Antiepileptic Treatments in Developing Countries.

BACKGROUND: Epilepsy affects about 70 million people worldwide, nearly 90% of whom live in developing countries. Epilepsy is surrounded by myths and stigma in these countries. Discrimination and social stigmatization are difficult obstacles for patients to overcome. Knowledge, attitudes and practices towards epilepsy are often inadequate, even sometimes totally false and then dangerous.

METHODS: The goal was to present the situation and analyse the determinants of using antiepileptic drugs in developing countries.

RESULTS: The treatment gap exceeds 75% in most low-income countries, and could be even higher in rural areas. Reasons for that are low accessibility, availability, and/or affordability, lack of trained medical personnel and the associated beliefs and stigma. The interactions between drugs or due to other factors, such as malnutrition, are frequent. A long-lasting treatment is not usual for populations in developing countries due to cultural beliefs. The traditional healers are the first ones consulted in such a context, then delaying the entry in the "modern" medical care system.

CONCLUSION: Information and education campaigns are mandatory among the general population and among the medical and paramedical staff to make progress on the management of epilepsy in developing countries.