Yardi Ruta, Radhakrishnan Kurupath, Samia Pauline, Wilson Janet, Ali Amza
Geisinger Neuroscience Institute, Danville, PA, USA.
Kerala Institute of Medical Sciences, Trivandrum, and Avitis Institute of Medical Sciences, Palghat, Kerala, India.
Epilepsy Curr. 2025 May 27:15357597251318562. doi: 10.1177/15357597251318562.
Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure medications (ASM), implementation of dietary therapies like the ketogenic diet, and cost-conscious presurgical evaluations. Enhancing emergency care systems, particularly for conditions like status epilepticus, is critical, as is the development of standardized diagnostic and treatment protocols and training programs for healthcare providers. By addressing these gaps, LMIC can improve outcomes for individuals with DRE and reduce the burden of untreated seizures on patients and healthcare systems.
耐药性癫痫（DRE）对低收入和中等收入国家（LMIC）的人群影响尤为严重，在这些国家，获得负担得起的有效治疗仍然是一项重大挑战。DRE患者面临高昂的医疗费用、癫痫手术可及性不足以及训练有素的专业人员数量有限等问题。本综述探讨了在资源有限的环境中管理DRE的多方面方法。关键策略包括合理联合使用具有成本效益的抗癫痫药物（ASM）、实施生酮饮食等饮食疗法以及注重成本的术前评估。加强急诊护理系统，特别是针对癫痫持续状态等病症的护理系统至关重要，制定标准化诊断和治疗方案以及为医疗服务提供者开展培训项目也同样重要。通过弥补这些差距，低收入和中等收入国家可以改善DRE患者的治疗效果，减轻未治疗癫痫发作给患者和医疗系统带来的负担。
