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Childhood epilepsy in Papua New Guinea
R T Danaya1, F A Johnson, U Ambihaipahar
1Port Moresby General Hospital, Division of Child Health, Boroko, NCD, Papua New Guinea.
Insights
Acute meningitis is a significant cause of epilepsy in young children in Port Moresby. Phenobarbitone effectively controls most cases of grand mal epilepsy, proving its utility as an anticonvulsant in developing nations.
Area of Science:
- Pediatrics
- Neurology
- Epidemiology
Background:
- Epilepsy is a common neurological disorder in children.
- Identifying causes and effective treatments is crucial, especially in developing regions.
- Port Moresby General Hospital serves a population where specific etiological factors may be prevalent.
Purpose of the Study:
- To investigate the causes, clinical presentation, and treatment outcomes of epilepsy in children in Port Moresby.
- To assess the efficacy of phenobarbitone as a primary anticonvulsant.
- To evaluate the social impact and treatment challenges of childhood epilepsy.
Main Methods:
- A prospective study was conducted on 40 children diagnosed with epilepsy.
- Data collected included medical history, epilepsy type, treatment regimens, and outcomes.
- Follow-up assessed clinical control, side-effects, and social impact.
Main Results:
- Acute meningitis was a significant etiological factor (38%) in childhood epilepsy.
- Grand mal epilepsy was the most common type (80%).
- Phenobarbitone monotherapy achieved complete seizure control in 45% of cases, with 10% experiencing side-effects requiring treatment changes.
Conclusions:
- Acute meningitis is a key preventable cause of epilepsy in young children in Port Moresby.
- Phenobarbitone remains an effective, accessible, and affordable anticonvulsant for managing grand mal epilepsy in resource-limited settings.
- Despite treatment, significant behavioral and social challenges persist for many children with epilepsy.
Abstract:
A prospective study of 40 children with epilepsy was carried out between June 1990 and August 1991 at Port Moresby General Hospital. Half of the children had yet to start school. Significant features in their past medical histories were acute meningitis (38%), tuberculous meningitis (10%), febrile convulsions (10%) and head trauma (5%). Most cases had grand mal epilepsy (80%). The majority of the children with epilepsy (90%) were treated with a single drug, which was usually phenobarbitone. 22% had received more than one drug, but not simultaneously. Significant side-effects requiring change of treatment occurred in 10%. Disturbed behaviour was reported in 55% and 22% had a poor social outcome. 45% had complete control of fits clinically. This study showed that in Port Moresby acute meningitis is a significant cause of epilepsy in young children, the majority of whom present with grand mal epilepsy, which is usually controlled by phenobarbitone, a readily available and cheap drug and still a useful anticonvulsant in the developing world.