Epilepsy in low- to middle-income countries

Area of Science:

• Global Health
• Neurology
• Public Health Policy

Background:

• Epilepsy affects a disproportionate number of individuals in low- and middle-income countries (LMICs).
• Significant diagnostic and treatment gaps persist in these regions.
• Cultural, socioeconomic, and infrastructural factors contribute to the epilepsy treatment gap.

Purpose of the Study:

• To highlight recent developments in epilepsy care.
• To showcase practical opportunities for improving epilepsy care in resource-limited settings.
• To address the persistent diagnostic and treatment gaps in LMICs.

Main Methods:

• Review of recent advancements in epilepsy diagnostics and therapeutics.
• Analysis of implementation strategies for global health action plans.
• Exploration of community engagement models to reduce stigma.

Main Results:

• Implementation of WHO Intersectoral Global Action Plan (WHO IGAP) and Mental Health Gap Action Program (mhGAP) can reduce the epilepsy education gap.
• Engaging community leaders and traditional healers can help reduce stigma associated with epilepsy.
• Development of tools like the Epilepsy Diagnostic Companion and 3-D printable EEG headsets shows promise for improved diagnosis in primary care and remote areas.
• Inclusion of levetiracetam on the WHO Essential Medicines List (EML) offers safer antiseizure medication (ASM) options.
• Epilepsy surgery programs present a potentially curative treatment option, even in LMICs.

Conclusions:

• Mobile applications, novel EEG prototypes, enhanced access to ASMs, and WHO iGAP implementation offer tangible opportunities to improve epilepsy care in LMICs.
• Facilitating bidirectional learning can extend benefits to underserved populations in high-income countries as well.