Pediatric epilepsy care in Nigeria: A management approach for the primary care physicians

Abstract

Epilepsy is a neurologic disorder of the brain characterized by an enduring predisposition to recurrent unprovoked seizures. It is the most common childhood neurologic disorder world-wide. Poor management often impacts negatively on the child's neurodevelopmental, emotional, physical, and social well-being. In resource-poor countries, the majority of children with epilepsy are managed by primary care physicians who are not sufficiently trained to offer effective care in pediatric epilepsy. Many low income countries do not have nationally approved guideline on management of pediatric epilepsy. Access to specialist care is costly and may involve long distance travels from rural areas to the cities. This often leads to a huge treatment gap. Efforts aimed at increasing the management skills of primary-care physicians in diagnosing and giving appropriate treatment is necessary in ensuring reduction in treatment gap. This review article is based on the authors' clinical experience and a review of 20 published works from review articles, recommendations, and guidelines sourced from PubMed and Google using the search terms “Paediatric epilepsy, management, primary care.” In the absence of any approved national guideline, a simplified approach to the clinical diagnosis, appropriate use of available diagnostic facilities, and cheap but cost-effective drugs will lead to better management of childhood epilepsy in resource-constrained settings.