Medical Treatment of Epilepsy in Resource-Poor Countries
Simon Shorvon MA MB BChir MD FRCP
Professor in Clinical Neurology and Consultant Neurologist
UCL Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
Search for more papers by this authorEmilio Perucca MD PhD FRCP(Edin)
Professor of Medical Pharmacology and Director, Clinical Trial Center
Clinical Pharmacology Unit, Department of Internal Medicine and Therapeutics University of Pavia, C. Mondino National Neurological Institute Pavia, Italy
Search for more papers by this authorJerome Engel Jr. MD PhD
Jonathan Sinay Distinguished Professor of Neurology and Director UCLA Seizure Disorder Center
Neurobiology, and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
Search for more papers by this authorSummary
The World Health Organization estimates that epilepsy causes 6.4 million disability adjusted life-years and 1.32 million years of life lost worldwide, with an estimated worldwide prevalence of 43 million people, of whom 80% live in low and middle income countries (LAMICs). Available data exist for over 25 different medications used in the treatment of epilepsy with more than half having been developed in the past two decades. However, in most LAMICs only the standard antiepileptic drugs and the benzodiazepines are readily available. Epilepsy service organization in LAMICs is hampered for the various reasons and no single approach is suitable for every LAMIC. An attempt to construct a sustainable programme for epilepsy care in LAMICs should first identify the local, regional and national burden of the disease. The medical management of the epilepsies in LAMICs is no different in some respects from that in high-income countries.
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