SEIZURE DISORDERS: Edited by John SternEpilepsy care challenges in developing countriesKvalsund, Michelle P.a; Birbeck, Gretchen L.b,c Author Information aDepartment of Neurology, Vanderbilt University Medical Center, Medical Center North, Nashville, Tennessee bInternational Neurologic & Psychiatric Epidemiology Program [INPEP], Michigan State University, East Lansing, Michigan, USA cEpilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia Correspondence to Gretchen L. Birbeck, International Neurologic & Psychiatric Epidemiology Program [INPEP], Michigan State University, #324 West Fee Hall, East Lansing, MI 48824, USA. Tel: +1 517 884 0277; fax: +1 517 884 0275; e-mail: [email protected] Current Opinion in Neurology: April 2012 - Volume 25 - Issue 2 - p 179-186 doi: 10.1097/WCO.0b013e328350baf8 Buy Metrics Abstract Purpose of review This review discusses recent literature relevant to the diagnosis and treatment of epilepsy in developing countries with particular attention to underlying causes, natural history, and advances made toward optimizing systems of care and bridging the treatment gap. Recent findings Prospective data suggest that cerebral malaria-induced brain injury may explain the high prevalence of epilepsy in malaria-endemic regions. Population-based mortality studies support the long proposed hypothesis that seizure-related deaths contribute to excessive premature mortality. WHO guidelines have the potential to improve care, but macrolevel barriers related to pharmaceutical regulation and distribution continue to contribute to the treatment gap. Evidence-based guidelines endorsed by the WHO and American Academy of Neurology regarding the optimal management of comorbid epilepsy and HIV may raise awareness regarding critical drug interactions between antiepileptic drugs and antiretrovirals, but are also problematic as the treatment regimen and diagnostic facilities routinely available in developing countries will prevent most healthcare providers from following the recommendations. Summary New insights into the causes, natural history and best care practices for epilepsy in developing countries are available but without prioritization and action from policy makers, the present treatment gap will likely to persist. © 2012 Lippincott Williams & Wilkins, Inc.