Epilepsy in Tibetan-Inhabited Plateau Regions of Western China: A Narrative Review of Epidemiology, Uncertainty About Chronic High-Altitude Effects, and Evidence-Informed Healthcare Priorities.
5 affiliations
- 1Department of Neurology, West China Hospital, Sichuan University, Chengdu 610000, China.
- 2Engineering Research Center of Brain-Machine Interactive Neuromodulation Sichuan Provincial, Chengdu 610000, China.
- 3Laboratory of Neuro-diseases and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610000, China.
- 4Sichuan Provincial Model Worker and Craftsman Innovation Studio, Chengdu 610000, China.
- 5Department of High Altitude Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu 610000, China.
Abstract
Background/objectives
In Tibetan-inhabited plateau regions of western China, remoteness, uneven access to care, and preventable causes complicate epilepsy care. We assessed whether regional evidence supports an independent effect of chronic altitude exposure on epilepsy risk and identified healthcare priorities.Methods
We conducted a targeted narrative review of English-language journal articles published through 12 June 2026 (PubMed/MEDLINE, Web of Science Core Collection, citation tracking). Altitude-related evidence was evaluated against four prespecified, review-defined features; core sources underwent structured qualitative appraisal.Results
Three community surveys with differing case definitions and ascertainment reported prevalence estimates of 2.5-23.5 per 1000; the most recent (Daofu County, 2025) reported 4.4 per 1000 (95% confidence interval 3.7-5.1). No population-based incidence study of long-term residents was identified among the retrieved publications, and no identified resident-population study reported all four features. Regional studies documented parasitic, traumatic, and vascular etiologies, historical treatment gaps of 97-100%, and uneven diagnostic and workforce capacity. Among 127 Daofu participants assessed in detail, 33.1% were classified as receiving nonstandard treatment and 14.2% as untreated; 35.4% and 52.0% screened positive for depressive and anxiety symptoms.Conclusions
Current evidence neither establishes nor excludes an independent effect of chronic altitude exposure. It supports prospective evaluation of prevention, treatment continuity, diagnostic and referral services, workforce development, integrated mental health care, and surveillance.
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BibTeX
@article{li2026epilepsy,
title = {{Epilepsy in Tibetan-Inhabited Plateau Regions of Western China: A Narrative Review of Epidemiology, Uncertainty About Chronic High-Altitude Effects, and Evidence-Informed Healthcare Priorities.}},
author = {Yulong Li and Yixiu Lin and Lei Chen},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203511},
url = {https://europepmc.org/article/MED/42940556},
note = {CC BY},
}
RIS
TY - JOUR
TI - Epilepsy in Tibetan-Inhabited Plateau Regions of Western China: A Narrative Review of Epidemiology, Uncertainty About Chronic High-Altitude Effects, and Evidence-Informed Healthcare Priorities.
AU - Yulong Li
AU - Yixiu Lin
AU - Lei Chen
PY - 2026
DA - 2026/10/19
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203511
UR - https://europepmc.org/article/MED/42940556
AB - Background/objectives In Tibetan-inhabited plateau regions of western China, remoteness, uneven access to care, and preventable causes complicate epilepsy care. We assessed whether regional evidence supports an independent effect of chronic altitude exposure on epilepsy risk and identified healthcare priorities.Methods We conducted a targeted narrative review of English-language journal articles published through 12 June 2026 (PubMed/MEDLINE, Web of Science Core Collection, citation tracking). Altitude-related evidence was evaluated against four prespecified, review-defined features; core sources underwent structured qualitative appraisal.Results Three community surveys with differing case definitions and ascertainment reported prevalence estimates of 2.5-23.5 per 1000; the most recent (Daofu County, 2025) reported 4.4 per 1000 (95% confidence interval 3.7-5.1). No population-based incidence study of long-term residents was identified among the retrieved publications, and no identified resident-population study reported all four features. Regional studies documented parasitic, traumatic, and vascular etiologies, historical treatment gaps of 97-100%, and uneven diagnostic and workforce capacity. Among 127 Daofu participants assessed in detail, 33.1% were classified as receiving nonstandard treatment and 14.2% as untreated; 35.4% and 52.0% screened positive for depressive and anxiety symptoms.Conclusions Current evidence neither establishes nor excludes an independent effect of chronic altitude exposure. It supports prospective evaluation of prevention, treatment continuity, diagnostic and referral services, workforce development, integrated mental health care, and surveillance.
SN - 2227-9032
ER -