CLINICAL PATTERNS, AETIOLOGIES, AND TREATMENT OUTCOMES OF EPILEPSY ACROSS AGE-AT-ONSET GROUPS IN NORTHEAST INDIA: PROSPECTIVE REAL-WORLD EVIDENCE ALIGNED WITH WHO IGAP
Author(s)
RUBY KASANA, PhD1, Mausumi Barthakur, MD, PhD2, Krishnapriya Velayudhan, iPHD3, Amit Ranjan Barua, MD, DNB2, Nomal Chandra Borah, MD, DNB4, Krishna Undela, PhD5.
1PhD Scholar, NIPER Guwahati, Assam, India, 2GNRC Institute of Medical Sciences, North Guwahati, India, 3NIPER Guwahati, Guwahati, India, 4GNRC Hospitals, Guwahati, India, 5NIPER Guwahati Assam, Guwahati, India.
1PhD Scholar, NIPER Guwahati, Assam, India, 2GNRC Institute of Medical Sciences, North Guwahati, India, 3NIPER Guwahati, Guwahati, India, 4GNRC Hospitals, Guwahati, India, 5NIPER Guwahati Assam, Guwahati, India.
OBJECTIVES: To characterise the clinical patterns, aetiologies, and treatment outcomes of epilepsy across age-at-onset groups using prospective real-world evidence, aiming to inform equitable, affordable epilepsy care in resource-limited settings.
METHODS: A prospective observational study was conducted at a tertiary care hospital from 2022 to 2025. Patients diagnosed according to the International League Against Epilepsy (ILAE) 2014 criteria and classified using the ILAE 2017 framework were enrolled regardless of age or sex. Data were collected from medical records, such as clinical history variables, investigation findings, and treatment outcomes. Associations were analysed using Pearson's chi-square test (p<0.05) in SPSS.
RESULTS: A total of 1,047 patients with epilepsy were enrolled (56.3% male; 83.4% from rural areas). Adult-onset was most common (32.6%), then childhood-onset (26.5%). Structural aetiology led (56.4%), mainly post-traumatic gliosis (29.8%) and post-hypoxic encephalopathy (21.3%). Adult-onset had higher EEG abnormalities (31.9%), neuroimaging issues (38.9%), and status epilepticus (40.9%) (all p<0.001). Seizure freedom was achieved in 61.3%; drug-resistant epilepsy detected in 19.3%, especially in childhood-onset (35.6%) and structural causes like mesial temporal sclerosis (p<0.001). Comorbidities like cognitive, psychiatric, hypertension, and diabetes were higher in adult-onset (all p<0.001).
CONCLUSIONS: The study highlights a preventable burden of structural epilepsy and drug resistance in Northeast India. Post-traumatic and post-HIE gliosis are leading causes, revealing gaps in neonatal care and road safety. Targeted interventions in prenatal care, care of newborns, prevention of infections and communicable diseases, awareness regarding remote symptomatic seizure with childhood febrile convulsion and its management, early diagnosis of refractory seizure, comprehensive epilepsy care, including epilepsy surgery, are urgently needed. Social stigma associated with epilepsy and its treatment needs to be removed. Social stigma is also one important point for this treatment gap. These findings align with the World Health Organization’s Intersectoral Global Action Plan on epilepsy 2022-2031 priorities and support evidence-based, patient-centred epilepsy care strategies across developing regions.
METHODS: A prospective observational study was conducted at a tertiary care hospital from 2022 to 2025. Patients diagnosed according to the International League Against Epilepsy (ILAE) 2014 criteria and classified using the ILAE 2017 framework were enrolled regardless of age or sex. Data were collected from medical records, such as clinical history variables, investigation findings, and treatment outcomes. Associations were analysed using Pearson's chi-square test (p<0.05) in SPSS.
RESULTS: A total of 1,047 patients with epilepsy were enrolled (56.3% male; 83.4% from rural areas). Adult-onset was most common (32.6%), then childhood-onset (26.5%). Structural aetiology led (56.4%), mainly post-traumatic gliosis (29.8%) and post-hypoxic encephalopathy (21.3%). Adult-onset had higher EEG abnormalities (31.9%), neuroimaging issues (38.9%), and status epilepticus (40.9%) (all p<0.001). Seizure freedom was achieved in 61.3%; drug-resistant epilepsy detected in 19.3%, especially in childhood-onset (35.6%) and structural causes like mesial temporal sclerosis (p<0.001). Comorbidities like cognitive, psychiatric, hypertension, and diabetes were higher in adult-onset (all p<0.001).
CONCLUSIONS: The study highlights a preventable burden of structural epilepsy and drug resistance in Northeast India. Post-traumatic and post-HIE gliosis are leading causes, revealing gaps in neonatal care and road safety. Targeted interventions in prenatal care, care of newborns, prevention of infections and communicable diseases, awareness regarding remote symptomatic seizure with childhood febrile convulsion and its management, early diagnosis of refractory seizure, comprehensive epilepsy care, including epilepsy surgery, are urgently needed. Social stigma associated with epilepsy and its treatment needs to be removed. Social stigma is also one important point for this treatment gap. These findings align with the World Health Organization’s Intersectoral Global Action Plan on epilepsy 2022-2031 priorities and support evidence-based, patient-centred epilepsy care strategies across developing regions.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH6
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Injury & Trauma, SDC: Neurological Disorders