Epilepsy and Social Stigma – Effects on Quality of life: Narrative Synthesis

Epilepsy remains one of the most stigmatized neurological disorders, with consequences that extend far beyond seizure control to quality of life, social participation, education, employment, and treatment adherence. This paper presents a narrative synthesis of observational studies from Eastern Europe that compared perceived stigma among adults with epilepsy with declared attitudes in the general population and, where available, in medical students as a proxy for future health professionals. The review was based on structured searches of PubMed, Scopus, Europe PMC and relevant regional publications from 2000 to 2025. The available evidence from Croatia, Bosnia and Herzegovina, Serbia and Bulgaria shows a recurrent discrepancy between relatively favorable declared public attitudes and the high burden of perceived stigma reported by patients. Perceived stigma is amplified by seizure burden, refractory disease, depression, anxiety, functional limitations and poor disease control, while direct contact with a person living with epilepsy is consistently associated with more favorable public attitudes. The synthesis supports multilevel interventions that combine public education, contact-based anti-stigma strategies, mental health screening, first-aid training, and clinician engagement. For the Republic of Moldova, the current evidence base remains limited and mainly indirect, which underlines the need for primary observational studies adapted to the regional sociocultural context.