Improving Epilepsy Treatment Around the World

Epilepsy affects patients around the world; however, the same care is not received by all patients. Patients with epilepsy living in lower income countries do not have access to the same extensive diagnostics and treatment options that are offered in more affluent areas.

What can be done to prevent these treatment discrepancies? Three epilepsy experts discussed this topic and what is being accomplished around the world at the American Epilepsy Society conference during the “Global Health in Epilepsy Get Involved!” special interest group.

This group, which presented on Friday, December 2, 2016, included opportunities for healthcare professionals, academic institutions, and governments around the world to collaborate with each other to improve the state of epilepsy treatment.

Jorge Burneo, MD, MSPH, started his presentation by asking the audience why we should care about global health. He said that global health is extremely important since diseases do not just affect 1 country, and that global security is dependent on it.

Dave Clarke, MBBS, discussed changes in epilepsy care in the Caribbean region and the strides it has made toward improvement through collaborative programs. Because the Caribbean epilepsy initiative includes many countries, Clarke said it was very important to change the name of this program from the Jamaican League Against Epilepsy to the Epilepsy Society of the Caribbean.

In fact, many of the speakers talked about the importance of working in unison with leaders from other countries, and Clarke said during the presentation that it is important to have “good coordinators and sincere, humble friends” working together. Without this, the programs would likely not have advanced care in the countries.

The speakers also outlined issues that need to be overcome if epilepsy treatment were to be improved around the world. In the Caribbean, patients lack access to computed tomography scans, which are used to diagnose the cause of the seizures. Dr Burneo said in his presentation that in African countries, there is a lack of access to electroencephalogram technology.

A lack of technology in lower income countries was mentioned by each speaker, but telemedicine could be implemented to help patients with epilepsy in areas without access to necessary diagnostic tools. The implementation of interventions that are low cost but effective can certainly improve epilepsy care among these patients, according to the session.

In Africa, there is also a lack of access to a ketogenic diet, which is a low-carb high-fat diet that can be used to control disease in certain patients with epilepsy. Unfortunately, patients in Africa who have refractory epilepsy cannot benefit from this treatment option and, therefore, could face poor health outcomes.

For all countries involved in these global health initiatives, the speakers expressed that language barriers also pose a challenge because languages vary even in countries within the same region. More challenges include the sustainability of these programs—How will we make these programs effective in a short period of time? Other challenges include proper training protocols, integrating local care, and auditing the care given. Overcoming these barriers is essential to having a successful epilepsy initiative.

Collaboration between various outreach initiatives can prove beneficial. Creating an international database of programs, along with communication systems between different programs and increasing member participation, can allow countries to see which programs work and how to implement them, according to the session.

To improve global health in epilepsy, physicians, nurses, pharmacists, and other healthcare professionals can all lend a hand to help countries with a lack of technology and treatment options.