Initiating a new national epilepsy surgery program: Experiences gathered in Georgia.

Surgery is the most effective therapeutic approach for medically refractory epilepsies and a safe and cost-efficient treatment in terms of long-term expenses of direct, indirect, and intangible costs. Georgia is a Caucasian low- to middle-income country with a remarkable effort to deal with epileptic diseases, but without an appropriate epilepsy surgery program. To address the needs for such a service in this country, two joint German-Georgian projects were initiated in 2017 and 2019. In the framework of these projects, a productive exchange program involving German and Georgian experts was undertaken in the past two years. This program included training and mentoring for Georgian clinical colleagues, as well as joint case conferences and workshops with the aim of optimizing presurgical diagnostics and preparing for an epilepsy surgery program in Georgia. Finally, a postsurgical medium- and long-term follow-up scheme was organized as the third component of this comprehensive approach. As a result of our efforts, the first patients underwent anterior temporal lobectomy and all of them remain seizure-free up to the present day. Hence, epilepsy surgery is not only feasible, but also already available in Georgia. In this report, we aim to share our experiences in the initiation and implementation of surgical epilepsy intervention in Georgia and illustrate our recent endeavor and achievements.

Knowledge, attitudes, and stigma towards epilepsy in different walks of life: a study in Georgia.

We conducted a survey to assess public awareness of epilepsy and stigma expression in different social groups in Tbilisi, Georgia. Respondents were divided into those from a medical or paramedical background, those with a nonmedical professional background, and a group with unskilled workers or unemployed individuals. One thousand and sixteen people completed a Knowledge, Attitude and Perception questionnaire. Medical and paramedical professionals had a better general knowledge about epilepsy, its possible causes, and its nature, but their views on treatment and attitudes towards epilepsy were the same or worse when compared to the other groups. Of the respondent, 14% would not let their children play with people with epilepsy, and 75% would not allow their children to marry a person with epilepsy. Nearly a third of teachers considered epilepsy a psychiatric disorder. This suggests a high degree of stigma towards epilepsy in Georgia. Increasing awareness is crucial to ameliorate this.