Telephonic follow-up with epilepsy patients who live far away could be introduced at the AIIMS here soon following a study that showed that some patients suffered seizures while travelling sleepless overnight in unreserved train compartments to reach the premier Delhi hospital.
The study, done by the Neurology Department of the All India Institute of Medical Sciences, found that many patients would be relieved to follow up of their cases on phone by the doctor concerned that saves them from the tensions of travelling long distances.
"The patients, mostly from Bihar or Uttar Pradesh, are on medication and remain seizure-free for months. But when they come in packed unreserved train compartments for follow-up visits to the doctor, they are unable to get sleep, and some of them suffer seizures on the train," Mamta Bhushan Singh, additional professor in the AIIMS’ neurolgy department, told IANS.
"Telephonic follow-up would save not just money but time. The study is to be published," she added.
The study was done on a randomized selection of 450 patients whose follow-up was done on the phone. They were asked if they were happy and satisfied. "They were extremely happy with the follow-up on phone," Singh said.
As part of the follow-up, the patient had to cite his or her file number, which the doctor would click open on a computer terminal for the patient’s data sheet, that would have the date of the last seizure, the medicines and the duration of medication. The doctor would then ask the set questions, including if the patient had suffered a seizure in the interim since meeting the doctor the last time, and how many seizures, if any dose of medicine was missed and any side effects of the drugs, said Singh.
"Maybe in future we may offer telephonic follow-ups," said the expert.
With India home to around 12 percent of epilepsy cases – or 1-2 percent per 100 people – Singh said there is a dire need for more doctors, especially in the rural areas, and also of health educators and volunteers who would help raise awareness of the health condition that most people still feel embarrassed to acknowledge.
"Epilepsy should be understood and treated. The treatment is affordable and, along with medicines, patients need to be educated about epilepsy, that it is perfectly treatable, that they should not miss medicine doses and have proper sleep," she said.
Singh also said that the figure of 12 million prevalence was an "underestimation" as "at least half of patients are not being treated".
One major reason for people reporting with seizures is ingestion of tapeworm eggs, either through eating pork that is not well cooked, or from dirty water or unwashed lettuce leaves or cabbage.
Neurocysticercosis, a parasitic infection that results from ingestion of eggs from the adult tapeworm, is a leading cause of seizures and epilepsy in the developing world.
"Once ingested, the fertilized egg of the tapeworm reaches the brain. This comes from contaminated water or eating salad leaves or cabbage which get the eggs due to open defecation," she added.