The pattern of epilepsy in Uganda

A composite picture of epilepsy in part of Uganda is presented, making use of both unpublished and previously published material obtained from four different groups of patients with epilepsy. All the patients were of African race and all were aged 10 years or more. The first group consisted of 46 in patients admitted to Mulago Hospital, Kampala; the second of 99 epileptics seen at the Neurological Clinic at Mulago Hospital; the third of 35 epileptics seen at the Mental Health Clinic at Mulago Hospital; and the fourth of 83 epileptics studied in a wholly rural setting about 70 km from Kampala. Sex distribution, age at onset, duration, type of fits, presumed aetiology and regime of drug treatment are analysed and compared. Males outnumbered females in all save the Rural Study group. Temporal lobe epilepsy was much commoner in patients attending the Mental Health Clinic (49% as compared with 4-10% in the other groups). Petit mal was everywhere uncommon. Three quarters of the patients in all groups had had their fits for not more than 10 years. This short duration is discussed in relation to the severe psychosocial disabilities which can be explained by the prevailing local beliefs concerning the disorder. Finally, the benefits of a simple well organised regime of therapy, based mainly on phenobarbitone, is emphasised