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Journal of the international Child Neurology Association Issue 2019
Submitted
January 12, 2019
Accepted
December 27, 2019
Published
December 28, 2019
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Abstract

Background


Most children with epilepsy reside in resource-limited regions such as sub-Saharan Africa, where the majority of studies have been conducted in rural areas with limited investigations. Medical records from children with epilepsy seen at an urban hospital in Kenya were examined to provide a comprehensive description of epilepsy in children from this hospital.


 


Methods


A retrospective observational study was conducted which involved reviewing medical records of 426 epilepsy patients (260 males and 166 females) aged 0 - 18 years, seen at Aga Khan University Hospital, Nairobi, Kenya between February 2011 and December 2014.


 


Results


The most frequent age at presentation; documented in 29% was in infancy. Generalized seizures due to structural brain abnormalities were the most common form of epilepsy (28%). Lennox-Gastaut Syndrome was the most common electroclinical syndrome (7%). Focal seizures and focal seizures with loss of awareness were identified in 12% of the population. There were no cases of childhood absence epilepsy in this group. Brain atrophy was the most common MRI finding, occurring in a fifth of the population (20%), while cystic encephalomalacia occurred in 13%. Half (50%) of all EEG recordings performed for this cohort were abnormal. Generalized seizures due to structural brain abnormalities and Lennox-Gastaut Syndrome (LGS) were significant predictors of a treatment history of three or more AEDs. At the conclusion of the review period, 16% of the patients had not visited the clinic for more than 12 months and were considered to be lost to follow-up.


 


Conclusion


The highest frequency of epilepsy cases was documented in children less than one year of age. Generalized seizures due to structural abnormalities and Lennox-Gastaut syndrome were the most common seizure type and syndrome. Improvement of public awareness of different types of seizures in children may increase identification of children with childhood absence epilepsy.

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Copyright (c) 2019 Pauline Samia, Arwen Barr, Subira B Levi, Kirsten A Donald, Jo M Wilmshurst, Charles R. Newton

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Author Biographies

Arwen Barr, University of Victoria, British Columbia, Canada

 

 

 

Subira B Levi, Dr, Aga Khan University, Nairobi, Kenya

 

 

Kirsten A Donald, Dr, Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

 

 

Jo M Wilmshurst, Prof, Division of Paediatric Neurology, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

 

 

 

 

Charles R. Newton, Prof, KEMRI-Wellcome Trust Collaborative Programme, Kilifi, Kenya

 

 

 

How to Cite
Samia, P., Barr, A., Levi, S. B., Donald, K. A., Wilmshurst, J. M., & Newton, C. R. (2019). Clinical characteristics of children with epilepsy managed at an urban hospital in Africa: a retrospective study. Journal of the International Child Neurology Association, 1(1). https://doi.org/10.17724/jicna.2019.162
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