Clinical features, proximate causes, and consequences of active convulsive epilepsy inAfrica

• DOI: 10.1111/epi.12392
• Publication Date: 2013-10-12T02:24:13Z
• Authors: Symon M. Kariuki; William Matuja; Albert Akpalu; Angelina Kakooza‐...; Martin Chabi; Ryan G. Wagner; Myles Connor; Eddie Chengo; Anthony K. Ngugi; Rachael Odhiambo; Christian Bottomley; Steven White; Josemir W. Sander; Brian G. R. Neville; Charles R. J. C. ...
• Keywords: Phenobarbital

Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies hospital-based, few have compared different ecological sites SSA. We described active convulsive epilepsy (ACE) identified cross-sectional community-based surveys SSA, to understand proximate causes, features, consequences.We performed a detailed neurophysiologic description of ACE cases from community survey 584,586 people using medical history, neurologic examination, electroencephalography (EEG) data five Africa: South Africa; Tanzania; Uganda; Kenya; Ghana. The were examined by clinicians discover risk factors, epilepsy. used logistic regression determine factors associated with comorbidities.Half (51%) 2,170 children 69% seizures began childhood. Focal (EEG, seizure types, deficits) present 58% cases, these varied significantly site. Status epilepticus occurred 25% ACE. Only 36% received antiepileptic drugs (phenobarbital was most drug [95%]), proportion Proximate causes adverse perinatal events (11%) for onset before 18 years; acute encephalopathy (10%) head injury prior (3%). Important comorbidities malnutrition (15%), cognitive impairment (23%), deficits (15%). burns (16%), injuries (postseizure) (1%), lack education (43%), being unmarried (67%) or unemployed (57%) adults, all more than those without epilepsy.There significant differences across sites. ACE, suggesting identifiable preventable causes. Malnutrition should be integrated into management this region. Consequences such as burns, education, poor marriage prospects, unemployment need addressed.