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EPILEPSY: GLOBAL ISSUES FOR THE PRACTICING NEUROLOGIST- part 9

Thông thường, giáo viên yêu cầu các bậc phụ huynh giữ con em mình ở nhà bởi vì họ không sẵn sàng để chịu trách nhiệm cho cơn co giật có thể xảy ra trong lớp. Những yếu tố này đóng góp khoảng cách giáo dục giữa các người bị động kinh và dân số nói chung, mà trầm trọng thêm gánh nặng của bệnh động kinh | Psychosocial Issues Often teachers ask parents to keep their child at home because they are not willing to take responsibility for seizures that might occur in class. These factors contribute to the education gap between people with epilepsy and the general population which aggravates the burden of epilepsy and negatively impacts the integration of people with epilepsy into society. FAILURE TO SEEK HELP Even where there are adequate means for treatment of epilepsy the majority of people suffering from this disorder in many developing countries are not treated. Large parts of the population who can geographically and financially reach modern medical facilities are treated intermittently. Either because their poverty does not allow them to afford the cheapest drugs or they have not been well health-educated about the necessity of a long-term treatment it is now estimated that the treatment gap related to modern medications is 80 of the population suffering from epilepsy in developing countries. In Ethiopia a prospective study identifying 139 people with previously diagnosed epilepsy reported that 39 were receiving AED treatment phenobarbital 19 were using only traditional treatment and 42 did not receive any modern or traditional treatment. PSYCHIATRIC COMORBIDITY IN DEVELOPING COUNTRIES Two main situations occur in developing countries regarding eventual neuropsychiatric comorbidity. The first is the association of epileptic seizures with a psychiatric condition. The main examples of this are epileptic encephalopathies. In this context consanguineous marriages are responsible for a familial distribution of such conditions. The family then is considered to be possessed and becomes feared and discriminated against. The second situation results from the fact that people with epilepsy are more often referred to psychiatrists than neurologists because there are fewer of the latter and because a large part of the population considers the clinical manifestations of many .