Childhood epilepsy in Papua New Guinea

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.