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Improving epilepsy care in the Caribbean

November 4, 2022 | Author: Royal College Staff

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When Dang Khoa Nguyen, MD, FRCPC, travelled to Trinidad and Tobago on a Neurology teaching mission in 2019, the country had only eight neurologists to treat a population of more than 1.34 million people.

“A lack of access to basic neurological care is an issue throughout the Caribbean,” says Dr. Nguyen. He and a group of neurologists with the Canadian League Against Epilepsy (CLAE) are using International Development, Aid and Collaboration funding to support their work to improve how epilepsy is diagnosed and managed in the region.

Work has the most impact in the Caribbean

Dr. Nguyen is a professor in the Department of Neuroscience at Université de Montréal and Canada Research Chair in Epilepsy and Functional Anatomy of the Human Brain. Having completed multiple teaching missions with CLAE on several continents, he is convinced the group’s efforts can have the greatest impact in the Caribbean, which includes some of the world’s lowest-income countries.

“The scarcity of epilepsy neurologists and neurophysiology technicians limits appropriate epilepsy management in the region,” he says. Meanwhile, a lack of infrastructure and education expertise create a cycle where these gaps persist.

Left to right: Dr. Luca Ratti, Martinique University Hospital, Morris Scantlebury, MD, FRCPC, Dr. Nicholas Maraj, Eric Williams Medical Sciences Complex, Anne Lortie, MD, FRCPC, Dang Khoa Nguyen, MD, FRCPC, and Dr. Avidesh Panday, Eric Williams Medical Sciences Complex, after an epilepsy seminar at the Eric Williams Medical Sciences Complex in Trinidad (submitted photo)

Improved diagnosis and management

Dr. Nguyen says the teaching he and his team have planned will improve global care of epilepsy by enabling physicians to make correct diagnoses, prescribe the most appropriate medications and make higher-quality interpretations of electroencephalograms (EEGs). “It’s essential in the treatment of epilepsy to first diagnose the disease and determine what type of seizures or epileptic syndrome the person has. Our training will enable local physicians to be more independent in making these kinds of diagnoses and control patients’ conditions more effectively,” he says. The project will address challenges in three principal ways:

• It will improve access and interpretation of EEGs, which is the cornerstone of epilepsy diagnosis.
• His team will offer educational consultations, including virtual clinics, which can be especially helpful in diagnosing and treating challenging cases of epilepsy. Canadian epilepsy centres will be paired with local Caribbean physicians to encourage long-term partnerships.
• His team will deliver seminars once a year, conduct in-person visits and receive trainees at the Université de Montréal as ways to stay connected. In addition to reinforcing the project’s training, seminars will enable networking and promote collaboration among Caribbean islands.

Although some education will be conducted online, “Nothing beats in-person visits,” says Dr. Nguyen. “Funding from IDAC will support our travel to Trinidad, Grenada and other countries so we can teach face-to-face.”

Creating future leaders

The project’s overarching goal is to create local leaders in epilepsy diagnosis and management who can teach the next generation of physicians in the Caribbean. “It’s not the number of people we train that is important in this case,” says Dr. Nguyen. “It is the quality of the training that trainees can then take forward into their communities.”