Is the Thailand epilepsy service adequate to help patients?

ABSTRACT

Background: Epilepsy is a common disease but to achieve successful seizure control in developing countries is still a challenge. This study aimed to investigate the epilepsy services in Thailand. Methods: This was a survey by questionnaires on epilepsy service sent to 1,033 public hospitals all over Thailand. Results: The response rate was 54.1%. The results show that most of physicians that provide care for persons with epilepsy were General Practitioners (91.5%). Epileptologists and Neurologists accounted for only 11.1% and 14.4%. There were only 52 EEG, 54 CT Scan, and 6 MRI instruments in the entire country of 65 million. Standard antiepileptic drugs (AEDs) were widely available, phenobarbital (99.9%), phenytoin (96.0%), carbamazepine (97.9%), and valproic acid (89%) of institutions. The availability of new AEDs were gabapentin (77.6%), topiramate (63.9%), levetiracetam (46.0%), lamotrigine (45.3%), pregabalin (33.6%), were also available in 77.6%, 63.9%, 46.0%, 45.3%, 33.6%, vigabatrin (14.5%), and oxcarbazepine (14.3%) of institutions. Intravenous AEDs used for status epilepticus patients include phenytoin (54.2%), phenobarbital (33.9%), and sodium valproate (12.1%). Therapeutic drug monitoring could be done in 45.7% of the responding hospitals. Conclusion: There is limited human and material resources for the care of epilepsy in Thailand. There is a need to develop a model of epilepsy care that is appropriate with the limited resources in the country.