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Small Change Could Stop Epilepsy Seizures for Millions

Medicine costing less than three dollars a year per patient could spare 30 millions poor people, many of them children, from the trauma and torment of epilepsy, a new study released Friday has found .

Some 85 percent of epilepsy sufferers in the developing world go without any treatment whatsoever because they cannot afford the drugs most often prescribed to impede the terrible seizures associated with the illness.

The least expensive of these medications, phenobarbital, has been recommended by the World Health Organization (WHO) for victims of convulsive seizures in poor countries, but has been otherwise shunned because it is thought to have more serious side-effects, especially on children.

A drug trial of 108 children in Bangladesh, however, comparing phenobarbital with carbamazepine -- commonly prescribed for epilepsy -- showed the less expensive drug to be equally effective. The study, led by paediatric neurophysiologist Selina Banu and to be published in the British Medical Journal, also concluded it did not provoke more behavioural problems, such as hyperactivity and restlessness.

A follow-up study a year later confirmed the initial findings. Carbamazepine, sold in generic form, retails for about 700 dollars (520 euros) at adult doses for a year's treatment, compared to less than three dollars for phenobarbital. "The burden of untreated epilepsy in terms of human suffering and social costs is enormous," the British Medical Journal said in an accompanying editorial.

"Governments and non-governmental organizations in developing countries need to ensure that effective treatment is effective for all." Epilepsy victims, especially children, are often stigmatized because of unpredictable and violent seizures that can be highly disruptive in daily life.

In some cases major attacks resulting in status epilepticus -- a condition in which seizures last for more than 30 minutes or follow in rapid succession -- require hospitalization.

The researchers cautioned that the conditions of the drug trial, carried out at the Children's Hospital in Dhaka, Bangladesh, were not ideal.

Some children dropped out of the follow up studies and there was a sex-ratio imbalance for one of the drug groups. But even with these shortcomings, the study showed that most children tolerated phenobarbital well and behaviour even improved in many, they reported.


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