R. Madhavan Nair Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Epilepsy Behav. 2011 Jun;21(2):137-42. doi: 10.1016/j.yebeh.2011.03.023. Epub 2011 May 4.
Although a majority of persons with epilepsy in developing countries are diagnosed, treated, and followed up by primary care doctors, few efforts have been made to examine their understanding with respect to epilepsy management. Through a questionnaire survey, we gathered information about the epilepsy management behavior of 500 primary care doctors distributed across the south Indian state of Kerala. Very few of them ever had diagnosed focal seizures, and the majority of them overutilize EEGs, prescribe continuous antiepileptic drug (AED) prophylaxis for febrile convulsions, use relatively expensive AEDs often in combination and in suboptimal doses, and did not know about alternate management options for AED-resistant epilepsies. A substantial proportion of the current large treatment gap in epilepsy in developing countries could be minimized by educating the primary care physicians about the diagnosis of epileptic seizures, cost-effective AED treatment, and need-based referral for specialized care.
尽管发展中国家的大多数癫痫患者由基层医疗医生进行诊断、治疗和随访，但针对他们对癫痫管理的理解程度，很少有研究对此进行调查。通过问卷调查，我们收集了分布在印度南部喀拉拉邦的 500 名基层医疗医生的癫痫管理行为信息。他们中很少有人曾诊断出过局灶性癫痫发作，而且大多数人过度使用脑电图，对热性惊厥开具长期抗癫痫药物（AED）预防治疗，经常使用相对昂贵的 AED 联合治疗且剂量不理想，也不了解耐药性癫痫的替代治疗选择。通过对基层医疗医生进行癫痫发作的诊断、具有成本效益的 AED 治疗以及针对专科医疗的需求转诊方面的教育，可以最大限度地减少发展中国家目前癫痫治疗巨大差距的一部分。
