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September 2018

Providing Surgery for Medically Intractable Epilepsy in Low- and Middle-Income Countries: Shifting the Focus From If to How

Author Affiliations
  • 1Department of Neuro-Oncology, Johns Hopkins University, Baltimore, Maryland
  • 2Division of Neurosurgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
JAMA Neurol. 2018;75(9):1041-1042. doi:10.1001/jamaneurol.2018.1318

Low- and middle-income countries (LMICs) represent a disproportionately high burden of epilepsy globally.1 Although many people with medically intractable epilepsy (MIE) can benefit from surgery, access is limited, particularly in LMICs. The Lancet Commission on Global Surgery has recommended a list of bellwether procedures that should be prioritized in LMICs, but neurosurgical interventions, including epilepsy surgery, were absent.2 Given the pressing, unmet need to deliver effective and sustainable treatments for epilepsy in LMICs, the assessment of surgical outcomes in LMICs that would support the prioritization of resource allocation is increasingly important.