Epilepsy: treatment in developing countries

Introduction
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By Manjari Tripathi MD

About 90% of persons with epilepsy inhabit the developing world. Recent studies in developed and developing countries have shown that up to 70% of newly diagnosed children and adults with epilepsy can be successfully treated with antiepileptic drugs; however, of the 35 million people with epilepsy who live in developing countries, around 85% receive no treatment at all (Kale 2002; World Health Organization et al 2005). As a consequence, they experience morbidity related to seizures and the psychosocial consequences of stigma and discrimination. Most of these people – many of whom are children – could have their seizures completely controlled and return to a normal life by taking a single daily dose of a drug that costs less than $3 per year (Kwan and Brodie 2004). Conducting clinical trials in resource-restricted countries is difficult (Perucca 2007), and there are wide treatment gaps in these regions that need to be narrowed. Regrettably, patients with intractable epilepsy and seizures that could have otherwise been prevented continue to suffer endlessly in need of medication, facilities for epilepsy surgery, and education about the disease.