Background: Epilepsy affects about 70 million people worldwide, nearly 90% of whom live in developing
countries. Epilepsy is surrounded by myths and stigma in these countries. Discrimination and social stigmatization
are difficult obstacles for patients to overcome. Knowledge, attitudes and practices towards epilepsy are
often inadequate, even sometimes totally false and then dangerous.
Methods: The goal was to present the situation and analyse the determinants of using antiepileptic drugs in developing
Results: The treatment gap exceeds 75% in most low-income countries, and could be even higher in rural areas.
Reasons for that are low accessibility, availability, and/or affordability, lack of trained medical personnel and the
associated beliefs and stigma. The interactions between drugs or due to other factors, such as malnutrition, are
frequent. A long-lasting treatment is not usual for populations in developing countries due to cultural beliefs. The
traditional healers are the first ones consulted in such a context, then delaying the entry in the “modern” medical
Conclusion: Information and education campaigns are mandatory among the general population and among the
medical and paramedical staff to make progress on the management of epilepsy in developing countries.