Boris Mendelevich: ‘It is no secret that people with epilepsy are reluctantly employed’

International Epilepsy Day is celebrated on February’s second Monday

Boris Mendelevich: ‘It is no secret that people with epilepsy are reluctantly employed’
Photo: Maksim Platonov

Psychiatrist, the State Duma’s deputy from Tatarstan Boris Mendelevich talks about the disease that is spread around the world.

What epilepsy is

Epilepsy is a chronic disease of the brain characterised by repeated unprovoked fits with different signs.

According to the World Health Organization, over 50 million people live with this diagnosis around the world. Up to 70% of them can live without fits of this disease if they regularly take anti-seizure medications. But about three-fourths of people with epilepsy in low- and middle-income countries can’t receive due treatment. We should understand that epileptic manifestations are completely different, and this category of patients requires individual observation: though the disease has been long known, its genesis isn’t completely clear. The priority task in case of epilepsy is to control fits. Because most problems of people who suffer from epilepsy are linked not only with manifestations of the disease in the form of fits but serious psychological disorders: it is depression, anxiety, low self-esteem, problems of social isolation, unemployment.

Legislation has clearly outlined restrictions to social activity for epileptics: depending on the severity of the disease, they are recognised unfit or partly fit for active service. Photo: Oleg Tikhonov

Difficulties in socialisation

It is no secret that people with epilepsy are reluctantly employed, there are restrictions for them when choosing a job.

Patients face great difficulties in socialisation, moreover, not only in Russia but around the world in general. For instance, such people in China and India can be prohibited from getting married or the disease can be the only reason for unilateral annulment of marriage. It is not unusual in Russia when children with epilepsy aren’t admitted into kindergartens, they are forced to go to other schools. Adults don’t find it easier: it is harder for them to choose a job, study in universities, do sport. Some restrictions do have a real foundation, but one should understand that some of them come from insufficient awareness and prejudice.

Legislation has clearly outlined restrictions on social activity for epileptics: depending on the severity of the disease, they are recognised unfit or partly fit for active service, they can’t work in hazardous facilities, in the workplace linked with carrying weapons. People with epilepsy can’t work at height, railways, in the kitchen, in hospitals, kindergartens. The positions of driver, hairdresser, miner, geologist are also banned.

Such patients are very often not allowed to work without foundation: for instance, there are cases in which people are forced to resign from shops after fits. Every such a case requires appealing to a jurist — one certainly should prove one’s rights.

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People with epilepsy can’t work at height, railways, in the kitchen, in hospitals, kindergartens. Photo: Marat Gayfullin

How epilepsy is treated and diagnosed

Time doesn’t stay still. For instance, in recent years a lot of new medications have been added to the arsenal of modern medicine. Most of them are registered in our country as well and available for patients. Thanks to treatment, fits can not be manifested for years.

Significant steps have been made in diagnostics: if earlier electroencephalography (a method of diagnostics of electric activity of the brain by placing electrodes in certain areas) was the main protocol, now the arsenal of diagnosis specialists includes MRI, PET (positron emission tomography), thanks to which one can get more accurate and objective data. Due to this, it is possible to detect so-called symptomatic epilepsy — a series of fits caused by other diseases: exchange processes of the brain, benign tumours and so on. And with such diseases, there is a chance of coping with them and expelling them forever.

The diagnostics of the disease in general, indeed, has moved forward, and now 90% of pathologies are detected, and patients receive information about their health. There is also a possibility of undergoing surgery — such intervention is applied when medications don’t help, in the severest cases. The nidus of the disease is detected in this treatment, and it is either removed or localised.

The patient’s mood matters as well. Yes, the presence of the disease makes its amendments to the patient and his relatives’ way of life. But epilepsy isn’t a sentence. We live in the 21st century, and a lot has already changed. Experts recommend taking an active stance on the disease, regularly do check-ups, take medications and live a full life if possible considering the organism’s peculiarities, and I agree with them.

Significant steps have been made in diagnostics: if earlier electroencephalography was the main protocol, now the arsenal of diagnosis specialists includes MRT, PET (positron emission tomography), thanks to which one can get more accurate and objective data. Photo: Maksim Platonov

Like in case of any disease, relatives’ support is very important when one has epilepsy. It changes the life of not only the patient but also the life of his family and circle. The patients’ relatives and family should learn key facts about this disease, know how it is manifested and how a fit develops, how to give first aid. This will help prevent injuries the patient might have during a fit.

By Boris Mendelevich
Tatarstan