It is the most difficult survey that we have encountered so far. Even in various medical camps that we hold from time to time, history of epilepsy or convulsions are not forthcoming. On hearing the word 'epilepsy', especially in most rural or backward areas, where people are not so educated, the audience tend to remain tight-lipped, as if they are concealing something.



Even in our day-to-day practice, patients do not like to label themselves as epileptic, and many a time, a bona fide patient goes on taking medicine from some outside practitioner, silently, so that no one gets to know about his disease, at his place of work.

Patients are not always at fault; social factors come in their way. Several problems arise for them or for their families, once it comes to be known that the person is epileptic. In any case, marriage is a big problem for the patient. If the patient is married, the problem may occur in respect of the marriage of his/her children, for though heredity has a limited role in this disease, the boy's/ girl's family may think that the disease runs in the family.

If the patient is working in the private sector, he may not be assigned essential duties.

Similarly, a child may not feel comfortable in school, although he may be good in his studies as well as in sports. He may be refused entry in a team for competition. The child suffers both ways. If he does not take the medicine, i.e. he conceals his disease, he can hardly carryon with his studies, especially when the attacks are frequent. If his disease comes in everyone's knowledge, although he may take suitable treatment at an appropriate place and his attacks are also controlled satisfactorily, he may suffer due to the ignorance of others. He may feel isolated when class-mates/teachers do not co-operate with him. Even at home he may, at times, find an adverse atmosphere.

It is for these reasons that a physician never labels a case epileptic, unless he is satisfied from all angles, i.e., clinical, investigations, etc. In a doubtful case, the diagnosis is never declared, or is withheld till the patient gets another attack of epilepsy. It is worth mentioning that a delay in diagnosis will not harm the person, but a false-positive diagnosis may, indeed, prove fatal.

Hence a massive awareness is required so that the patients themselves report for a check-up, and the disease is controlled in time. This will save the family and the patient from further misery.

Another important factor which poses a practical problem in such a mass survey is the lack of availability of eyewitnesses, since the diagnosis of the disease is a clinical one, and mostly depends on the information of a person who has seen the patient during the period of the attack. Therefore, in such a survey, the full co-operation of the whole area/place including family members/friends is required in identifying such occult/ hidden cases of epilepsy.

The foremost task relating to mass awareness is that people should be guided about the treatable nature of the disease, through -magazines, newspapers, radio, TV, pamphlet etc., emphasizing that the disease is neither a shame nor disgrace in society, and that it is only one of the common diseases. Once guided, people will themselves approach the physician for treatment, and even the eyewitnesses will fully co-operate. Till this is accomplished, no mass survey, however efficient, will be able to control the disease.