Neurodevelopmental problems in Ghanaian children: Part I. Convulsive disorder

Area of Science:

• Pediatrics
• Neurology
• Clinical Medicine

Background:

• Convulsive disorders represent a significant patient load in pediatric settings.
• In Accra, Ghana, 51.5% of children in a neuro-developmental clinic had epilepsy.
• Generalized tonic-clonic seizures were the most prevalent seizure type.

Purpose of the Study:

• To characterize pediatric epilepsy in Accra, Ghana.
• To evaluate the efficacy and safety of conventional antiepileptic drugs (AEDs).
• To explore the possibility of discontinuing AEDs after long-term seizure control.

Main Methods:

• Retrospective analysis of new patients in a pediatric department and neuro-developmental clinic.
• Review of seizure types, etiological factors, neurological examinations, and electroencephalograph (EEG) findings.
• Assessment of response to antiepileptic drugs (AEDs) and incidence of adverse events.

Main Results:

• Children with convulsive disorders constituted 3% of new pediatric patients and 51.5% of those in the neuro-developmental clinic.
• Generalized tonic-clonic seizures were observed in 76.5% of patients.
• Most patients had no identifiable cause and normal neurological exams; 47.7% of EEGs showed abnormalities.
• Conventional AEDs were effective, with 7.1% discontinuing therapy after achieving seizure freedom for ≥2 years.
• Adverse drug reactions and laboratory abnormalities were infrequent.

Conclusions:

• Pediatric epilepsy is a substantial health issue in Accra, Ghana, with a high prevalence of generalized tonic-clonic seizures.
• Conventional antiepileptic drugs (AEDs) demonstrate good efficacy and tolerability in this population.
• Discontinuation of AEDs is feasible for a subset of children who achieve prolonged seizure remission.