Epilepsy is one of the most frequent neurological disorders and affect 0.5-1% of all inhabitants of Western societies. The frequency in most Eastern countries is not well known, but appear to be higher due to cultural and economic factors. Epilepsy care in most Eastern countries, including Moldova, are still influenced by old Soviet standards, i.e.epilepsy is considered a psychiatric disease. Thus, not neurologist but psychiatrists take care of epileptic patients, which ultimately result in an even greater stigmatization of these patients. Psychiatric care and treatment cannot be considered appropriate for epileptic patients, since it usually includes different utilization of diagnostic tools and treatment options. The present institutional partnership intends to change this situation in Moldova, a country, which became independent from Russia in 1991 and comprises approximately 4.3 Mio people.
In several steps during the 3 years of funding, we try to change gradually the hospital route for epilepsy patients in creating an epilepsy center in the university hospital of Moldova. First, a functioning out-patient clinics needs to be established making optimal use of the existing facilities, i.e. EEG system and training of technicians. Second, in-patient monitoring facilities need to be set up in order to provide additional diagnostic resources and the possibility of presurgical evaluation. In an emerging country such as Moldova, with a limited economic scope, surgical treatment is an important alternative to life-long medical treatment. Transfer of 3D-EEG localization programs and software allow to carry out modern focus identification, since other rather expensive technologies, such as nuclear imaging, are not yet present. The familiarization of comprehensive epilepsy care will be achieved by mutual visits of both partners and their collaborators. Along the creation of the center, epidemiological groundwork will be done, which will give a better idea of the needs of Moldovian society. In particular the needs of children and women should be addressed who suffer probably even more from the marginalization when the diagnosis “epilepsy”is posed. At the end of an intensive working and learning period, the transition to modern epilepsy care is achieved, providing improved facilities for the patients as well as for research.