical guidelines and remain seizure-free for the recommended time.

What should be done during a seizure?

If one witnesses someone having a seizure, stay calm. Loosen their clothing, protect their head, and make sure they are safe. Whatever you do, don’t put anything in their mouth. That is a common but dangerous myth. New treatments like nasal sprays can quickly stop a seizure. These are particularly useful in public settings like schools, where fast action can make a big difference. If a seizure doesn’t stop even after five minutes, take the patient to a hospital.

What are the advancements in treatment?

Epilepsy treatment has come a long way. There are new surgical options for severe cases and ongoing developments in medication. Neurology is a relatively young field, but it is making strides. Doctors should stay informed about the latest in treatment.

How to avoid an epilepsy attack?

Certain factors can increase the chance of a seizure, and understanding these triggers is key to managing epilepsy. One of the most common triggers is missing a dose of medication. It is crucial to stay consistent with your treatment plan. Poor sleep or sleep disruptions can also set off seizures – getting enough rest is essential for anyone with epilepsy. Stress, whether physical or emotional, can lower the brain’s resistance to seizures, so finding effective ways to manage stress is important. Substance abuse including alcohol and recreational drugs can interfere with medications and destabilise brain function. By avoiding these triggers – keeping a regular medication routine, getting good sleep, managing stress, and steering clear of harmful substances – one can greatly reduce the risk of seizures.