The treatment of epilepsy in developing countries: where do we go from here?

Epilepsy is the most common serious neurological disorder and is one of the world's most prevalent noncommunicable diseases. As the understanding of i ts physical and social burden has increased it has moved higher up the worl d health agenda. Over four-fifths of the 50 million people with epilepsy ar e thought to be in developing countries; much of this condition results fro m preventable causes. Around 90% of people with epilepsy in developing coun tries are not receiving appropriate treatment. Consequently, people with ep ilepsy continue to be stigmatized and have a lower quality of life than peo ple with other chronic illnesses. However, bridging the treatment gap and r educing the burden of epilepsy is not straightforward and faces many constr aints, Cultural attitudes, a lack of prioritization, poor health system inf rastructure, and inadequate supplies of antiepileptic drugs all conspire to hinder appropriate treatment. Nevertheless, there have been successful att empts to provide treatment, which have shown the importance of community-ba sed approaches and also indicate that provision for sustained intervention over the long term is necessary in any treatment programme. Approaches bein g adopted in the demonstration projects of the Global Campaign Against Epil epsy - implemented by the International League Against Epilepsy, the Intern ational Bureau for Epilepsy, and the World Health Organization - may provid e further advances. Much remains to be done but it is hoped that current ef forts will lead to better treatment of people with epilepsy in developing c ountries.