Some problems and pitfalls in developing countries

In developed countries with well-structured health care and reimbursement systems, epilepsy care is evidence based. By contrast, in developing countries, patients with epilepsy encounter several significant barriers to adequate treatment and are more often managed according to local ethnic, racial, religious, economic, educational, and cultural diversities. Cost is one issue that clearly determines antiepileptic drug (AED) selection, and it is reasonable to recommend one of the traditional, and cheaper, AEDs as first-line therapy. However, the appropriate choice of drug in an individual patient is a balance of efficacy, tolerability, and cost and should be tailored to individual affordability.