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Year : 2014  |  Volume : 62  |  Issue : 6  |  Page : 606--609

Epilepsy: Some controversies, some knowledge and some experience from Cambodia

1 Cambodian Society of Neurology; Department of Neurology, Calmette Hospital, Phnom Penh, Cambodia
2 Cambodian Society of Neurology; Department of Neurology, Kossamak Hospital, Phnom Penh, Cambodia
3 Cambodian Society of Neurology; Department of Neurology, Calmette Hospital; Department of Neurology, University of Health Sciences, Phnom Penh, Cambodia
4 Cambodian Society of Neurology, Calmette Hospital, Phnom Penh, Cambodia

Correspondence Address:
Devender Bhalla
Cambodian Society of Neurology, (An Entity Approved by the Government of Cambodia), 21 A, Street 261, Sangkat Teuk La Ak II, Khan Toul Kork, Phnom Penh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.149376

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Epilepsy-related health outcomes remain unacceptably low in much of the developing world. According to us, it is because of the failure since long to see, and address, epilepsy beyond its preset conventional image. The objective of this paper was to highlight the presence, and influence, of these conventional practices and also to demonstrate what happened when a bold unconventional approach to address epilepsy was taken in Cambodia. Data are taken from existing published literature on epilepsy as well as our field experience during several population-based surveys conducted in Cambodia. We complimented this with our knowledge gained over this long period. It is demonstrated that epilepsy is far more important in Asia that it is currently considered to be, and also vis-à-vis other geographic regions. Pregnancy and birth-related factors carry far higher odds for epilepsy than several "highly vocal" infections. A refocus in epilepsy is required to help move from its traditional negative image to an image where epilepsy is considered a "positive-looking" disorder that is full of "opportunities;" such as availability of safe effective inexpensive treatment, etc. Stigma is a two-side entity (i.e., it is present, and it is influential), and diligence should be therefore practiced before using the stigma label. Nevertheless, psychosocial aspects shouldn't be limited to stigma or Jacoby stigma scale alone. Quality of life is a subjective phenomenon, and patients should determine directly what affects them. It is highly desirable that if we want to find newer answers to old problems in epilepsy, we need to shed our conventional approach and preset conclusions. We should choose to move toward "opportunities" visibly present in epilepsy. Our Cambodian experience demonstrates more intimately that opportunities do get identified when preset conclusions are questioned, and an approach that goes beyond expected and by default is taken.


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