Epilepsy remains one of the most common neurological disorders globally. Firstpost brings out experts’ views on signs, developmental impact, rural-urban treatment gaps and how AI and precision medicine are transforming epilepsy management.
Epilepsy remains one of the world’s most common neurological conditions, affecting more than 50 million people globally, according to the World Health Organisation. In India, the challenge is particularly acute, where the “treatment gap”, the proportion of people with active epilepsy who do not receive appropriate treatment can be as high as 70 to 90 per cent in rural areas.
In children, epilepsy does not always appear as dramatic convulsions or fits, as many people assume. Subtle symptoms are often overlooked, delaying intervention at a stage when early diagnosis can prevent developmental and psychological harm. At the same time, disparities between urban and rural healthcare systems, limited awareness, and socio-economic barriers continue to widen the treatment gap.
Firstpost talked to Dr. Sankalp Mohan, Senior Consultant Neurology at Fortis (Manesar) to shed light on the early red flags for parents, the psychological impact of the condition and how cutting-edge technology is bridging the care gap between urban centers and rural heartlands.
Warning signs of childhood epilepsy
Dr. Sankalp: Epilepsy in children often shows up in ways that are easy to miss. Parents should look beyond dramatic convulsions and watch for repeated blank stares, sudden pauses in activity, brief jerks of the limbs, unexplained falls or episodes of confusion. Seizures may be generalised or focal, which may arise from a specific area of the brain. Subtle signs like lip-smacking, repetitive movements, sudden fear or inappropriate laughter can be present. In infants, specific flexion of the body with a head nod forward—also known as “salaam spells” should be looked for. What matters most is repetition: events that look similar each time. Any loss of previously achieved developmental milestones should be treated as a red flag. Early recognition allows timely treatment.
Developmental and psychological impact of epilepsy
Dr Sankalp: Epilepsy can affect a child far beyond seizures alone. Frequent or uncontrolled seizures may interfere with attention, memory, language and academic performance. Some children experience developmental delays while others struggle with anxiety, low confidence or depression. The fear of having a seizure in public can lead to isolation or withdrawal from school and peer activities. That said, many children with epilepsy develop normally, especially when seizures are well-controlled. Early diagnosis, appropriate medication, psychological support and school-based accommodations are key. Managing epilepsy as both a neurological and psychosocial condition is essential for a child’s long-term well-being.
What gaps exist between rural and urban epilepsy care?
Dr Sankalp: The gap between rural and urban epilepsy care is largely one of access and awareness. Urban centres usually have neurologists, EEG and MRI facilities, and specialised epilepsy clinics. In contrast, rural areas often lack trained specialists, leading to delayed diagnosis, misdiagnosis, or inappropriate treatment. Patients may rely on unqualified providers or discontinue medicines due to cost and poor availability. Social stigma and myths about epilepsy remain stronger in rural communities. In India, especially in rural communities, seizures are believed to be caused by a diety or “divine punishment”. Families take help from religious leaers or faith healers. Distance, loss of daily wages and limited follow-up add to the challenge.
Can awareness reduce epilepsy stigma?
Dr Sankalp: Awareness is one of the most powerful tools in epilepsy care. Misconceptions such as epilepsy being contagious, supernatural, or a mental illness continue to drive stigma and discrimination. Public education helps shift epilepsy into the category of a treatable medical condition, encouraging families to seek timely care and adhere to treatment. Awareness also equips teachers, employers, and peers to respond appropriately during seizures and support inclusion. Media has a crucial role in shaping the understanding of epilepsy. Responsible reporting can reduce fear and enhance empathy. Digital media ,short videos, podcasts allow doctors and patients to share accurate relatable content.
AI’s role in epilepsy diagnosis and monitoring
Dr Sankalp: Artificial intelligence is increasingly supporting clinicians in epilepsy care. AI-powered tools can analyse EEG recordings to detect seizure patterns more quickly and accurately, particularly in long-term monitoring. In brain imaging, AI assists in identifying subtle structural abnormalities linked to epilepsy. Wearable devices and smartphone-based technologies now use AI to detect seizures through movement and physiological changes, providing real-time alerts to caregivers. These tools are especially useful for nocturnal seizures and patients unable to report events reliably. While AI does not replace clinical expertise, it enhances precision, speeds up diagnosis and improves continuous monitoring, especially in settings with limited specialist availability.
Can telemedicine expand rural epilepsy care?
Dr Sankalp: Telemedicine has made a meaningful difference in epilepsy care, particularly in remote and underserved regions. Virtual consultations reduce the need for long-distance travel and enable regular follow-up, medication adjustments, and caregiver education. Patients with chronic epilepsy benefit from continuity of care without repeated hospital visits. Telemedicine also allows local doctors to consult specialists, improving diagnostic accuracy and treatment decisions. While challenges such as internet access and digital literacy persist, tele-neurology has helped bridge long-standing gaps in specialist care. For a lifelong condition like epilepsy, this model has improved adherence, reduced treatment delays, and enhanced overall outcomes.
Advances shaping epilepsy treatment
Dr Sankalp: Epilepsy care is entering an era of precision medicine. Advances in genetics are helping identify specific epilepsy syndromes, enabling more targeted treatments. Monitoring allows precise correlation between clinical events and brain activity. High resolution MRI techniques, now helps detect subtle abnormalities that were previously missed. Prolonged Video EEG monitoring allows precise correlation between clinical events and brain activity. Wearable EEG devices are being used especially when monitoring facilities are limited. Newer anti-seizure medications are offering better seizure control with fewer side effects. For drug-resistant epilepsy, minimally invasive surgical techniques, neurostimulation devices, such as vagal nerve stimulation are improving seizure control in selected patients. Together, these advances are moving epilepsy management beyond seizure control toward a more personalised ,patient-centred approach.
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