Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, USA,
Curr Neurol Neurosci Rep. 2014 Aug;14(8):480. doi: 10.1007/s11910-014-0480-6.
Epilepsy affects approximately 50 million people worldwide. Among them, at least 40 million people are currently living in the developing world, where resources and standards of care are suboptimal. Around 90 % of people with epilepsy in resource-poor countries do not currently receive appropriate treatments, at a time when two thirds of these patients could have achieved good control of their epileptic seizures had they had access to appropriate therapies. Scarcity of epilepsy specialists, poor availability or access to diagnostic facilities and treatments, poor community knowledge about epilepsy-related issues, stigma, and other societal and cultural barriers are only some of the issues contributing to this deficiency. These issues in epilepsy treatment have been well recognized, and ongoing concerted efforts to address them have been undertaken by both local authorities and international organizations. In many cases, patients resort to the use of traditional local and alternative medicines (herbs, religious practices, etc.) that are closer to indigenous cosmovision, are more holistic, and are more culture-friendly, preserving an optimum subtlety of Afrocentric character shading. Compared with imported Western medicines, patients find these approaches to be more relevant to their ways of thinking, their ways of being, and their belief systems, more accessible, and more acceptable methods of dealing with health and disease states. The impressive local wealth in these natural resources has established them as a preferred source of healing in these regions, but has also fueled interest in exploring their therapeutic potential in the very few existing local research centers. In this review, we discuss the known issues related to the epilepsy treatment gap in resource-poor regions, focusing in particular on African countries, introduce the role and issues related to the use and validation of alternative medical therapies in epilepsy, and comment on the importance and repercussions of initiatives to validate such therapies, primarily for local practices, but also for possible wider international applications.
全世界约有 5000 万人患有癫痫。其中，至少有 4000 万人生活在发展中国家，那里的资源和医疗保健标准欠佳。在资源匮乏的国家，大约 90%的癫痫患者目前未得到适当治疗，而这些患者中有三分之二如果能够获得适当的治疗，他们的癫痫发作就可以得到很好的控制。癫痫专家短缺、诊断设施和治疗方法可及性差、社区对癫痫相关问题的认识不足、耻辱感以及其他社会和文化障碍只是导致这种不足的部分原因。这些癫痫治疗方面的问题已经得到充分认识，地方当局和国际组织一直在共同努力解决这些问题。在许多情况下，患者求助于使用更接近本土世界观的传统当地和替代药物（草药、宗教习俗等），这些药物更具整体性，更符合文化，保留了最佳的非洲中心特征。与进口西药相比，患者发现这些方法更符合他们的思维方式、存在方式和信仰体系，更容易接受，是处理健康和疾病状态的更可接受的方法。这些自然资源的丰富地方财富使它们成为这些地区的首选治疗资源，但也激发了人们在为数不多的现有地方研究中心探索其治疗潜力的兴趣。在这篇综述中，我们讨论了资源匮乏地区癫痫治疗差距的相关问题，特别关注非洲国家，介绍替代医学疗法在癫痫中的作用和相关问题，并评论了验证这些疗法的重要性和影响，主要是针对当地实践，但也可能有更广泛的国际应用。
