Problems of Epilepsy in Poland

There are 32 million people in Poland, half of whom live in towns and the other half in villages. The national insurance system in Poland entitles all employed citizens, their families and also pensioners to free medical treatment in out‐patient departments, hospitals and convalescent homes. Some individual farmers contribute to the cost of medical treatment, others belong to cooperatives and are insured. All insured patients can obtain drugs at 30 % of cost; some drugs used in chronic diseases, including hydantoin derivatives, are sold at 10% of their normal price. Drugs are free to disabled and pensioned persons. Individual farmers and craftsmen pay full prices. Epileptic patients are examined and treated in neurological and psychiatric ambulatory clinics and in Medical School and Regional Hospitals. Serious neuro‐psychiatric cases are cared for in 31 Residential Units; when they are epileptic, their mental rather than their seizure status is the main indication. Only few of these Units are exclusively for epileptic children needing long‐term care. In addition there are two Neuropsychiatric Centers mainly for epileptic children with in all 330 beds, with schools, workshops and laboratories to give the children training. Patients may be treated by general practitioners or referred by them to outpatient clinics; as a rule they are also seen by specialists. There are, however, epileptics who in spite of their seizures and the possibility of free medical treatment do not seek medical help; how many is not known but they may be not few (unpublished observations). Many of them may have infrequent or nocturnal seizures. Epilepsy is one of the main research problems in seven Medical School departments: three neurological, one psychiatric and three neurosurgical. Several Medical Schools have special out‐patient clinics for epileptics.