"Technological advances in recent years have benefited people with epilepsy in the industrialized world, but they have had little impact on the much larger number of people with epilepsy who live in countries with limited resources," said neurologist Jerome Engel, Jr., MD, PhD, of the University of California, Los Angeles, the co-chair of the Global Campaign Against Epilepsy who wrote an editorial accompanying the study.
Engel said that relatively inexpensive efforts such as public education to remove the stigma associated with epilepsy in developing countries and professional training to better identify people with epilepsy could greatly reduce the physical and social effects of the disease.
For the Chinese study, questionnaires were given door-to-door to a total of 58,806 people in five rural communities. Of those, 869 people were identified as possible cases and were screened by a neurologist. A diagnosis of epilepsy was determined for 387 people.
A total of 7 out of every 1,000 people had experienced epilepsy at some point in their lifetime, and 41 percent of all cases had never received appropriate treatment. The study found that 4.6 out of every 1,000 people had active epilepsy, and 63 percent of those had not received treatment in the week prior to the survey. Active epilepsy was defined as having two or more unprovoked seizures in the past 12 months.
Study author and neurologist Wenzhi Wang, MD, of the Beijing Neurosurgical Institute said that the lifetime prevalence of epilepsy was nearly 50 percent higher than previously estimated and the "treatment gap," or the difference between the number of people with epilepsy and the number receiving adequate therapy, was more than 30 percent higher than estimated.
"The total number of people with epilepsy in the People's Republic of China is now estimated at almost 9 million," Wang said. "The worldwide prevalence of epilepsy and the treatment gap may also be underestimated. These data show the need for epilepsy to become a high priority in China and around the world. In China, successful treatment of even 60 to 70 percent of cases could provide a productive boost to the nation's economy."
Wang said perceptions about epilepsy may lead to the treatment gap. "People may not view epilepsy as a treatable condition," he said. "The disorder is stigmatized and people are unlikely to admit they have epilepsy or to know that treatment exists."
The Chinese study was the first step in a pilot project; other pilot projects are underway in Senegal, Zimbabwe and Argentina. Other goals for the pilot projects include evaluating the effectiveness of training programs for health professionals, promoting new attitudes about epilepsy in the community and eliminating preventable causes of the condition. Results from the pilot projects will be used to develop national programs throughout the developing world, according to Engel.
The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.
For more information about the American Academy of Neurology, visit its web site at www.aan.com.
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