Epilepsy-Related Misconceptions, Cultural Beliefs, and Their Impact on Health Outcomes: A Systematic Review

Epilepsy is still a highly stigmatized neurological condition globally, and health outcomes in patients are greatly impacted by cultural misunderstandings. Treatment delays, poor adherence, and social isolation can result from misconceptions that attribute epilepsy to supernatural origins, contagion, or genetic factors. This is especially true in low- and middle-income countries (LMICs). In light of this, we conducted this systematic review to analyze various aspects related to the topic. Out of 499 publications that were retrieved using Semantic Scholar, 40 research articles from Africa, Asia, Europe, and the Americas were examined. Cultural attitudes, stigma, and epilepsy health outcomes were the main topics of the inclusion criteria. To assess misunderstandings, social consequences, healthcare-seeking behaviors, and the efficacy of interventions, data were thematically synthesized. In 66-72% of the groups examined, supernatural beliefs (such as witchcraft and curses) were common, which resulted in a preference for traditional healers and a delay in receiving care. Stigma took the form of prejudice in marriage, job (72% exclusion from the workplace), and education (66% opposed education for individuals with epilepsy in Rwanda). In LMICs, interventions such as culturally sensitive treatment and community education increased adherence but were not scalable. Cultural misconceptions perpetuate epilepsy-related stigma and poor health outcomes. Effective strategies require integrated approaches combining biomedical care with community-based education and policy reforms. Future research should prioritize scalable, culturally adapted interventions to reduce the global epilepsy "treatment gaps."