Beneath the Seizures: A Closer look at Epilepsy's Demographic and Clinical Landscape in India- The REMAP study

Background: Epilepsy, a chronic neurological disorder, poses a significant burden globally—especially in low- and middle-income countries like India, where challenges such as underdiagnosis, limited care access, poor treatment adherence, and social stigma persist. This study explores the demographic, clinical, and treatment profiles, along with comorbidities, in a large Indian epilepsy cohort Methods: This retrospective, multicenter cross-sectional study across Indian healthcare settings collected data on demographics, seizure characteristics, lifestyle factors, treatment patterns, and comorbidities. Statistical analysis was conducted using SPSS, with significance set at p < 0.05. Results: The study analyzed 9,201 patients aged 18–80 years (mean age 43.3 ± 11.2 years). The mean age of epilepsy onset was 11 years, indicating early manifestation. Generalized tonic-clinic seizures were the most prevalent (61.9%), followed by focal seizures (38.1%). A positive family history was observed in 20% of cases. Comorbid psychiatric conditions were prominent, with depression reported in 34% of patients, followed by sleep disturbances (11.5%) and psychotic disorders (8.5%). Levetiracetam was the most frequently prescribed AED, with 78.9% of patients managed on monotherapy. Conclusions: This large-scale analysis offers valuable insights into the Indian epilepsy population, highlighting early-onset disease, the predominance of generalized seizures, and a substantial burden of psychiatric comorbidities—particularly depression. These findings emphasize the urgent need for improved diagnostic pathways, equitable treatment access, and integrated neuropsychiatric care to address the multifaceted needs of epilepsy patients in India.