Epilepsy surgery in Nigeria: the current state and prospects

Abstract

Epilepsy, a common neurologic disease, has puzzled mankind since ancient times. The disease has been attributed to different scientific, metaphysical, and spiritual causes and as such many interesting treatment modalities have been used in its management. The course of the modern-day management of epilepsy mirrors the advances in understanding of medicine and neuroscience over time, as well as technological advancements of the past century. Although anti-epileptic drugs (AEDs) are widely used as the mainstay of treatment, some forms of epilepsy are pharmaco-resistant. To tackle these pharmaco-resistant or anatomically complex forms of epilepsy, many neuroscientists, neurologists and neurosurgeons have researched, developed, and refined several successful surgical approaches for the treatment of epilepsy over the past century. These surgeries have revolutionized care for patients with drug resistant epilepsy ensuring seizure control or complete seizure freedom and are widely used in developed countries. Unfortunately, access to epilepsy surgery (ES) is little or non-existent in countries of the global south, often due to varying combinations of financial and infrastructural constraints as well as knowledge and skill gaps among healthcare professionals, and cultural and religious beliefs among the populace. In Nigeria particularly, ES is in the nascent stage and efforts to improve access to ES through local research and international collaborations for capacity building and system strengthening are currently underway.