In response to Establishment of Epilepsy Surgery in Peru

I read with some interest the description of the recent development of not one, but two epilepsy surgery programs in Peru. There are certainly laudable aspects of the work including that, as described, it represents a true transfer of technical and medical capacity and not a “mission trip” with external experts dropping in briefly to declare victory over disease.

Subsequently, over a 5-year period, 93 patients have undergone surgery. Nonetheless, in a county which the World Health Organization reports1 has no national epilepsy action plan or legislation (over half the countries in the region do) and no epilepsy rehabilitation programs to serve the 150,000 Peruvian people with epilepsy,2 it bears asking whether this represents the optimal approach to advancing epilepsy care services in Peru.

With an epilepsy treatment gap in some rural regions of 75%3, one has to hope that there are also ongoing activities and efforts to address the lower hanging fruit of rolling out basic care to the masses.


  1. Pan American Health Organization paho_report_2013.pdf Report on Epilepsy in Latin America and the Caribbean. 2013.
  2. Bruno E, Bartoloni A, Zammarchi L, et al. Epilepsy and neurocysticercosis in Latin America: a systematic review and meta-analysis. PLoS Negl Trop Dis 2013;7:e2480.
  3. Auditeau E, Moyano LM, Bourdy G, et al. Herbal medicine uses to treat people with epilepsy: A survey in rural communities of northern Peru. J Ethnopharmacol 2018;215:184-190.


Gretchen L. Birbeck, MD, MPH

Gretchen L. Birbeck, MD, MPH

Gretchen Birbeck is a neurologist who divides her time between the US and Africa. Her US academic home is the University of Rochester where she is the Rykenboer Professor of Neurology and Research Director for the Strong Epilepsy Center with adjunct appointments in the Center for Human Experimental Therapeutics and the Department of Public Health. Her additional skills in epidemiology, health services research, and tropical medicine are brought to bear during the 6-months annually she spends in Africa where she serves as Director for the Chikankata Epilepsy Care Team in rural Mazabuka, Zambia, an Honorary Lecturer at the University of Zambia and a consultant for the Paediatric Research Ward at Queen Elizabeth Central Hospital in Blantyre, Malawi. Gretchen’s research programs are aimed at identifying opportunities to prevent or ameliorate the medical and social morbidities of common neurologic conditions in low-income, tropical settings with the ultimate goal of developing successful interventions feasible for scale up and broad implementation. She has been recognized as an Ambassador for Epilepsy by the International League against Epilepsy, a Global Health Research Ambassador by the US Paul Rogers Society, a National Outreach Scholar by the WK Kellogg Foundation and a Leader in Medicine by the American Medical Students Association.

More Posts