Experts Say 70% Of Nigerians Living With Epilepsy Untreated

The Nigerian Society of Neurological Sciences (NSNS) has raised an alarm over Nigeria’s widening epilepsy treatment gap.

The society disclosed this on Monday in a communiqué issued at the end of its 58th Annual Scientific Conference and General Meeting held between Feb. 10 and Feb. 12 in Kano.

The communiqué was signed by the President of the society, Prof. Morenikeji Komolafe; the Secretary, Dr Iwuozo Emmanuel; and the Chairman of the Local Organising Committee, Prof. Lukman Owolabi.

According to the communiqué, more than 70 per cent of persons living with epilepsy in the country are not receiving appropriate anti-seizure medications.

With an estimated epilepsy prevalence of between eight and 13 per 1,000 population in Nigeria, translating to nearly two to three million Nigerians affected, experts warned that the country faces a major public health and social challenge if urgent policy interventions are not implemented.

The conference, themed “Bridging Gaps in Epilepsy Care: Innovations, Integration and Interdisciplinary Collaboration”, brought together 152 delegates from across the six geopolitical zones and the diaspora.

According to the communiqué, the high treatment gap is driven by poor access to specialists, limited diagnostic facilities, high cost of medicines, stigma, and weak integration of epilepsy care into primary healthcare services.

It noted that in line with global epidemiology in low- and middle-income countries, over 70 per cent of persons living with epilepsy in Nigeria were not on appropriate antiseizure medications.

It described the disease as a preventable crisis, adding that epilepsy was treatable and that patients could achieve seizure control with appropriate medications.

The NSNS however said affordability remained a major barrier.

“The cost of anti-seizure medicines is prohibitive, particularly for rural dwellers and low-income households, where out-of-pocket spending dominates health financing.

“Nigeria’s health expenditure remains heavily reliant on household spending, with limited insurance coverage for neurological conditions,” the communique said.

It therefore called for improved financing mechanisms, including stronger integration of epilepsy services into the Basic Healthcare Provision Fund (BHCPF) and expanded coverage under the national health insurance framework.

The society also recommended enhanced collaboration between the government and pharmaceutical companies to ensure availability and subsidisation of anti-seizure medications.

The communiqué noted that beyond medicines, infrastructure gaps remain significant.

According to it, specialised facilities with modern diagnostic tools for epilepsy evaluation are scarce nationwide.

Advanced imaging such as 1.5 Tesla and 3.0 Tesla Magnetic Resonance Imaging (MRI) machines are needed for accurate localisation of epileptogenic foci, especially in patients being considered for surgery.”

It urged the Federal Government to equip more teaching hospitals and Federal Medical Centres with at least 1.5 Tesla MRI machines while preparing for higher-capacity 3.0 Tesla systems as power supply improves.

It said that advanced imaging modalities required for comprehensive epilepsy surgery workup, including Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT), are largely unavailable in Nigeria.

The communiqué noted that in spite of the constraints, the society had made encouraging progress in local capacity.

According to the communiqué, limited numbers of epilepsy surgeries have been successfully conducted within Nigeria with good outcomes, demonstrating available expertise in-country.

“Epilepsy surgery remains a cornerstone in the management of drug-resistant epilepsy and carries relatively low surgical risk when appropriately selected.”

The Society therefore recommended the establishment of dedicated epilepsy centres across the six geopolitical zones to manage complex cases and expand surgical services.

It also emphasised the urgent need to expand specialist training and recruitment, citing shortages of neurologists, paediatric neurologists, neurosurgeons, psychiatrists, psychologists, neuro-nurses, and electroencephalography (EEG) technologists.

“Nigeria currently has fewer than 500 neurologists serving a population of over 200 million, resulting in severe workforce disparities, particularly in rural areas,” said.

It also noted that cultural misconceptions continue to isolate persons living with epilepsy, limiting education, employment, and social inclusion opportunities.

It therefore called for nationwide awareness campaigns involving federal, state, and local governments, as well as non-governmental organisations, to reduce stigma and promote early care-seeking.

The NSNS also announced that it had developed a national guideline for epilepsy management tailored to Nigeria’s context.

The guideline, it said, should be adopted across all levels of care, from primary healthcare centres to tertiary hospitals, to standardise treatment and improve outcomes.

It quoted Prof. Edwin Trevathan, of that Vanderbilt University, United States, as emphasising the urgent need to close diagnostic and treatment gaps in epilepsy and other neurological disorders in Nigeria during his key note address.

Trevathan highlighted ongoing research in Nigeria on the epidemiology, genetics, and treatment of epilepsy, as well as emerging genetic studies on dementia.

He expressed optimism that findings from dementia research could contribute to prevention strategies and potentially support the development of new therapies.