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Childhood epilepsy in Ilorin, Nigeria
1Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Ilorin, Nigeria.
Insights
This study on childhood epilepsy found generalized tonic-clonic seizures are most common. Poor drug compliance and medication access significantly hinder effective seizure control in children.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Epilepsy is a prevalent neurological disorder in children.
- Understanding the epidemiology and clinical characteristics of childhood epilepsy is crucial for effective management.
Purpose of the Study:
- To prospectively investigate the clinical features, seizure types, neurological sequelae, and treatment outcomes of epilepsy in children.
- To identify challenges in seizure control and drug compliance in a specific healthcare setting.
Main Methods:
- Prospective study of 98 children with epilepsy over two years at the University of Ilorin Teaching Hospital.
- Data collection included seizure types, age of onset, neurological examination, skull radiography, and electroencephalography (EEG).
Main Results:
- Generalized tonic-clonic seizures (62.2%) and partial seizures (17.4%) were the most frequent types.
- Hemiplegia was the most common neurological sequela (30.3%).
- Abnormal findings were noted in 11.2% of skull radiographs and 43.9% of EEGs.
Conclusions:
- Single anticonvulsant therapy is often effective, but challenges like focal seizures and infantile spasms require tailored approaches.
- Poor drug compliance, drug unavailability, and cost are significant barriers to adequate seizure control in this population.
Abstract:
Ninety eight children with epilepsy attending the Neurology clinic, University of Ilorin Teaching Hospital over a two year period were studied prospectively. Males were more affected than females in a ratio of 5:3. Generalised tonic-clonic seizures accounted for 62.2% of the cases, and partial seizures for 17.4%. Infantile spasms were seen exclusively in infants less than two years old and absence and generalised seizures in children more than three years of age. Skull radiography showed abnormal findings in 11.2%. Ectroencephalography showed typical findings in 43.9%. Hemiplegia was the most common neurological sequelae (30.3%). Other sequelae include hyperactivity, irrational behaviour, expressive aphasia, mental subnormality, deafness, and blindness in that order. Therapy with a single appropriate anticonvulsant was usually effective for seizure control except in some patients with focal seizures, infantile spasms, severely delayed developmental milestones and prolonged seizures. Poor drug compliance remains the major constraint to adequate seizure control, further compounded in this environment by nonavailability of drugs and unaffordable costs.