Three cheers for Dr. Mamta Bhushan Singh whose candid editorial in the November issue of Seizure really sums up the problems of epilepsy research and care in the developing world today. 1 Such a maddening paradox—70% of epilepsy cases would respond to basic treatment, if provided. And rather than expending efforts to assure we put systems in place to roll out sustainable care to the masses, we in the global epilepsy arena continue to focus most of our attention and resources on the 30% of patients with treatment resistant epilepsy. This approach might make sense in developed settings, but certainly not in low and middle income settings where the treatment gap really hasn’t budged in more than two decades.
In May 2015, the World Health Assembly approved the World Health Organizations Resolution on the Global Burden of Epilepsy but no tangible benefits of this are evident from my perspective. If anything, failure to deal internationally with regulatory hurdles has made the situation worsen over the past 3 years. 2 A growing emphasize on the establishment of epilepsy surgery programs where even basic services may not be established further illustrates the problem. 3, 4 Dr. Singh’s editorial is a refreshing voice of reason in an otherwise discouraging time.
- Singh MB. What should drive epilepsy research? Seizure 2018;62:1-2
- Birbeck GL. The Forgotten. Neurology 2018;91:800-803
- Mansouri A, Ibrahim GM. Providing Surgery for Medically Intractable Epilepsy in Low- and Middle-Income Countries: Shifting the Focus From If to How. JAMA Neurol 2018;75:1041-1042.
- Steven DA, Vasquez CM, Delgado JC, et al. Establishment of epilepsy surgery in Peru. Neurology 2018;91:368-370