EPILEPSY - Dr Navneet Kumar MD,DM(Neurology)

Disease Information
Common Myth & Misconceptions
Frequently asked questions(FAQs):
Pioneering work of Dr Navneet Kumar on Epilepsy:
Multimedia
Important Links

Disease Information :

Neuropsychiatric disorders which, although not usually immediate cause of death, can cause a substantial amount of suffering during lifetime of a person. The estimate of the burden from mental and neurological disorders is huge when disease burden measurement includes years lived with disability. Currently about 450 million people worldwide suffer from these disorders – one in four people will be affected at some point during lifetime. In the South East Asia region of WHO, 27% of disability is due to neuropsychiatric disorders, including epilepsy. Epilepsy occurs in men & women & can begin at any age. Up to 5% of the world’s population may have a single seizure at some time in their lives, but a diagnosis of epilepsy is reserved for those who have recurring seizures, i.e. at least two unprovoked seizures.

Epilepsy affects about 1% of the population of the South East Asia Region of WHO. Thus there are approximately 15 million people with epilepsy in this region.Despite global advances in modern medicine, epilepsy continues to be surrounded by myths and misconceptions. Patients with epilepsy may be taken to faith healers rather than medical doctors, and only 10-20% of all patients with epilepsy receive appropriate treatment. People with epilepsy & their families have suffered ostracism by society & deprived of treatment, leading to frequent injuries and sometimes, death. The situation is particularly bad in rural & remote areas where almost no services for epilepsy are available. It is a fact that 70-80% of people with epilepsy can lead normal lives if properly treated, it is time to introspect as to why epilepsy are not being treated at all. We must try to find an answer and take appropriate action now.

Common Myth & Misconceptions :

Epilepsy, regardless of its immediate causation, is frequently thought of as a punishment for evil deeds or the breaking of certain taboos. These myths and misconceptions often prevent people with epilepsy from seeking medical treatment. The strange behaviour caused by some forms of epilepsy has led to a common rural belief that epilepsy is due to “possession by spirits”. In some parts of India, Indonesia, Nepal, Sri Lanka and Thailand, people believing in supernatural powers at work offer worship and animal sacrifice. In some rural areas of India, attempts are made to exorcise evil spirits from people with epilepsy. In Indonesia, epilepsy is often considered as a punishment from unknown dark forces.

Some myths prevalent in South-East Asia…

Myth: Epilepsy is due to possession by evil spirits. Take the person to a sorcerer and have these spirits exorcised.

Fact: Epilepsy is a medical disorder. It is now easy to treat with modern medication, so patients should be taken to doctors.

Myth:Never touch a patient having a seizure. The disorder will be passed on to you.

Fact: The patient having a seizure needs your help and should be given appropriate care. Epilepsy cannot be passed on to others by touching the patient.

Myth:Someone with epilepsy brings stigma to the family, so this should be concealed.

Fact: Unfortunately, the stigma against people with epilepsy and their families continues to be widely prevalent. Every effort should be made to remove this stigma through education.

Myth:Epilepsy is a form of madness, so it should be treated in a lunatic asylum.

Fact: Epilepsy is a disorder of the brain, so it should be treated by physicians, neurologists or psychiatrists

Myth: Women with epilepsy can never have children, so they should never marry.

Fact:Most women with epilepsy can safely have children, with no adverse effects on the baby. Marriage of women with epilepsy is a delicate and sensitive issue and should be handled appropriately. There is no bar against marriage.

Frequently asked questions(FAQs) :

Epilepsy Basics

1. What is epilepsy?

Epilepsy is a chronic disorder of the brain that affects people worldwide. It is characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized), and are sometimes accompanied by loss of consciousness and urinary and/or fecal incontinance.

Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures can also vary in frequency, from less than 1 per year to several per day.

One seizure does not signify epilepsy (up to 10% of people worldwide have one seizure during their lifetime). Epilepsy is defined as having 2 or more unprovoked seizures.

2. How long do seizures usually last?

Usually, a seizure lasts from a few seconds to a few minutes. It depends on the type of seizure.

3.What are the major types of epilepsy?

Sometimes it is hard to tell when a person is having a seizure. A person having a seizure may seem confused or look like they are staring at something that isn’t there. Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.

Seizures are classified into two groups.

Generalized seizures affect both sides of the body.
Focal seizures affect just one area of the body. These seizures are also called partial seizures.

A person with epilepsy can have more than one kind of seizure

4: If I have a seizure, does that mean I have epilepsy?

Not always. Seizures can also happen because of other medical problems. These problems include:

A high fever

Low blood sugar

Alcohol or drug withdrawal

5.What causes epilepsy?

Epilepsy can be caused by different conditions that affect a person’s brain. Some known causes include:

Cryptogenic or Idiopathic – In about 50% of patients, the cause of epilepsy is unknown
Traumatic brain injury or head injury.
Brain infection, like neurocysticercosis.
Birth injury
Stroke.
Brain tumor.
Neurocutaneous syndromes

Managing Epilepsy

1. How is epilepsy diagnosed?

If you have had two or more seizures that started in the brain you may be diagnosed with epilepsy. Getting a diagnosis is not always easy as there is no single test that can diagnose epilepsy. Diagnosing epilepsy usually involves collecting information from different tests, finding out what happens before, during and after your seizures, and speaking to someone else who might have seen your seizures. With all the collected information the most likely cause of your seizures may be found.

2. What tests might I have?

Your neurologist or specialist may ask you to have some tests to get extra information about your seizures.

Tests to diagnose epilepsy

No test can say for certain that you do or do not have epilepsy. But when the information from the tests is added to the description of what happens during your seizures, this builds up a clearer picture of what happened. This can help with the diagnosis and when choosing treatment.

Electroencephalogram (EEG)

An EEG is used to record the electrical activity of the brain by picking up the electrical signals from the brain cells. These signals are picked up by electrodes on the head and are recorded on paper or on a computer.

What does an EEG show?

An EEG gives information about the electrical activity of the brain during the time the test is happening. When someone has an epileptic seizure their brain activity changes. This change, known as epileptiform brain activity, can sometimes be seen on an EEG recording. Some people can have epileptiform brain activity even when they do not appear to be having a seizure, so an EEG can be particularly useful for them. Epileptiform activity can sometimes be provoked (brought on) by deep breathing. The test may include deep breathing to see if epileptiform activity can be provoked and recorded.

Brain scans

A brain scan may help to find the cause of your seizures. The scan produces pictures of the brain which might show a physical cause for epilepsy, such as a scar on the brain. But for many people a brain scan does not show up a cause for their seizures, and even if no physical cause is seen, the person may still have epilepsy. The two common types of brain scan are Magnetic Resonance Imaging (MRI) and Computerised Axial Tomography (CT or CAT).

Magnetic Resonance Imaging (MRI) scan

An MRI scan looks at the structure of the brain and may help to find the cause of your epilepsy. During the scan detailed pictures are produced using strong magnetic fields. Because of the magnetic fields, metal objects in or near the machine can affect, or be affected by, the machine.

Computerised Axial Tomography (CT or CAT) scan

Some people may have a CT scan if they are not able to have an MRI scan. For example, if they have a heart pacemaker, if they might need to have an anaesthetic to have an MRI, or if information is needed quickly about what might be causing their seizures.

2.How is epilepsy treated?

Epilepsy is usually treated with anti-epileptic drugs (AEDs). AEDs aim to prevent seizures from happening but don’t cure epilepsy. Up to 70% (7 in 10) of people with epilepsy could have their seizures completely stopped with AEDs. AEDs do not stop seizures happening for everyone, so in refractory cases other types of treatment may be considered, such as vagus nerve stimulation therapy (VNS) or epilepsy surgery. Most people with epilepsy take anti-epileptic drugs to stop or reduce the number of seizures they have.

What is the aim of anti-epileptic drugs (AEDs)?

Anti-epileptic drugs (AEDs) are used to stop seizures. They make the brain less likely to have seizures by reducing the excessive electrical activity (or excitability) of the neurones (nerve cells) that normally cause a seizure. Different AEDs work in different ways but they all aim to stop seizures happening. Around 70% (70 in 100) of people with epilepsy could get seizure control (stop having seizures) with the right medication. ‘Optimal therapy’ is seizure control using the smallest dose of the fewest AEDs, and with the fewest side effects. Some people may not get complete seizure control, even though they have had the most suitable drug treatment. In this case they may need to take more than one type of AED, to reduce seizures as much as possible. Before starting on AEDs, it is important that your neurologist finds out as much as possible about your epilepsy. This is because the AED that they prescribe depends on the type(s) of seizures you have. Some AEDs work better for certain types of seizures, or types of epilepsy,than others. AEDs are taken every day to stop seizures happening. AEDs are needed to be taken over a number of years, Suddenly stopping AEDs can cause seizures to start again, or happen more often and last longer than before. Taking extra AEDs can cause side effects. For these reasons, changes to AEDs are best done with your neurologist.

What if AEDs are taken irregularly?

AEDs work best when they are taken regularly. This is because once taken, they start to be broken down and absorbed into the bloodstream, and go to the brain to start working. As time passes, the drug leaves the body, so the level of drug in the body goes down. Taking the drugs regularly means that the drug is ‘topped up’ so there is a steadier level in the body all the time. Although the exact timing of doses is not usually crucial, it is helpful to take the right dose around the same time or times each day, so that the doses are evenly spaced out.

AEDs and alcohol?

Whether to drink alcohol when taking AEDs is a personal choice. However, alcohol can trigger seizures, especially during a hangover. Alcohol can also affect how AEDs work, depending on the AED, the individual and how much they drink.

Effect on contraception, pregnancy and AEDs?

Some types of contraception are less effective for women taking some AEDs. This depends on the individual, which AEDs they take and the type of contraception they use. There is a chance that taking AEDs while pregnant may affect a developing baby. However, these risks need to be carefully considered for each person and balanced against the possibility of seizures happening during pregnancy, which may also affect a developing baby or the safety of the mother.

3.What are the side effects of epilepsy medicine?

As is true of all drugs, the drugs used to treat epilepsy have side effects. The occurrence of side effects depends on the dose, type of medicine, and length of treatment. The side effects worsen with higher doses but tend to be less severe with time as the body adjusts to the medicine. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier. Side effects of epilepsy drugs are variable and they depend from drug to drug in use.

4.What is epilepsy surgery?

Epilepsy surgery involves the surgical removal of the region of the brain responsible for the abnormal electrical signals that cause seizures. This region of brain is called the epileptogenic zone. It is determined by neuroimaging studies, electrical recordings from the scalp (EEG), and clinical signs during a seizure. Epilepsy surgery can provide a “cure” for epilepsy, in that it can eliminate the source of seizures and epilepsy.

5. What are the side effects of epilepsy medicine?

As is true of all drugs, the drugs used to treat epilepsy have side effects. The occurrence of side effects depends on the dose, type of medicine, and length of treatment. The side effects worsen with higher doses but tend to be less severe with time as the body adjusts to the medicine. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier. Side effects of epilepsy drugs can include blurry or double vision, fatigue, sleepiness, unsteadiness, stomach upset, skin rashes, low blood cell counts, liver problems, swelling of the gums, hair loss, weight gain, and tremor.

6. What is epilepsy surgery?

7. Who is a candidate for epilepsy surgery?

Generally, patients who have seizures that start in a focal area of the brain, and that have not been controlled with medicine, are considered for surgery. This region might be small or might involve several lobes of the brain. A comprehensive pre-surgical evaluation — starting with EEG-video monitoring and high-resolution brain MRI at an experienced epilepsy surgery center — is typically performed before a patient is recommended for epilepsy surgery.

8. What types of surgery are performed?

Surgery typically involves resection, or removing the abnormal portion of brain that is causing the seizures. Brain tumors, vascular (blood vessel) abnormalities, old strokes, and congenital malformations might also be treated if they are believed to be causing the seizures. The most common type of resective epilepsy surgery performed is the temporal lobectomy, which involves removing a portion of the temporal lobe, usually for a syndrome called mesial temporal sclerosis. Resection can be performed in other brain regions, such as the frontal lobe (frontal lobectomy), depending on where the epileptogenic zone is located. Prior to resection, surgery might be necessary to implant EEG electrodes directly on or in the brain to help localize the seizures. After seizures are recorded from these implanted electrodes, another surgery is performed to remove the electrodes and perform the resection. Other types of surgery might involve resection of more than one lobe or brain region. In severe cases, when an entire cerebral hemisphere is involved in the epilepsy, surgery might involve disconnecting that hemisphere from the rest of the brain.

9. What are other surgical treatments for epilepsy?

Vagal nerve stimulation (VNS) is another surgical option for the treatment of epilepsy. It involves implantation of an electrode that stimulates the vagus nerve, a nerve that travels through the neck and is connected to various areas of the brain. With this new treatment, approximately 40 percent to 60 percent of patients are helped, in that seizures might become less frequent or less severe. VNS is typically reserved for those epilepsy patients who are not candidates for resective surgery

Health and Safety Concerns

1.Are there special concerns for women who have epilepsy?

There are some issues around epilepsy and its treatment that are specific to women, and do not apply in the same way to men. These include links between epilepsy and hormones, puberty, contraception, pregnancy and the menopause.

Hormonal influences

Research has shown that for some women with epilepsy there may be a close link between hormones and epileptic seizures. Hormone levels can change throughout a woman’s life and may affect when her epilepsy starts, how often her seizures happen, and if and when she stops having seizures. Epilepsy can be different for everyone, and changing hormones may affect some women and not others. Oestrogen and progesterone are two hormones that are naturally produced in a woman’s body. These hormones can speed up or slow down brain activity, and can affect when a woman has seizures.

Contraception

There are many different methods of contraception. Some may be less effective in preventing pregnancy for women taking certain AEDs. This is because some AEDs affect how well methods of contraception work. AEDs are either enzyme-inducing or non-enzyme-inducing. Enzyme-inducing AEDs may affect methods of contraception that contain hormones, such as the Pill, or contraceptive implants. This is because they increase the amount of enzymes that break down hormones in the body. This means the hormones in contraceptives are broken down more quickly than usual, so they stay in the body for less time and are less effective in preventing pregnancy. If you take an enzyme-inducing AED, you may be advised by your doctors to use a method of contraception that is not affected by your AED, such as a barrier method, or to use more than one method to help prevent pregnancy.

Starting a family

Having epilepsy does not necessarily mean that starting a family will be any more difficult for you than for anyone else. However it may mean that you have a few more things to consider, such as AEDs or the effects of epilepsy on you and your baby. If you are thinking about becoming pregnant, you can ask to have preconception counselling with your GP, epilepsy specialist nurse or neurologist. This is an opportunity to talk through any issues you may have before becoming pregnant: to plan the pregnancy and to review your epilepsy and its treatment

The menopause

The menopause is the time in a woman’s life when her periods stop and she can no longer become pregnant. During the menopause, a women’s body stops making natural hormones and this can cause symptoms such as hot flushes and mood swings. Hormone replacement therapy (HRT) is sometimes used to treat these symptoms. HRT contains either oestrogen or a combination of oestrogen and progestogen. Oestrogen is known to have a pro-convulsant (seizure causing) effect for some women.

Osteoporosis

The mineral calcium is important for our bones. Vitamin D helps calcium to get into the bones, and the calcium helps to make the bones strong. When calcium is lost, bones become thinner, more brittle and break more easily. This is called osteoporosis. Osteoporosis can happen to anyone but it is more common in women than men, especially after the menopause. Epilepsy and taking AEDs may contribute to the risk of developing osteoporosis, but how much they contribute to this risk is not clear, and will vary from person to person.

2.Can a person die from epilepsy?

Most people with epilepsy live a full life. However, the risk of early death is higher for some. We know that the best possible seizure control and living safely can reduce the risk of epilepsy-related death. Factors that increase the risk of early death include:

More serious health problems, such as a stroke or a tumor. These conditions carry an increased risk of death and may cause seizures.
Falls or other injuries that happen because of seizures. These injuries can be life-threatening.
Seizures that last over 5 minutes. This is a condition called status epilepticus. Status epilepticus can sometimes happen when a person suddenly stops taking seizure medication.

Rarely, people with epilepsy can experience sudden unexpected death in epilepsy (SUDEP). SUDEP is not well understood and experts don’t know what causes it, but they suspect that it is sometimes due to a change in heart beats (rhythm) during a seizure. Sudden death due to heart rhythm changes also happens in people who do not have seizures.

The risk of sudden death is larger for people with major uncontrolled seizures.

3.If I have epilepsy, can I still drive a car?

Laws with regards to epilepsy and driving vary from country to country. In general, it is not advisable for persons with epilepsy to drive during the first two years of treatment. Some countries allow driving after an individual has been seizure free for two or more years. Those persons whose fits are not controlled should not drive any vehicle. Similarly, stricter precautions have to be followed for driving heavy goods vehicles or public transport vehicles. In any case, the driving of a vehicle by person with epilepsy should not be a source of danger to the public

4.If I have epilepsy, can I exercise and play sports?

Sometimes people with epilepsy worry that exercise or sports may worsen their seizures. Exercise is rarely a “trigger” for seizure activity. In fact, regular exercise may improve seizure control. Safely playing sports can also be great for your physical, mental, and emotional well-being. It is always important to avoid sports-related injuries that can increase the risk of seizures. Read more about safe physical activity for people with epilepsy on the Epilepsy 5. If I have epilepsy, can I still work?

Safety at work

Having epilepsy does not necessarily stop someone from doing the job they want, but there are some issues which can affect work. Risks to safety will depend on what your epilepsy is like and what the job involves. Some jobs may be a risk if you have seizures. For example, working at heights, around unguarded machinery or near open water. As each situation is different, your employer may need to do a risk assessment to look at how your epilepsy could affect your safety at work.

Schooling

1.Is any special care needed for children with epilepsy while at school or play?

Epilepsy is common in school going children. Most children with epilepsy can be in a normal class or school and have the same intelligence and learning abilities as compared to children without epilepsy. Some children (those with poorly controlled seizures or associated handicaps) may need special attention while at school and play. Children with epilepsy, whose fits are well controlled, must be encouraged to express their full potential as they can do as well as their peers. Children with poorly controlled seizures can be on multiple drugs and have associated physical or mental handicaps. They can have poor school performance due to frequent fits and effect of anti-epileptic drugs on the learning and memory. These situations should be recognized and proper attention given as and when possible. Such children should not be overprotected. Concern about safety of children with epilepsy may lead to them being stopped from their daily activities. Such restrictions are often unnecessary and should be individualized for each child. Children whose seizures are controlled can participate in most normal activities including sports, athletics, cycling etc. Even those who do not have complete control of seizures can carry out most such activities under supervision. Most children with epilepsy can watch TV and play with video games.

Prevention of Epilepsy –

How can I prevent epilepsy?

Sometimes we can prevent epilepsy. These are some of the most common ways to reduce your risk of developing epilepsy:

Have a healthy pregnancy. Some problems during pregnancy and childbirth may lead to epilepsy. Follow a prenatal care plan with your healthcare provider to keep you and your baby healthy
Prevent brain injuries.
Lower the chances of stroke and heart disease.
Be up-to-date on your vaccinations.
Wash your hands and prepare food safely to prevent infections such as cysticercosis.

Merriage & Pregnency

1: Can persons with epilepsy have a normal married life?

From a medical point of view, persons with epilepsy can marry. However, in some countries there have been laws and in others even now there are laws that prevent persons with epilepsy to marry. It is important that the would be spouse of a person with epilepsy should be aware of the situation. This prevents a lot of unnecessary misunderstandings later on in life. Counseling for marriage is a very delicate and special situation where extreme caution is necessary. The belief that epilepsy (especially in young girls) can be cured by marriage invariably complicates the whole problem and all efforts must be made to get rid of this notion. On the other hand, epilepsy should not be a bar to marriage in individuals with good seizure control. In a case where the seizures are too frequent with poor control, marriage may be inadvisable because of the obvious handicap. The individual should be told to inform the prospective marriage partner of the nature of the problem so that subsequent disasters can be avoided. It is useful to remember that anyone can have seizures and at any age. It should be understood that only some types of epilepsy have a hereditary basis. In such situations, the epileptic person is at risk of passing the epilepsy on to his/her children. In practical terms, the chance of one epileptic parent passing on epilepsy to the child is small. The risk of a child of an epileptic parent having epilepsy is only marginally higher than the risk of a child born to non-epileptic parents except when the parents have one of the well-defined hereditary epileptic syndromes. However, if both parents have epilepsy the risk of their children developing epilepsy is substantially higher than in general population. It is, therefore, medically recommended that most patients with epilepsy can marry and have children. As in many other situations, such decisions need to be taken separately for each individual keeping in mind many factors that may affect the decision. The marriageable girls with epilepsy must be reassured that most of the drugs can safely be continued throughout pregnancy and the risk of the baby is not greater than the harm that may be caused by stopping the treatment and precipitating seizures.

2: What is the effect of epilepsy on pregnancy and pregnancy on epilepsy?

It has been seen that in 1/4 of pregnant women with epilepsy the seizures can worsen, in another 1/4 the seizures can improve and in the remaining half there is no change in the seizure frequency during pregnancy. Epilepsy can affect the pregnancy in many ways. Seizures during pregnancy can harm both the pregnant woman and her baby, especially if the seizures are frequent. Practically all the drugs that are used to treat epilepsy have effect on the fetus. Carbamazepine is probably safer than other anti-epileptic drugs available today. On the whole, there may be about 2-3 times more risk of an abnormal baby being born to epileptic mothers who are on treatment as compared to the general population. Even with this increased risk, almost 90 to 95% epileptic mothers can have a normal baby. The anti-epileptic drugs must be continued in the same dosage during the entire pregnancy. Treatment with one drug is preferred as the harmful effects to the baby increase if more than one drug are used. Occasionally estimation of drugs level in the blood may be required. The delivery of epileptic mothers should always be carried out in a well-equipped medical setup (preferably in a hospital) with regular antenatal visits. It must again be pointed out that most of epileptic mothers usually have an eventful pregnancy and produce normal and healthy babies.

3: Can mothers with epilepsy breast feed their babies while taking anti-epileptic drugs?

Most of the anti-epileptic drugs taken by mothers are excreted in breast milk but their concentration varies according to chemical properties of the drug. Drugs like phenobarbitone can have significant concentration in the milk and infants being fed on such milk can be lethargic and irritable. Carbamazepine can also be present in low concentrations in breast milk but diphenylhydantoin and valproate rarely cause any problems. On the whole, most mothers having epilepsy can safely breast-feed their babies while taking their anti-epileptic drugs. In case of any problems, they should get in touch with their treating doctor.

Pioneering work of Dr Navneet Kumar on Epilepsy :

Contributions of Dr Navneet Kumar on EPILEPSY

Dr. Navneet is a general neurologist but is more interested in epilepsy. He has attended several International and national conferences and CME on epilepsy. He has managed more than around 15000 epilepsy patients till date. He recently organized National Epilepsy Update in Kanpur on 9th May 2015. His other pioneering work on epilepsy includes

Extramural ICMR funded Research Project as Principal Investigator:

Development and Evaluation of Training Module for health care workers for diagnosing epilepsy in community settings”. Started recently in collaboration between department of Neurology, GSVM Medical college Kanpur, MRHU Ghatampur & JALMA Agra.

Books Authored:

Text Books: 2

Navneet Kumar “ Epilepsy An overview for general Physician” Shagni Printech Pvt. Ltd. 1997.
Navneet Kumar “ Epilepsy An easy guide to causes, diagnosis and cure” Vitasta Publication Pvt. Ltd. 2009.

Hand Book: 1

Epilepsy facts & Fiction first edition: 2004, Second Edition:2013

Several book chapters in following books:

Epilepsy chapters in Neurology update 2003& 2007
Epilepsy – an easy guide to causes, diagnosis and cure 2008
Epilepsy – an overview for general physicians 1997

List of publications on Epilepsy:

Agarwal P, Kumar N, Gupta G. “Randomized study of intravenous valproate and phenytoin in status epilepticus “. Seizure, 2007, 16,527-532
Agarwal P, Kumar N. “Epilepsy in India -Nuptiality behaviour and fertility”. Seizure; 2006,15-409-415
Kumar N, Kumar V, Gupta S “Anti epileptic drugs” published in National Neurology Update: 2013; 45-52
Kumar N, Shukla A “Newer concepts in Epilepsy Management” published in Neurology Update: 2007; 69-78
Kumar N, Kumar A“Mind Management” published in Medicine Update: 2003. 3-6
Kumar N,. Gupta A.K “Juvenile Myoclonic Epilepsy” published in Neurology Update ; 2003. 1-4
Navneet Kumar “Management of convulsive status” Published in CME book of Neurology update 99 organized by K.G.M.C. Medical College, Lucknow.(1999)
Navneet Kumar, Dr.D.Nag, Dr.A.M.Kar, Dr.R.Narain, Dr.S.Sinha. Psychological disturbances associated with psychomotor epilepsy ( Complex partial seizure). Ind Jour of Clinical psychology ( 1987)
Article on – Non Pharmacological Tt of Epilepsy – Published in Text book of Epilepsy published by Academic wing of API .
Navneet Kumar, M.Kulshrestha, R.Chandra, Dwivedi, S.K. Saxena, I.N.Bajpai & V.Anand. Correlation of EEG & CT Scan with partial seizure.NSI Journal Suppl. Vol 44 No.4 (1996).

Multimedia :

Links Related to Important Websites :

Indian Epilepsy association:www.epilepsyindia.org
Epilepsy support group India:www.epilepsysupport.aarogya.com
World Health organization:www.who.int/mediacentre/factsheets/fs165/en
Centre for disease control, USA:www.cdc.gov/epilepsy
Raising child with special need :www.childraise.com
American Epilepsy society:www.epilepsy.com