As one of the most common neurological conditions in the world, epilepsy hits resource-poor communities particularly hard. Although there are simple and inexpensive ways to treat epilepsy, the stigmatization of the disorder in developing countries leaves those suffering from epilepsy misunderstood and untreated. In addition, health care providers in developing countries often lack training in diagnosing and treating neurological disorders like epilepsy. Thus, shedding light on the facts about epilepsy is crucial to improving the lives of those affected by epilepsy in developing regions of the world.

1. Epilepsy is characterized by recurrent and unprovoked seizures, so a single occurrence of an epileptic seizure does not guarantee that a person has epilepsy. Epileptic seizures occur due to abnormal neuronal activity in the brain. The most common visible effect of an epileptic seizure is uncontrollable jerking movements, but the effects can also be as subtle as a momentary loss of awareness.
2. An estimated 50 million people worldwide have epilepsy, and 80 percent of those live in developing countries, according to the World Health Organization (WHO).
3. Epilepsy in developing countries is commonly caused by neurocysticercosis. Cysticercosis is a parasitic infection that occurs from the ingestion of eggs from the adult tapeworm, Taenia solium, according to the National Center for Biotechnology Information (NCBI). When cysticercosis affects the central nervous system, it is referred to as neurocysticercosis and can lead to recurrent epileptic seizures.
4. Some common causes of epilepsy include head trauma, genetic susceptibility, and malnutrition.
5. Epilepsy is a chronic neurological disorder, not a mental illness. In many developing countries, including Uganda, epilepsy care is relegated to the mental health sector–often the most underfunded health sector in resource-poor countries, according to NCBI.
6. Another erroneous belief is that epilepsy is contagious. The stigmatization of epilepsy in developing countries is partly due to the fear of contagion from bodily fluids, such as saliva, that can be emitted during a seizure. However, epilepsy is a non-communicable disease.
7. The mortality rate of people with epilepsy is estimated to be two to three times higher than the general population in resource-poor communities. This is mostly due to the increased risk of fatal injury, trauma, or drowning during an epileptic seizure.
8. Of the 35 million people with epilepsy who live in developing countries, around 85 percent receive no treatment at all, according to WHO. In order to close the treatment gap, WHO is calling for consistent and reliable access to anti-epileptic drugs (AED) that are critical to addressing the prevalence of epilepsy in the developing world.
9. Educating primary care providers in developing countries on the facts about epilepsy is vital to ensuring that epilepsy is de-stigmatized and properly treated. Since access to equipment used to test for epilepsy are rare or often inaccurate in developing countries, increasing the number of neurologists and/or health care providers that can diagnose epilepsy is important, especially in rural areas.
10. Cost-effective drugs exist to treat epilepsy. Phenobarbital, an older AED that costs $0.12 per daily dose, is currently being used in countries throughout Africa to some success. Although phenobarbital is known to have adverse side effects, the WHO supports the conclusion that phenobarbital is relatively well tolerated in developing countries as evidenced by observational studies.

By ensuring healthcare providers know how to diagnose epilepsy, consistently distributing AED’s to both rural and urban communities and erasing the stigma surrounding the disorder, the prevalence of epilepsy in developing countries has the potential to be reduced as low or lower than in developed countries.

– Daniela Sarabia

Photo: Medscape