John Libbey Eurotext

Epilepsy management during difficult times Ahead of print

Authors
1 Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar
2 UCL NIHR BRC Great Ormond Street Institute of Child Health, & Great Ormond Street Hospital for Children NHS Trust, London, UK
3 Department of Medicine, Austin Health, The University of Melbourne, and Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
4 Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
* Correspondence: Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar

Major disruption in the delivery of healthcare services can occur in exceptional situations such as natural disasters, conflicts, periods of severe economic hardship, and epidemics. These disruptions typically affect to the greatest extent the most vulnerable segments of the population, including people with epilepsy. Inability to access healthcare services can lead to failure to undergo necessary diagnostic investigations, or to receive needed therapeutic interventions, including epilepsy surgery. Stress and other factors associated with the nature or the cause of the disruption can adversely affect seizure control status, or precipitate the occurrence of psychiatric disorders and other comorbid conditions. Failure to access antiseizure medications is a common occurrence in these situations and can result in loss of seizure control, withdrawal seizures, and status epilepticus. In this article, we provide examples of recent disruptions in healthcare and their implications for people with epilepsy. We discuss the consequences of natural disasters, conflicts, economic sanctions, and focus in greater detail on lessons learnt during the COVID-19 pandemic. We also discuss possible mitigation procedures, focusing in particular on the application of telemedicine to epilepsy care. Finally, we underline the need for governments, healthcare authorities, and international organizations to improve their preparedness to deal with exceptional situations that may arise in the future.