title: The dilemma of arranged marriages in people with epilepsy. An expert group appraisal.
abstract: Matrimony remains a challenging psychosocial problem confronting people with epilepsy (PWE). People with epilepsy are less likely to marry; however, their marital prospects are most seriously compromised in arranged marriages.
  
  
  
  The aim of this study was to document marital prospects and outcomes in PWE going through arranged marriage and to propose optimal practices for counseling PWE contemplating arranged marriage.
  
  
  
  A MEDLINE search and literature review were conducted, followed by a cross-disciplinary meeting of experts to generate consensus.
  
  
  
  People with epilepsy experience high levels of felt and enacted stigma in arranged marriages, but the repercussions are heavily biased against women. Hiding epilepsy is common during marital negotiations but may be associated with poor medication adherence, reduced physician visits, and poor marital outcome. Although divorce rates are generally insubstantial in PWE, divorce rates appear to be higher in PWE undergoing arranged marriages. In these marriages, hiding epilepsy during marital negotiations is a risk factor for divorce.
  
  
  
  In communities in which arranged marriages are common, physicians caring for PWE are best-equipped to counsel them about their marital prospects. Marital plans and aspirations should be discussed with the family of the person with epilepsy in a timely and proactive manner. The benefits of disclosing epilepsy during marital negotiations should be underscored.
authors.affiliation: Department of Neurology, Dayanand Medical College, Ludhiana, India. Electronic address: g.singh@ucl.ac.uk.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Singh
authors.affiliation: Department of Neurology, Mahatma Gandhi Memorial Medical College, Indore, India.
authors.forename: Apoorva
authors.initials: A
authors.lastname: Pauranik
authors.affiliation: Department of Neurology, Narayana Medical College, Nellore, India.
authors.forename: Bindu
authors.initials: B
authors.lastname: Menon
authors.affiliation: Department of Neurology, Dayanand Medical College, Ludhiana, India.
authors.forename: Birinder S
authors.initials: BS
authors.lastname: Paul
authors.affiliation: UCL Institute of Neurology, Queen Square, London, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Selai
authors.affiliation: G.B. Pant Hospital, New Delhi, India.
authors.forename: Debashish
authors.initials: D
authors.lastname: Chowdhury
authors.affiliation: Department of Neurology, Himalayan Institute Hospital Trust University, Dehradun, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Goel
authors.affiliation: Department of Neurology, Sagar Hospital, Bengaluru, India.
authors.forename: H V
authors.initials: HV
authors.lastname: Srinivas
authors.affiliation: Department of Anatomy, Dayanand Medical College, Ludhiana, India.
authors.forename: Hitant
authors.initials: H
authors.lastname: Vohra
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Duncan
authors.affiliation: Wanted Umbrella, New Delhi, India.
authors.forename: Kalyani
authors.initials: K
authors.lastname: Khona
authors.affiliation: Department of Neurology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Modi
authors.affiliation: Janakpuri Superspecialty Hospital, New Delhi, India.
authors.forename: Man Mohan
authors.initials: MM
authors.lastname: Mehndiratta
authors.affiliation: Department of Neurology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Parampreet
authors.initials: P
authors.lastname: Kharbanda
authors.affiliation: Department of Neurology, Dayanand Medical College, Ludhiana, India.
authors.forename: Parveen
authors.initials: P
authors.lastname: Goel
authors.affiliation: Department of Neurology, Fortis Hospital, Mumbai, India.
authors.forename: Pravina
authors.initials: P
authors.lastname: Shah
authors.affiliation: Department of Neurology, Dayanand Medical College, Ludhiana, India.
authors.forename: Rajinder
authors.initials: R
authors.lastname: Bansal
authors.affiliation: Center for Women's Development Studies, New Delhi, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Addlakha
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Indian Epilepsy Centre, New Delhi, India.
authors.forename: Satish
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Neurology, K.E.M. Hospital, Mumbai, India.
authors.forename: Urvashi
authors.initials: U
authors.lastname: Shah
authors.affiliation: Indian Epilepsy Association, Gurgaon, India.
authors.forename: V S
authors.initials: VS
authors.lastname: Saxena
authors.affiliation: Human Rights Law Network, Chandigarh, India.
authors.forename: Veena
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Neurology, Mangesh Neuro Centre, Indore, India.
authors.forename: V V
authors.initials: VV
authors.lastname: Nadkarni
authors.affiliation: Samvedana Epilepsy Group, Pune, India.
authors.forename: Yashoda
authors.initials: Y
authors.lastname: Wakankar
mesh_terms: D032921:Consensus; D004243:Divorce / Q000523:psychology*; D004644:Emotions; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology*; D014342:Truth Disclosure
keywords: Divorce; Epilepsy; Marriage; Outcome