Source of Support: None, Conflict of Interest: None
Twenty three mentally retarded adults affected with epilepsy and institutionalised in a home were managed by us for more than 2 years. The peculiarities of the epilepsy and the various difficulties confronted while treating them are documented. All of them were retarded since birth or early childhood and dependent for guidance on the caregivers for self care and other day today activities. 1) A mixture of atonic and genralised tonic clonic seizure was observed in 22%. 2) Sixty nine percent had at least one attack of GTCS per week. 3) At the end of 2 years of adequate treatment 48% continued to have breakthrough seizure once in 2- 4 weeks. 4) Behaviour disorder was noticed in 65% (15) initially and with the control of epilepsy forced normalisation occurred in 33% (5) of them. The caregivers played the vital role in (a) identifying the type of seizure (b) administering the drugs regularly in spite of several difficulties and (c) observing as well as informing the physician about the adverse effect of the drugs and changes in the behaviour early. For successful management of mentally challenged epileptic adults, a well co-ordinated effort by both the physician and dedicated, knowledgeable caregivers is essential.