DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172658

Clinical profile of childhood epilepsy in Nigerian children seen in a tertiary hospital

Komomo Ibor Eyong, Emmanuel E. Ekanem, Asindi A. Asindi, Torty Chimaeze

Abstract


Background: Epilepsies are the most common conditions encountered in most paediatric neurology clinics in many parts of the developing world. In sub-Saharan Africa epilepsies are secondary, reflecting persistently high risks at birth, and the adverse neurological sequelae of CNS infections during and beyond childhood. The study was designed to determine the clinical pattern of childhood epilepsies, probable aetiologies and associated comorbidities of the disease children.

Methods: The study was conducted within an 18 months period among children having established epilepsy attending the Neurology Clinic of University of Calabar Teaching Hospital (UCTH). The children and or care givers were interviewed by the authors and the following data were obtained and recorded in a questionnaire; bio data, age at onset of seizure. History was obtained to determine the possible cause of the seizure, type of epilepsy and associated comorbidities. The data obtained was analysed with SPSS version 20. P-value <0.05 was considered significant.

Results: Of the one hundred eighty children seen with various neurological morbidities during the study period, one hundred and seven had epilepsy which constitutes 59.4%. Generalized tonic clonic epilepsy was the commonest type of epilepsy found in 66 (61.1%) of the children with epilepsy, followed by simple partial and myoclonic epilepsy in 18.5% and 6.5% respectively. Severe birth asphyxia was responsible was the commonest identifiable cause of epilepsy in 19 (17.8%) of cases while central nervous system infection accounted for 14 (13.1%). Cerebral palsy was the commonest comorbidity in 20 (18.6%) followed by mental retardation in 17 (15.9%) of the children.

Conclusions: The study showed epilepsy to be the commonest neurological presentation among children presenting at the paediatric neurology clinic of our facility. Primary generalised tonic clonic epilepsy was the commonest type of epilepsy seen, followed by simple partial seizures. Cerebral palsy and mental retardation were the main associated comorbidities. Birth injuries mainly severe birth asphyxia and CNS infection were the major causes of epilepsy in our study. In conclusion, epilepsy is the commonest neurological morbidity in our environment, limited facilities and resources still militate against identifying the actual aetiology in most children with the disease. Effort should be intensifying to eradicate the preventable causes of the disease.


Keywords


Clinical, Childhood, Epilepsy, Profile

Full Text:

PDF

References


Neurological and psychiatric disorders: Meeting the challenge in the developing world. Washington DC, Institute of Medicine; 2001:1

Dent W, Helbok R, Matuja WB. Prevalence of active epilepsy in rural Tanzania: a door-to-door survey. Epilepsia. 2005;46:1963-9.

Velez A and Eslava-Cobos J. Epilepsy in Colombia: epidemiological profile and classification of epileptic seizures and syndromes. Epilepsia. 2006;47:193-200.

Rwiza HAT, Kilonzo GP, Haule J. Prevalence and incidence of epilepsy in Ulanga, a rural Tanzania district: a community-based study. Epilepsia. 1992;33:1051-6.

Izuora GI, Iloeje SO. A review of neurological disorders at the Paediatric Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu. Ann Trop Pediatr. 1989;9:185-90.

Ojuawo A, Joiner KT. Childhood epilepsy in Ilorin, Nigeria. East Afr Med J. 1997;74:72-5.

Izuora GI, Anis AS. Neurologic disorders in Saudi Children at the Al-Majardah General Hospital, Asir region. Ann Saudi Med. 1992;12:191-5.

Shorvon SD, Farmer PJ. Epilepsy in developing countries: a review of epidemiological, sociocultural, and treatment aspects. Epilepsia. 1988;29:36-54.

Durkin MS, Davidson LL, Hasan MZ, Hasan Z, Hauser WA, Khan N, et al. Estimates of the prevalence of childhood seizure disorders in communities where professional resources are scarce: results from Bangladesh, Jamaica, Pakistan. Pediatr Perinatal Epidemiol. 1992;6: 166-80.

Preux PM, Druet-Cabanac M. Epidemiology and aetiology of epilepsy in sub-Saharan Africa. Lancet Neurol. 2005;4:21-31.

The Global Campaign Against Epilepsy. Geneva, World Health Organization, 2000 (Information Pack for the launch of the Global Campaign’s Second Phase; 2001.

Wright, J. A population-based study of the prevalence, clinical characteristics and effect of ethnicity in epilepsy. Seizure. 2000;9(5):309-13.

Aziz H, Akhtar SW, Hasan KZ. Epilepsy in Pakistan: stigma and psychosocial problems: a population‐based epidemiologic study. Epilepsia. 1997.38(10):1069-73.

Senanayake N, Román GC. Epidemiology of epilepsy in developing countries. Bull World Health Organ. 1993;71:247-58.

Del Brutto HO. Neurocysticercosis. Seminars in Neurology. 2005;25:243-51.

Garcia HH, Gonzalez AE. Evans CAW, Gilman RH. Taenia solium cysticercosis. Lancet. 2003;362:547-56.

Hedderick E, Buchhalter JR. Comorbidity of childhood-onset epilepsy and psychiatric and behavioral disorders: a population-based study. Ann Neurol. 2003;54(7):115.

Eyong KI and Asindi AA Cerebral Palsy in Calabar, Nigeria – a preliminary study. Nig Med Pract. 2010;58:105-10.

National Institute of Neurological Disorders and Stroke. Seizures and epilepsy:Hope through research. Available at: www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm.

Eyong KI, Maxwell AU, Asindi AA, Ubi IO. Nigerian secondary school teachers' knowledge and attitudes towards schoolchildren with epilepsy J Pediatr Neurol. 2012;10:111-5.