Montego Bay, St James – Jamaica is poised to join a select group of countries, outside of the developed world, to offer cutting-edge epilepsy surgery in another year or two, according to epileptologist and head of the Jamaica League Against Epilepsy (JLAE), Dr Amza Ali.

The breakthrough, Dr Ali said, will be made possible through the assistance of several overseas agencies, which have already given their commitment to help implement the programme, as well as the Video EEG unit, established at Andrews Memorial Hospital in Kingston in 2004.

“I cannot give a timeline, but we expect to be able to do our first patients within the next year or two,” said Ali, whose organisation, in conjunction with the Jamaica Epilepsy Association (JEA), has been working locally to improve knowledge and care of epileptics, including a recent submission to the Government seeking to amend the Road Traffic Regulations, which currently prevent epileptics from obtaining driver’s licences.

“Epilepsy surgery is really something that has only been done in developed countries,” Ali told the Sunday Observer. “When we do go into this sphere of things we really will be joining a very select group of places that actually do this surgery outside of the developed world.”

According to Ali, only Egypt, Colombia, India and Brazil offer this final modality in care for persons with epilepsy – about one per cent of the population or about 27,000 persons. It is recommended only for patients who have been thoroughly checked out and are not responding to medication.

He said that the work at the EEG Unit – initially funded by the Government’s Health Support Fund and now maintained by the JEA, which recently launched a $4-million fund-raising effort – was very important to the implementation of the programme.

“It’s what we use to document the type of seizures patients are having and where the seizures are coming from,” he said. “This facilitates accurate diagnoses of epilepsy and hence appropriate treatment.”

To date, he said, some 80 persons have been evaluated at the unit, with 11 of them already identified for surgery when it comes on board.

“In another two weeks I am also going to be presenting the data of the first 60 patients evaluated at the unit at the American Epilepsy Society meeting in San Diego, California,” he said.

Meanwhile, Ali said he expects a favourable response to the organisation’s submission for a review of the traffic regulations that currently prohibits persons with epilepsy – a disease characterised by sudden, recurring, unprovoked seizures – from driving.

“The fact is that in 70 per cent of cases, epilepsy can be completely controlled by medication,” said Ali. “There can be no guarantees that somebody won’t have a seizure, but they (developed countries) have looked at this statistically over several decades and they have found that people with epilepsy are no more prone to accidents than the ordinary person.”

He said the submission, currently being reviewed by the Ministry of Transport, recommends that people who have been completely seizure free for two full years and those whose seizures have only occurred at night during sleep for three full years, be allowed to obtain driver’s licences.

“These regulations are actually less liberal than in many places in the world,” he explained. “For example England, where you are allowed to drive after one year and in the United States, where you are allowed to drive if you have not had a seizure in six or even three months.”

Furthermore, he pointed out that persons with diseases which predisposes them to seizures, such as diabetics, who can go hypoglycaemic and become impaired, potentially being unable to drive effectively, are not prevented from obtaining driver’s licences.

He said that there is a stigma against people with epilepsy which the JEA and the JLAE have been trying to combat since the inception of the two organisations.

wrightk@jamaicaobserver.com