“My mother has suffered from epilepsy since she was 18. She was under care at the Social Security Institute; this year her medication was changed because, given her age, her system needed to be cleared. In recent weeks she had an accident triggered by a seizure; she went for an appointment because she is also under care for depressive symptoms. She was referred to a specialist, but when she arrived they told her the doctor who had been treating her had resigned and she now had to start the process to get an appointment,” said María, who spoke with El Diario de Hoy and asked to use a fictitious name to protect her mother.
A new crisis is crippling care for epilepsy patients at the Salvadoran Social Security Institute (ISSS), according to the Sindicato de Médicos Trabajadores del ISSS (SIMETRISSS). The reason, the union says, is that the recent resignation of one of the epileptology specialists has caused wait times for appointments to extend up to a year, heightening the distress of thousands of beneficiaries who depend on this type of care.
According to information provided by the union, the ISSS network had only two foreign-trained epileptologists to handle the most severe and difficult-to-control cases at the ISSS General Hospital. With the resignation of one of them, the institution is now left with only one specialist for the entire country. This means that, according to SIMETRISSS estimates, around 5,000 patients will have to reapply for an appointment, creating a bottleneck in the system and further delaying diagnosis and treatment processes.
The union explained that before this resignation, the average wait time hovered between six and nine months to see a clinical neurologist. However, when that specialist determined it was necessary to refer the patient to an epileptologist, the wait extended an additional three months. With only one epileptologist on duty, timelines will stretch to 12 months or more, mirroring conditions already seen in areas like ophthalmology, where patients must wait between 12 and 18 months for care.
SIMETRISSS warned that this crisis undermines not only access to care but also diagnostic quality. Epileptologists handle the most complex cases, such as refractory epilepsy, conditions that are hard to control or diagnose, and cases that require specialized studies such as sleep electroencephalograms.
Without this level of care, patients are exposed to incomplete or less effective treatments, which can erode their quality of life and, in some cases, have irreversible consequences.
The union noted that, in the absence of subspecialists, many cases will end up being handled by general neurologists who do not have training in epileptology. Although these physicians can prescribe antiepileptic drugs, they cannot access the more complex studies needed to address delicate cases.
Furthermore, patients face another obstacle: an incomplete supply of medicines. Currently, drugs for treating epilepsy are at 75% availability in the Social Security network, according to information presented by the union.
Cases like that of María’s mother receive prescriptions for just five days of medication, and these are not always in stock at Social Security pharmacies, forcing them to visit one or more locations.
SIMETRISSS explained that the specialist’s resignation was driven by several adverse conditions within the institution: appointment slots reduced to just 20 minutes per patient, outdated equipment for diagnostic studies, patient overload, and a work environment marked by bureaucracy and administrative pressure.
They also pointed out that persistent hurdles to attending conferences or pursuing professional development discourage specialists, who often decide to move to the private sector.
The union further alleged that the authorities have tried to hire physicians under professional-services contracts, offering pay below the established scale.
The ISSS communications office was queried about these allegations, but as with prior complaints, no response was forthcoming.
For patients, the barriers keep getting higher. Those who already had appointments scheduled with the specialist who resigned, like María’s mother, must start the process all over again, landing on a waiting list with thousands of other beneficiaries.
The backlog of cases further delays care and aggravates medical complications. The union insisted that the shortage of epileptologists reflects a widespread deterioration within the ISSS, where an exodus of specialists is affecting multiple areas, from neurology to transplants. As of September of this year, 377 doctors have resigned from the institution. Each resignation, they indicated, has a direct impact on the lives of patients, who depend on the Social Security Institute for treatments they could hardly afford in the private sector.
María and her family are evaluating the cost of private care for her mother, as the change in medication has triggered adverse effects; otherwise, they must wait until 2026 to be seen, at the risk of her condition worsening.
The crisis in epilepsy care adds to existing complaints about medication shortages and deficient hospital infrastructure. For the union’s doctors, the situation is alarming. “Every resignation worsens the delays, and patients bear the brunt,” they stated.
With only one epileptologist available in the entire ISSS, patients will have to wait up to 12 months to receive specialized care, a timeline that, according to SIMETRISSS, is untenable for those with hard-to-control diseases.
Request for Information
After receiving the union’s complaints, a request for information was sent to the Social Security authorities and the institute’s communications department to inquire about the following:
- What short- and medium-term plans or strategies will the ISSS implement to guarantee care for epilepsy patients, given the resignation of one of the two specialists in this area?
- How does the ISSS plan to reduce wait times, which can currently exceed 12 months for an epileptology appointment, and what immediate measures are being taken to prevent the situation from worsening?
No immediate response was received from the authorities.
Medication Shortages
In June 2025, epilepsy patients were impacted by medication shortages in the Social Security system. Complaints filed by SIMETRISSS exposed how this had led to an increase in relapses among patients who had been stable for years.
Beneficiaries told the union that they had to check for medicines at different Social Security pharmacies but ran the risk of their prescriptions expiring before they could obtain their treatments.
Epilepsy Patients Face Waits of Up to a Year for Appointments, Denounces SIMETRISSS
“My mother has suffered from epilepsy since she was 18. She was under care at the Social Security Institute; this year her medication was changed because, given her age, her system needed to be cleared. In recent weeks she had an accident triggered by a seizure; she went for an appointment because she is also under care for depressive symptoms. She was referred to a specialist, but when she arrived they told her the doctor who had been treating her had resigned and she now had to start the process to get an appointment,” said María, who spoke with El Diario de Hoy and asked to use a fictitious name to protect her mother.
A new crisis is crippling care for epilepsy patients at the Salvadoran Social Security Institute (ISSS), according to the Sindicato de Médicos Trabajadores del ISSS (SIMETRISSS). The reason, the union says, is that the recent resignation of one of the epileptology specialists has caused wait times for appointments to extend up to a year, heightening the distress of thousands of beneficiaries who depend on this type of care.
According to information provided by the union, the ISSS network had only two foreign-trained epileptologists to handle the most severe and difficult-to-control cases at the ISSS General Hospital. With the resignation of one of them, the institution is now left with only one specialist for the entire country. This means that, according to SIMETRISSS estimates, around 5,000 patients will have to reapply for an appointment, creating a bottleneck in the system and further delaying diagnosis and treatment processes.
The union explained that before this resignation, the average wait time hovered between six and nine months to see a clinical neurologist. However, when that specialist determined it was necessary to refer the patient to an epileptologist, the wait extended an additional three months. With only one epileptologist on duty, timelines will stretch to 12 months or more, mirroring conditions already seen in areas like ophthalmology, where patients must wait between 12 and 18 months for care.
SIMETRISSS warned that this crisis undermines not only access to care but also diagnostic quality. Epileptologists handle the most complex cases, such as refractory epilepsy, conditions that are hard to control or diagnose, and cases that require specialized studies such as sleep electroencephalograms.
Without this level of care, patients are exposed to incomplete or less effective treatments, which can erode their quality of life and, in some cases, have irreversible consequences.
The union noted that, in the absence of subspecialists, many cases will end up being handled by general neurologists who do not have training in epileptology. Although these physicians can prescribe antiepileptic drugs, they cannot access the more complex studies needed to address delicate cases.
Furthermore, patients face another obstacle: an incomplete supply of medicines. Currently, drugs for treating epilepsy are at 75% availability in the Social Security network, according to information presented by the union.
Cases like that of María’s mother receive prescriptions for just five days of medication, and these are not always in stock at Social Security pharmacies, forcing them to visit one or more locations.
SIMETRISSS explained that the specialist’s resignation was driven by several adverse conditions within the institution: appointment slots reduced to just 20 minutes per patient, outdated equipment for diagnostic studies, patient overload, and a work environment marked by bureaucracy and administrative pressure.
They also pointed out that persistent hurdles to attending conferences or pursuing professional development discourage specialists, who often decide to move to the private sector.
The union further alleged that the authorities have tried to hire physicians under professional-services contracts, offering pay below the established scale.
The ISSS communications office was queried about these allegations, but as with prior complaints, no response was forthcoming.
For patients, the barriers keep getting higher. Those who already had appointments scheduled with the specialist who resigned, like María’s mother, must start the process all over again, landing on a waiting list with thousands of other beneficiaries.
The backlog of cases further delays care and aggravates medical complications. The union insisted that the shortage of epileptologists reflects a widespread deterioration within the ISSS, where an exodus of specialists is affecting multiple areas, from neurology to transplants. As of September of this year, 377 doctors have resigned from the institution. Each resignation, they indicated, has a direct impact on the lives of patients, who depend on the Social Security Institute for treatments they could hardly afford in the private sector.
María and her family are evaluating the cost of private care for her mother, as the change in medication has triggered adverse effects; otherwise, they must wait until 2026 to be seen, at the risk of her condition worsening.
The crisis in epilepsy care adds to existing complaints about medication shortages and deficient hospital infrastructure. For the union’s doctors, the situation is alarming. “Every resignation worsens the delays, and patients bear the brunt,” they stated.
With only one epileptologist available in the entire ISSS, patients will have to wait up to 12 months to receive specialized care, a timeline that, according to SIMETRISSS, is untenable for those with hard-to-control diseases.
Request for Information
After receiving the union’s complaints, a request for information was sent to the Social Security authorities and the institute’s communications department to inquire about the following:
- What short- and medium-term plans or strategies will the ISSS implement to guarantee care for epilepsy patients, given the resignation of one of the two specialists in this area?
- How does the ISSS plan to reduce wait times, which can currently exceed 12 months for an epileptology appointment, and what immediate measures are being taken to prevent the situation from worsening?
No immediate response was received from the authorities.
Medication Shortages
In June 2025, epilepsy patients were impacted by medication shortages in the Social Security system. Complaints filed by SIMETRISSS exposed how this had led to an increase in relapses among patients who had been stable for years.
Beneficiaries told the union that they had to check for medicines at different Social Security pharmacies but ran the risk of their prescriptions expiring before they could obtain their treatments.
Pacientes con epilepsia deben esperar hasta un año para consulta, denuncia SIMETRISSS
El sindicato de médicos detalló que el ISSS solo contaba con dos epileptólogos especializados para tratar casos graves y, tras varias irregularidades, uno de ellos decidió renunciar en las últimas semanas.
“Mi madre ha sufrido epilepsia desde los 18 años. Estaba en control en el Seguro Social, este año se le había cambiado la medicación porque su cuerpo necesitaba desintoxicarse por la edad. Durante las últimas semanas tuvo un accidente a raíz de una crisis, fue a pasar consulta porque también está en control por tendencias depresivas, la refirieron con el especialista, pero cuando llegó le dijeron que el médico que la atendía había renunciado y ahora debía iniciar el proceso para recibir cita”, señaló María, quien habló con El Diario de Hoy, y solicitó exponer su caso con un nombre ficticio para proteger a su madre.
Una nueva crisis golpea a los pacientes con epilepsia en el Instituto Salvadoreño del Seguro Social (ISSS), según el Sindicato de Médicos Trabajadores del ISSS (SIMETRISSS). La razón, según el sindicato, es que la reciente renuncia de una de las especialistas en epileptología ha provocado que los tiempos de espera para recibir una cita se prolonguen hasta un año, lo que incrementa la angustia de miles de derechohabientes que dependen de este tipo de atención.
De acuerdo con la información proporcionada por el sindicato, en la red del ISSS únicamente se contaba con dos epileptólogos, formados en el extranjero, para la atención de los casos más graves y de difícil control en el Hospital General del ISSS. Con la renuncia de uno de ellos, la institución se ha quedado únicamente con un especialista para todo el país. Esto significa que, según cálculos del SIMETRISSS, alrededor de 5,000 pacientes deberán volver a solicitar una cita, lo que generará un embudo en el sistema y retrasará aún más los procesos de diagnóstico y tratamiento.
El sindicato explicó que, antes de esta renuncia, el tiempo promedio de espera rondaba entre seis y nueve meses para pasar con un neurólogo clínico. Sin embargo, cuando ese especialista determinaba que era necesario referir al paciente con un epileptólogo, la espera se alargaba otros tres meses. Con un solo epileptólogo en funciones, los tiempos se extenderán hasta los 12 meses e incluso más, en condiciones similares a las que ya se experimentan en áreas como oftalmología, donde los pacientes deben esperar entre 12 y 18 meses para ser atendidos.
SIMETRISSS advirtió que esta crisis no solo impacta en la atención médica, sino también en la calidad de los diagnósticos. Los epileptólogos son quienes atienden los casos más complicados como epilepsias refractarias, de difícil control o diagnóstico, y cuadros que requieren estudios especializados como electroencefalogramas de sueño.
Sin este nivel de atención, los pacientes quedan expuestos a tratamientos incompletos o menos efectivos, lo que puede deteriorar su calidad de vida y en algunos casos puede tener consecuencias irreversibles.
El sindicato señaló que, ante la falta de personal especializado, muchos casos terminarán siendo atendidos por neurólogos clínicos que no cuentan con la formación en epileptología. Aunque estos médicos pueden prescribir medicamentos antiepilépticos, no pueden acceder a estudios más complejos necesarios para abordar los cuadros delicados.
Además, los pacientes se enfrentan a otro obstáculo: la falta de abastecimiento completo de medicinas. Actualmente, los fármacos para tratar los cuadros de epilepsia se encuentran en un 75% de disponibilidad en la red del Seguro Social, según información presentada por el sindicato.
Casos como el de la madre de María, reciben recetas con medicamentos para cinco días y estos no siempre se encuentran disponibles en las farmacias del Seguro Social, por lo que deben visitar una o más.
SIMETRISSS explicó que la renuncia la especialista estuvo motivada por varias condiciones adversas dentro de la institución. Entre ellas se mencionan la reducción del tiempo de consulta a solo 20 minutos por paciente, equipo obsoleto para la realización de estudios, sobrecarga de pacientes y un ambiente laboral marcado por la burocracia y la presión administrativa.
También señalaron que las constantes dificultades para asistir a congresos o desarrollarse profesionalmente desaniman a los especialistas, quienes muchas veces deciden migrar al sector privado.
El sindicato denunció, además, que las autoridades han intentado contratar médicos bajo la modalidad de servicios profesionales con lo que se ofrece un salario menor de lo establecido.
Se consultó a la oficina de comunicaciones del ISSS sobre estas denuncias, pero al igual que en denuncias pasadas, no hubo respuesta.
Para los pacientes, esta situación representa una barrera cada vez más alta. Aquellos que ya tenían citas programadas con el especialista que renunció, como la madre de María, deben volver a iniciar el proceso, quedando en lista de espera, junto a miles de otros derechohabientes.
La acumulación de casos retrasa aún más la atención y agrava las complicaciones médicas.
El sindicato insistió en que la falta de epileptólogos es un reflejo del deterioro generalizado en el ISSS, donde la fuga de especialistas afecta a múltiples áreas, desde neurología hasta trasplantes, hasta septiembre de este año 377 médicos han renunciado a la institución. Cada renuncia, indicaron, tiene un impacto directo en la vida de los pacientes, quienes dependen del Seguro Social para recibir tratamientos que difícilmente podrían costear en el sector privado.
María y su familia se encuentran evaluando el costo de atención privada para su madre, ya que el cambio de medicamentos le ha generado efectos adversos; caso contrario deben esperar hasta 2026 para ser atendidos con el riesgo de agravar su cuadro.
La crisis en el área de epilepsia se suma a las ya existentes denuncias de desabastecimiento de medicamentos y precariedad en infraestructura hospitalaria. Para los médicos del sindicato, la situación es preocupante. “Cada renuncia agudiza los retrasos, y los pacientes son los más golpeados”, señalaron.
Con un solo epileptólogo disponible en todo el ISSS, los pacientes deberán esperar hasta 12 meses para recibir atención especializada, una cifra que, según SIMETRISSS, es insostenible para quienes enfrentan enfermedades de difícil control.
Solicitud de información
Tras recibir las denuncias del sindicato se envió una solicitud de información a las autoridades del Seguro Social y al área de comunicaciones del instituto para conocer:
- ¿Qué planes o estrategias de corto y mediano plazo implementará el ISSS para garantizar la atención a los pacientes con epilepsia, ante la renuncia de uno de los dos especialistas en esta área?
- ¿De qué manera el ISSS prevé reducir los tiempos de espera, que actualmente pueden superar los 12 meses para una cita de epileptología, y qué medidas inmediatas se están tomando para evitar que esta situación se agrave?
De forma inmediata no se recibió respuesta por parte de las autoridades.
Falta de medicamentos
En junio de 2025, los pacientes con epilepsia se vieron impactados por el desabastecimiento de medicamentos en el Seguro Social. Denuncias presentadas por el SIMETRISSS expusieron cómo se había generado un incremento en las recaídas de pacientes controlados por años.
Derechohabientes indicaron al sindicato que debían consultar por medicamentos en diferentes farmacias del Seguro Social, pero corrían el riesgo que la receta se venciera antes de poder obtener sus tratamientos.