Pattern of childhood epilepsies in Sagumu, Nigeria

Objective: To determine the prevalence, aetiology and clinical pattern of childhood epilepsies in a Nigerian tertiary hospital. Methods: A review of hospital records of children managed for epilepsies at the Pediatric Neurology Clinic. Data studied included the age at presentation, sex, socio-economic class, probable aetiology, clinical type of seizure, Electroencephalopgraphic (EEG) pattern and presence of other neurologic disorders co-existing with seizures. Results: Out of 183 children, 138 had epilepsies giving a prevalence of 75.4%. Sixty nine (54.7%) were aged 6 months to 3 years at the first visit and 115 (69.9%) belonged to lower socio-economic classes IV and V. Birth asphyxia 47 (37.3%) and brain infections in 28 (21.9%) were the leading aetiologies. Generalized tonic-clonic seizures, complex partial seizures and rolandic seizures occurred in 55 (76.9%), 8 (6.3%) and 2 (4.8%) children respectively. Inter-ictal EEG abnormalities were recorded among 72/77 children. Seizures co-existed with other neurologic deficits in 86 (68.3%) of all epileptic cases. 95 (75.4%) children had defaulted from the clinic as at the time of the study. 21 (19.6%) had poor response to drug treatment. Presence of other neurological disorders (p = 0.029) and multiple aetiologies (p = 0.0000) were associated with poor response to drug treatment. Conclusion: Most cases of childhood epilepsy in Sagamu, Nigeria are due to preventable perinatal and neonatal conditions. Therefore, improved obstetric and neonatal care may reduce the prevalence of this condition. © 2009 Dr. K C Chaudhuri Foundation.