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Clinical and therapeutic profile of childhood epilepsy in an Onchocerciasis-endemic rural Area
Last modified: 2018-09-09
Abstract
Introduction: A high prevalence of epilepsy is usually reported in many onchocerciasis-endemic regions. Specific data on childhood epilepsy in a rural area with endemic onchocerciasis are scarce.
Methods: This study aimed to determine the clinical, diagnostic and therapeutic features in children living in an onchocerciasis-endemic rural area. We conducted a prospective cross-sectional study with included all children and adolescent aged 1 month to 18 years, presenting with active epilepsy.
Results: A total of 107 patients were included (girls: 57%), with a mean age of 12.6 ± 3.8 years. Generalized seizures were the most common clinical presentation with 82.2% of cases. In 96.3% of patients, the diagnosis was based solely on clinical arguments. We encountered 1 case of Nodding syndrome and 1 case of Nakalanga syndrome. Of the 107 children, only 21 had been examined by a doctor (19.6%) and 4 (3.8%) had done an electroencephalogram. The antiepileptic drugs prescribed were: carbamazepine (57.5%), phenobarbital (18.9%) and sodium valproate (3.8%). The search for microfilaria was positive in 10.2% (5/49) of the cases and 19.6% (21/107) had received ivermectin from the national onchocerciasis control program.
Conclusion/discussion: This study highlights the diagnostic and therapeutic difficulties faced by the families of children with epilepsy in a rural area due to lack of trained personnel and equipments. It also reveals that 1/10th of children with epilepsy in this onchocerciasis-endemic area have a positive microfilaria test.
Methods: This study aimed to determine the clinical, diagnostic and therapeutic features in children living in an onchocerciasis-endemic rural area. We conducted a prospective cross-sectional study with included all children and adolescent aged 1 month to 18 years, presenting with active epilepsy.
Results: A total of 107 patients were included (girls: 57%), with a mean age of 12.6 ± 3.8 years. Generalized seizures were the most common clinical presentation with 82.2% of cases. In 96.3% of patients, the diagnosis was based solely on clinical arguments. We encountered 1 case of Nodding syndrome and 1 case of Nakalanga syndrome. Of the 107 children, only 21 had been examined by a doctor (19.6%) and 4 (3.8%) had done an electroencephalogram. The antiepileptic drugs prescribed were: carbamazepine (57.5%), phenobarbital (18.9%) and sodium valproate (3.8%). The search for microfilaria was positive in 10.2% (5/49) of the cases and 19.6% (21/107) had received ivermectin from the national onchocerciasis control program.
Conclusion/discussion: This study highlights the diagnostic and therapeutic difficulties faced by the families of children with epilepsy in a rural area due to lack of trained personnel and equipments. It also reveals that 1/10th of children with epilepsy in this onchocerciasis-endemic area have a positive microfilaria test.
Keywords
Epilepsy; children; rural area; onchocerciasis; ivermectin
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