Neurology in India

Nevertheless, during the last one and one-half decades, considerable progress has been made in the management of people with epilepsy in India. Investigational facilities such as electroencephalography (EEG), computed tomography (CT) and magnetic resonance imaging (MRI) scans are available in most major cities. Antiepileptic drugs (AEDs), including several of the new ones are widely available. Over 1500 surgeries for medically refractory epilepsy have been performed during the last 10 years, which is several fold more than those undertaken during the previous 50 years. The burden of epilepsy Recent community-based surveys have shown that epidemiological indices of epilepsy in India are comparable to those from developed countries, with a prevalence rate of ~5 per 1000 2,3 and incidence rate of ~50 per 100,000. 4 With around 1000 neurologists and ~5 million people with epilepsy, in India, there would be approximately 1 neurologist to take care of ~5000 persons with epilepsy. While 70% of the Indian population resides in rural areas, nearly all neurologists practice at or close to big cities and towns. A majority of people with epilepsy in India are therefore managed by primary and secondary care physicians with very little knowledge of the present day management of the epilepsies. In general, patients in India pay for medical care from their own resources. Epidemiological studies from rural parts of India have found that the medical treatment gap, which is defined as the proportion of persons with active epilepsy in the population who have never received AED treatment, is around 70%. 4,5