Source of Support: None, Conflict of Interest: None
One hundred consecutive adults with epilepsy attending the outpatient clinic for the first time were interviewed to find out the various belief-based rituals practiced by them for the control of epilepsy. They were compared with a control group consisting an equal number of patients with chronic daily headache. The various rituals practiced by them were 1. Exorcism to expel the demon in 22% of the study and 4% of the control group (p value < 0.00015). 2. Tying "Thayathu" around neck, loin or arm in 29% of the study and 10% of the control group(p value <0.00069), 3. wearing "Kappu" (a metal ring) around wrist in 13% of the study group and none in the control group and 4. Tying "Holi thread" around wrist, neck or loin in 22% of the study group and 10% of the control group(p value>0.021). Any one of the above rituals was performed by 51% of the study group and 17% of the control group (p value <0.0001). Most of the patients who practiced the rituals were from suburban towns and rural areas. The mean delay in seeking medical treatment for epilepsy was 26 months among those who performed rituals and 19 months in the rest. During the ictal phase of the seizure, iron made objects such as key, chain, a rod or pipe was thrust into the hand of 80% of patients by a bystander or a relative for the control of convulsion, without providing first aid. The importance of epilepsy awareness programmes for the rural and suburban community as well as health professionals is stressed.