Epilepsy is considered grounds for divorce and the annulment of marriages in both India and China reports the World Health Organization (WHO). This is primarily due to more pronounced negative socio-economic conditions caused by the disease in these countries. This results from what is referred to as the “treatment gap” between low-to-middle income countries and their wealthier counterparts. In the former, those suffering from epilepsy often do not receive adequate levels of treatment. Epilepsy then becomes are far more life altering condition, with seizures a more common phenomenon.
The WHO estimates that low-to-middle incomes shoulder around 80 percent of the world’s epilepsy burden.The treatment gap encompasses around 75 percent of epilepsy patients who receive no treatment at all within these countries.
India has around one fifth of the world’s epilepsy burden, It harbours around 12 million patients with the disease according to the WHO. However, some sources place the number of people with active symptoms to less than half of this figure. The Hindu claims the number of people with active symptoms is far lower, numbering five million. Mentioned within this article is the fact that the treatment gap is roughly 50-60 percent, meaning the total number of those with the disease is still a conservative estimate compared to WHO data.
One primary issue that inhibits treatment in India is that many will be left undiagnosed as they do not seek treatment. In urban areas, 60 percent of patients seek treatment, while in rural areas those seeking treatment fall into the minority, between 20 and 40 percent. This makes accurate quantification of disease burden all but impossible.
Among the disease’s defining symptoms are seizures. These come with other potential side effects such as falls causing broken bones and fractures, with the potential for fatalities. Depending on the area of the brain in which the disturbance causing the epilepsy first starts, early stage symptoms can range from hallucinations, imbalances in mood as well as disturbed movement.
Epilepsy in India is often poorly understood due to a lack of awareness, especially in rural communities. The spontaneous seizures may be alarming to some. The sufferer (and, often, their family) may become the victim of social stigma and discrimination as a result. For those with severe symptoms it may have socio-economic effects such as the inability to work, this may be one of the primary factors for its use in divorce cases.
Data published by the WHO claims 70 percent of patients respond to treatment without the need for surgical intervention. Though of those who opt for the surgery the prognosis following the procedure is typically positive.
Antiepileptic drugs (AEDs) are now available that are low cost, as low as $5 USD a year for daily doses. Issues arise due to the availability of the AEDs, largely being below 50 percent. This creates a situation where not only do sufferers of the condition often fail to seek medical treatment, but in many situations would be unable to receive the AEDs even if they were to seek help.
When AEDs are both cheap, and shown to alleviate seizures in 70 percent of cases, with the possibility of withdrawal from the medications after a few years with no relapse symptoms, it is unacceptable that they are not more readily available.
Awareness campaigns and charities are also a step in the right direction, such as the Shri Pragya Mirgi Rog (Epilepsy) Hospital in place in Rajasthan recently hailed in epilepsyindia.org. Through education to promote awareness and better access to medication, epilepsy sufferers may see some improvement in the future.