Epilepsy

© 2018 Elsevier Inc. All rights reserved. Tropical countries carry a significant proportion of the global burden of epilepsy, since the incidence and mortality of epilepsy is highest in these regions. The epidemiology of epilepsy in tropical regions is complicated by cultural beliefs of epilepsy, lack of reliable medical records, lack of expertise in the diagnosis of epilepsy, different definitions used, and lack of investigative facilities to examine risk factors and causes. Prevalence and incidence of epilepsy are higher in tropical areas, but surprisingly not in tropical Asia, without a clear explanation for the moment. Mortality is also higher than in non-tropical zones. Infections and perinatal factors are the most important risk factors. Sociocultural misbeliefs lead patients to seek first advice of traditional medicine. The treatment gap is very high: more than 80% in many countries. Efforts should be made to propose interventions strategies in primary care settings to better identify and manage patients with epilepsy, involving healthcare system authorities.