Post-traumatic epilepsy is a complicated disease that remains challenging to treat even for patients who are able to access care regularly. People experiencing homelessness (PEH) represent a vulnerable demographic for
neurologic disorders, especially due to gaps in care, limited resources, and low health literacy. This is a case of a 53-year-old male experiencing homelessness who was encountered by low-resource medical providers in an extra-clinical setting. His medical history was pertinent for a
traumatic brain injury at a construction site a few years prior. He was diagnosed with
post-traumatic epilepsy but was lost to follow-up due to being homeless and lacking health insurance. He also had a history of multiple hospitalizations secondary to
seizures and did not consistently take his anti-epileptic medications. He was noted to have multiple facial
wounds of unclear etiology. Upon further investigation, he complained of episodes of waking up on the sidewalk with
facial injuries. The high-risk characteristics of his
seizures prompted street medicine providers to quickly arrange an appointment with a primary care doctor. The process was further expedited by petitioning other local charitable organizations. He was later connected to a physician and re-prescribed
levetiracetam 1000 mg twice daily for his
post-traumatic epilepsy. After taking his medication regularly, his facial
wounds were noted to have dramatic improvement. In this way, his medication adherence was measured as a function of his healing
wounds since a lack of fresh
wounds implied a lack of spontaneous
seizures and subsequent
reinjury. Low-resource medical providers caring for PEH in extra-clinical settings may necessitate using unconventional indicators to assess disease status.