Epilepsy surgery in Nigeria: the current state and prospects

Authors

  • Aliu O. Yakubu College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
  • Oreoluwa E. Morakinyo College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
  • Ismat D. Ghazal College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
  • Hameed A. Obituyi Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Ago Iwoye, Ogun State, Nigeria
  • Abdul-Rasaq T. Raheem College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria

DOI:

https://doi.org/10.18203/2349-2902.isj20223183

Keywords:

Epilepsy surgery, Anti-epileptic drugs, Nigeria

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.

References

Thijs RD, Surges R, O’Brien TJ, Sander JW. Epilepsy in adults. Lancet. 2019;393(10172):689-701.

Saxena S, Li S. Defeating epilepsy: a global public health commitment. Epilepsia Open. 2017;2(2):153-5.

Picot MC, Baldy-Moulinier M, Daurès JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country. Epilepsia. 2008;49(7):1230-8.

Wiebe S, Blume WT, Girvin JP. Effectiveness, efficiency of surgery for temporal lobe epilepsy study G. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001;345:311-8.

Qiu J. Epilepsy surgery: challenges for developing countries. Lancet Neurol. 2009;8(5):420-1.

Kissani N, Nafia S, ElKhiat A, Bengamara N, Maiga Y, Sogoba Y, et al. Epilepsy surgery in Africa: state of the art and challenges. Epilepsy Behav. 2021;118(107910):107910.

Worldometer. Fact sheet: Nigeria population, 2022. Available at: https://www.worldometers.info/world-population/nigeria-population. Accessed on 7 September 2022.

Owolabi LF, Owolabi SD, Taura AA, Alhaji ID, Ogunniyi A. Prevalence and burden of epilepsy in Nigeria: a systematic review and meta-analysis of community-based door-to-door surveys. Epilepsy Behav. 2019;92:226-34.

Gross RA. A brief history of epilepsy and its therapy in the western hemisphere. Epilepsy Res. 1992;12(2):65-74.

Asadi-Pooya AA, Rostami C. History of surgery for temporal lobe epilepsy. Epilepsy Behav. 2017;70:57-60.

Sinha S, Danish SF. History and technical approaches and considerations for ablative surgery for epilepsy. Neurosurg Clin N Am. 2016;27(1):27-36.

Feindel W, Leblanc R, deAlmeida AN. Epilepsy surgery: Historical highlight. 1909-2009. Epilepsia. 2009;50:131-51.

Vaddiparti A, Huang R, Blihar D, DuPlessis M, Montalbano MJ, Tubbs RS, et al. The evolution of corpus callosotomy for epilepsy management. World Neurosurg. 2021;145:455-61.

Balarabe S, Watila M, Joseph M, Otte W, Igwe S, Fawale M, et al. Epilepsy treatment gap and determinants of access to care in Nigeria. J Neurol Sci. 2019;405:87-8.

Nwani PO, Nwosu MC, Enwereji KO, Asomugha AL, Arinzechi EO, Ogunniyi AO. Epilepsy treatment gap: prevalence and associated factors in Southeast Nigeria. Acta Neurol Scand. 2013;128(2):83-90.

Adewumi T, Oladipo E, Adewuya AO. Public perception and attitude towards people living with epilepsy in Nigeria. Epilepsy Behav. 2020;106(107033):107033.

Ilae.org. Chapter spotlight. Nigeria. Available at: https://www.ilae.org/regions-and-countries/national-chapters/chapter-spotlights/nigeria. Accessed on 26 August 2022.

Federal Republic of Nigeria. Fact sheet: Budget Office of the Federation. Available at: https://www.budgetoffice.gov.ng/index.php/component/edocman/search-result?start=30. Accessed on 4 September 2022.

Imam A. Practical neurology. London, England: BMJ Books; 2016.

Morgan E, Nwatuzor C. Starting a neurosurgical service in a Southern Nigeria rural community. Prospect, challenges, and future-the Irrua experience. Egypt J Neurosurg. 2020;35(1).

Samanta D, Ostendorf AP, Singh R, Gedela S, Elumalai V, Hoyt ML, et al. Physicians’ perspectives on presurgical discussion and shared decision-making in pediatric epilepsy surgery. J Child Neurol. 2022;37(5):416-25.

Servadei F, Rossini Z, Nicolosi F, Morselli C, Park KB. The role of neurosurgery in countries with limited facilities: facts and challenges. World Neurosurg. 2018;112:315-21.

Abdulmalik J, Kola L, Fadahunsi W, Adebayo K, Yasamy MT, Musa E, et al. Country contextualization of the mental health gap action programme intervention guide: a case study from Nigeria. PLoS Med. 2013;10(8):1001501.

Aliyu MH, Abdullahi AT, Iliyasu Z, Salihu AS, Adamu H, Sabo U, et al. Bridging the childhood epilepsy treatment gap in northern Nigeria (BRIDGE): rationale and design of pre-clinical trial studies. Contemp Clin Trials Commun. 2019;15(100362):100362.

Owolabi L, Akinyemi R, Owolabi MM, Sani U, Ogunniyi A. Epilepsy profile in adult Nigerians with late onset epilepsy secondary to brain tumor. Neurol Asia. 2013;18(1):23-7.

Regions Neuro. Fact sheet: Epilepsy monitoring unit and continuous video EEG-regions healthcare. Available at: https://regionsneuro.com/epilepsy-monitoring-unit-and-continuous-video-eeg/. Accessed on 7 September 2022.

Downloads

Published

2022-11-28

Issue

Section

Review Articles