Abstract
Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment
gaps exist across the world, most so in areas of financial constraint. Classification
permits the best approaches to treatment and to ascertaining prognosis. The International
League Against Epilepsy's new classification system emphasizes clinical aspects and
utilizes all available resources to determine whether it is a focal or generalized
epilepsy. The most important tools are a careful history, clinical examination, electroencephalography,
and appropriate neuroimaging. Inadequate, delayed, and incomplete evaluation may lead
to misdiagnosis and costly mismanagement. Treatment is generally pharmacological,
with approximately 20 to 30% of patients eventually proving refractory to medications
and thus becoming potential surgical candidates. The type of epilepsy, age, gender,
comorbidities, drug interactions, and drug cost are important factors in choosing
an antiepileptic drug (AED). The teratogenic potential of some AEDs, weight gain,
and menstrual hormone–related issues are important considerations in women. The impact
of AEDs on bone health is critical in all age groups, particularly in the elderly.
Psychiatric problems, mostly depression and anxiety, can have a great impact on seizure
control and overall quality of life. Finally, effective partnerships and collaborations
can bring resources, both human and financial, to regions that would otherwise find
it impossible to effect change on their own.
Keywords
Epilepsy - stigma - cost - gender - collaboration
