What is epilepsy and how is it treated?
Epilepsy is a chronic non-communicable disorder of the brain that affects an estimated 65 million people worldwide.
The disorder is characterized by recurrent seizures and affects people of all ages, including young children.
The risk of premature death for those with epilepsy is two-to-three times higher than for the general population.
Fear, misunderstanding, discrimination, and social stigma have surrounded epilepsy for centuries. Treatment often begins with diagnosis obtained through a patient history and/or an electroencephalogram (“EEG”) study, typically resulting in prescription of an anti-seizure medication (ASM). Epilepsy can be successfully treated with ASMs in about 70% of cases. In high-income countries, most people with epilepsy live seizure-free lives thanks to effective treatments that are widely available.
The Epilepsy Treatment Gap in Under-Resourced Regions
Approximately 80% of the estimated 65 million people with epilepsy live in lower-resource regions where access to appropriate care is lacking, stigma continues to be a huge problem, and people with epilepsy face limited healthcare and education options. While the gap in low- and middle-income countries (LMICs) is estimated at 75%, in many African countries a staggering 90% or more are left untreated. Just how big is the epilepsy treatment gap?
39 million people live with untreated epilepsy in LMICs...
Enough to fill Madison Square Garden every day for more than 5 years.
Why is the treatment gap so large?
- Medical personnel shortage – LMICs often have only 0-2 neurologists.
- Medical equipment shortage – EEG machines (and technologists) are not widely available.
- Cultural myths – Belief in spiritual causes often leads to seeking non-medical help.
- Poverty – Healthcare costs and travel expenses can be prohibitive.
- Lack of treatment options – Low-resource countries have few medication choices, often in short supply.
Additionally, there are surprisingly few resources available for epilepsy in low-income areas. Large international donors have not made epilepsy a priority.
Consequences of Untreated Epilepsy
Uncontrolled seizures result in risks of physical harm, as well as social stigmatization and discrimination:
- Serious developmental impairment in children with untreated seizures
- Widespread human rights violations including denial of education, employment or the right to marry
- Social isolation in the community or targets of abuse
There are established comorbidities between epilepsy and psychiatric disorders, such as depression, anxiety, and psychosis. As with epilepsy, those with psychiatric disorders also fall victim to severe stigmatization, as well as economic and social consequences to themselves and their families.