Clinical profile of patients with epilepsy in developing countries: experience at Kano, North Western Nigeria

Abstract

INTRODUCTION: Throughout the world epilepsy is a major neurologic disease with considerable personal and social impact. It constitutes the commonest non-infectious disease of the nervous system that brings the Africans to the hospital. The present study set out to describe the clinical profile of epilepsy in Kano, Northwestern Nigeria.
MATERIALS AND METHODS: The present study was based on the systematic study of consecutive epileptic patients seen at the adult Neurology Clinic of Aminu Kano Teaching Hospital and Murtala Specialist Hospital Kano
over a period of 3 years. Data was collected using a structured questionnaire, which was pretested for clarity, and it was administered by a neurologist and resident doctors, EEGs were obtained and neuroimaging was done where necessary. Analysis of data was done using a statistical software package SPSS version16.
RESULTS: Two hundred and ten patients comprising one hundred and twenty four (59 %) males and eighty six (41%) females were studied. The median age of the male patients was 34 years (range: 17 -77 years) and the median age of the female patients was 35 years (range: 14 -85 years). Eighty eight (41.9%) of the patients had complex partial seizures while eighty three (39.5%) had primarily generalized tonic clonic seizures. The most common (55.6%) aura and automatism encountered in the patients with complex partial seizure were sensory, oro-alimentary respectively. Neurologic deficit was much more likely to be found in simple partial seizure compared to primarily generalized seizure with an odd ratio of 69.4. The most common etiological factors identified on neuroimmaging were cerebral infarcts (4.8%) and tumors (3.3%). Abnormality on neuroimmaging was much more likely to be found in simple partial seizure compared to primarily generalized seizure, odd ratio was 33.9. Abnormal EEG was recorded in 60% of the patients. At presentation, 44.3 % were already on traditional or spiritual mode of treatment. Subsequently, all the patients had anticonvulsants, 55.7% had adequate seizure control. No mortality was recorded during the study period.
Conclusion: In our study, Complex partial and generalized tonic-clonic seizures appeared to be the most common epileptic seizure type seen in Kano. Cerebral infract and tumour appeared to be the most common etiologic factors among subset of patients with symptomatic seizure. Majority of the patients would have sought spiritual or traditional treatment before coming to the hospital stressing the need for education.