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Epilepsy is one of the most common neurological disorders globally. According to the WHO, it affects over 50 million people with 80% of those living in low to middle income countries (LMICs). Additionally, around 15 million women of reproductive age live with epilepsy, making it the most common serious neurological condition encountered in pregnancy.
Epilepsy remains underdiagnosed, undertreated and poorly understood, particularly in LMICs, where there are shortages of neurologists, diagnostic tools and essential medications. Through the collection of comprehensive, standardised data on epilepsy and pregnancy outcomes, the MOMENTUM study will help inform national policy, shape culturally sensitive approaches to treatment and contribute to global efforts to address epilepsy and maternal health in countries, such as Nepal, where resource is limited.
Bringing together researchers from NDCN, Nuffield Department of Women’s and Reproductive Health, the Centre for Global Epilepsy and the Nepal Public Health Foundation (NPHF), the study will also build much needed research capacity in Nepal and strengthen international collaboration.
The work planned will explore the vitally important intersections between seizure disorders and maternal health with a clear plan to improvements in brain health policy more broadly
Understanding the true burden
In Nepal, there is limited up-to-date data on the burden of epilepsy. A 2020 survey reported 8.5 cases of epilepsy per 1,000 people and an estimated 70-80% not receiving the treatment they need. The true burden of epilepsy has likely worsened given poor infrastructure, limited access to diagnostic tools, and continued lack of public awareness of the condition.
This study will generate the first dataset on epilepsy in Nepal in nearly two decades. At the National Academy of Medical Sciences (NAMS) and Paropakar Maternity and Women's Hospital in Kathmandu, the Global Epilepsy Research Database (GERD) questionnaire will be used to collect data, both from existing records and an ongoing study of new patient cohorts. It will also collect comprehensive, standardised data on epilepsy and pregnancy outcomes in Nepal
Interviews with affected individuals will explore lived experiences, providing deeper insights into cultural interpretations of epilepsy in the region. Stigma remains a major barrier to epilepsy treatment, with misconceptions about the condition preventing individuals from seeking appropriate help and contributing to a poor quality of life. Additional mental disorders, such as anxiety and depression, are also common in people with epilepsy, yet these are often overlooked.
A focus on maternal health
Pregnant women with epilepsy face additional challenges, from increased risk of death during pregnancy or childbirth to complications such as pre-eclampsia, premature delivery and prolonged seizures. Furthermore, infants exposed to certain anti-seizure medications (ASMs) are at higher risk of congenital anomalies and neurodevelopmental delay.
The lack of data on pregnancy outcomes and the safe use of medications is a particular challenge in an environment where there is limited support to manage these risks and medical guidance is unclear.
As part of this collaboration, Ms Deepesha Silpakar, Project Coordinator at NPHF, recently joined the Centre for Global Epilepsy as an Oxford Martin School Visiting Fellow. In December 2025 she shared insights from her work at a talk examining how epilepsy is addressed within maternal health frameworks in Nepal.
Reflecting on her fellowship, Deepesha explained ‘I gained important insights into the existing gaps between research, policy, and practice in the care of women with epilepsy in Nepal, particularly during pregnancy. There is urgent need for clear clinical and policy guidelines that link epilepsy care with maternal health pathways to ensure quality of care for women throughout pregnancy, childbirth, and the postnatal period in Nepal.'
Professor Arjune Sen, Professor of Global Epilepsy at the University of Oxford, added ' It is both a delight and a privilege to be initiating the MOMENTUM project with Nepal Public Health Foundation, a core partner of the Centre for Global Epilepsy. The work planned will explore the vitally important intersections between seizure disorders and maternal health with a clear plan to improvements in brain health policy more broadly. It is also wonderful that The MOMENTUM project is being directly funded by NDCN/CGE – a clear example of University of Oxford’s enduring commitment to positively empower epilepsy research and care worldwide.'