The epilepsy treatment gap in low- and middle-income countries especially sub-Saharan countries is substantial, driven by socioeconomic challenges, inadequate infrastructure, and limited access to diagnosis, treatment and care. The diagnostic gap further compounds this, with many patients remaining undiagnosed or misdiagnosed due to lack of skilled healthcare professionals, inadequate diagnostic facilities, and limited access to specialized care.

A comprehensive approach that uses sustainable solutions, prioritizing local ownership, capacity building and community engagement are crucial for bridging the epilepsy treatment and diagnostic gaps. This includes a collaborative effort between the neurology community and opinion leaders as well as policy makers.

Targeted solutions such as training more neurologists through locally relevant programs and training of primary and community healthcare workers for task-shifting and task-sharing interventions. Also strengthening supply chains and procurement processes to ensure constant supply of affordable antiseizure medications. It is critical to promote leveraging of technology such as use of smartphone video recordings, remote EEG and telemedicine tools. Further collection of data is needed inclusive of registries for disease burden, to enhance consistency in diagnostic categorization, follow up and understandings of supply chain efficiency. Overlying these clinical interventions implementation of public awareness campaigns and policy reforms to reduce stigma and promote inclusivity are critical for bridging the epilepsy treatment and diagnostic gaps.

Research should focus on understanding the socioeconomic and public health factors contributing to the treatment and diagnostic gaps, and evaluating the effectiveness of rolled-out interventions.