Treatment of epilepsy: with special reference to developing countries. 1979

B O Osuntokun
Department of Medicine, University of Ibadan, Nigeria.

1. Epilepsy, a common chronic neurological disorder, constitutes an important medical problem especially as in the developing countries there is a great dearth and shortage of health personnel, especially trained ones, in clinical neurosciences. The prevalence of epilepsy in developing countries is probably higher than in the Caucasians although accurate epidemiological data are lacking. 2. Epilepsy is discussed with special regard to the need for accurate diagnosis, and the difficulties encountered in developing countries. 3. Pharmacotherapy should be as simple as possible and suggestions are made on the essential drugs useful in the control of epilepsy with special reference to developing countries and in the context of economics and ready availability. Grand mal and focal epilepsies could be controlled by phenobarbitone, with phenytoin, sulthiame and carbamazepine kept as reserves or adjuncts. Minor (generalised) epilepsies could be controlled by ethosuximide, with clonazepam and sodium valproate (sodium dipropylacetate) as reserve drugs and adjuncts. For status epilepticus, diazepam is effective and readily available, with clonazepam and phenytoin as alternatives. 4. The problems in the management of epilepsy in the developing countries include lack of facilities and personnel to ensure accurate diagnosis and treatment, inadequate supply or non-availability of drugs, high defaulting rate of patients, the adverse and often pernicious social stigmatisation of the epileptic. 5. Possible solutions to some of these problems include integration of management (in simple terms) of convulsive disorders into the basic health system of delivery of health care in developing countries, aggressive pursuit of health education of the public by governmental and non-governmental agencies, active, intensive and sustained promotion of training of health personnel in clinical neurosciences and research aimed at producing long-acting anticonvulsants.

UI MeSH Term Description Entries
D008487 Medical History Taking Acquiring information from a patient on past medical conditions and treatments. Medical History, Previous,Past Medical History, Family,Previous Medical History,Family Health History,Family History, Health,Family History, Medical,Family Medical History,History Taking, Medical,Family Health Histories,Family Medical Histories,Health Family Histories,Health Family History,Health History, Family,History, Previous Medical,Medical Family Histories,Medical Family History,Medical Histories, Previous,Medical History, Family,Previous Medical Histories
D009938 Organizations Groups of people working together in a structured manner to pursue common goals and objectives. Non-Governmental Organizations,Nongovernmental Organizations,Organizations, Nongovernmental,Non Governmental Organizations,Non-Governmental Organization,Nongovernmental Organization,Organization,Organization, Non-Governmental,Organization, Nongovernmental,Organizations, Non-Governmental
D003906 Developing Countries Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. LMICs,Less-Developed Countries,Low Income Countries,Low and Middle Income Countries,Lower-Middle-Income Country,Middle Income Countries,Third-World Countries,Under-Developed Countries,Developing Nations,Least Developed Countries,Less-Developed Nations,Third-World Nations,Under-Developed Nations,Countries, Middle Income,Countries, Third-World,Country, Least Developed,Country, Less-Developed,Country, Low Income,Country, Lower-Middle-Income,Country, Middle Income,Country, Third-World,Country, Under-Developed,Developed Country, Least,Developing Country,Developing Nation,Least Developed Country,Less Developed Countries,Less Developed Nations,Less-Developed Country,Less-Developed Nation,Low Income Country,Lower Middle Income Country,Lower-Middle-Income Countries,Middle Income Country,Nation, Less-Developed,Nation, Third-World,Nation, Under-Developed,Third World Countries,Third World Nations,Third-World Country,Third-World Nation,Under Developed Countries,Under Developed Nations,Under-Developed Country,Under-Developed Nation
D004827 Epilepsy A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313) Aura,Awakening Epilepsy,Seizure Disorder,Epilepsy, Cryptogenic,Auras,Cryptogenic Epilepsies,Cryptogenic Epilepsy,Epilepsies,Epilepsies, Cryptogenic,Epilepsy, Awakening,Seizure Disorders
D006266 Health Education Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. Community Health Education,Education, Health,Education, Community Health,Health Education, Community
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000349 Africa The continent south of EUROPE, east of the ATLANTIC OCEAN and west of the INDIAN OCEAN.

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