Sleep disorders and behavioral disorders in Jamaican children with epilepsy: A case-control study.

Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differences in reports, the aim was to evaluate sleep and behavior in Jamaican CWE and determine any association with epilepsy-related variables. Children with epilepsy were identified along with age and gender-matched controls from the University Hospital of the West Indies and the Bustamante Hospital for Children. Written informed consent was obtained followed by the completion of questionnaires assessing sleep, behavior, and background of both cases and controls. Parents of 61 children (26 cases and 35 controls) participated in the study. There was no difference in sleep scores or frequency of sleep disorders between cases and controls (p > 0.05). Children with epilepsy had worse scores than controls in peer problems (3.85 vs 2.32, p < 0.01), internal problems (7.42 vs 4.71, p < 0.01), and total behavioral problem (16.27 vs 12.09, p < 0.01). When compared with controls, CWE had a higher frequency of abnormal peer problems (66% vs 32%, p < 0.05) and emotional problems score (42% vs 15%, p < 0.05). Children with learning difficulty were three times more likely to have abnormal behavioral score Odds Ratio (OR) = 3.818, p < 0.05). Jamaican CWE have similar sleep scores to their healthy peers but have a higher frequency of peer and emotional problems.

Parent and caregiver knowledge, beliefs, and responses to convulsive seizures in children in Kingston, Jamaica - A hospital-based survey.

OBJECTIVE: The objective of this study was to determine the knowledge and beliefs about seizures and actions during seizures of parents/caregivers of Jamaican children hospitalized for convulsive seizures. DESIGN AND METHODS: This was a cross-sectional study of parents and caregivers of children with acute convulsive seizures hospitalized at the Bustamante Hospital, Kingston, Jamaica between May 1 and October 31, 2013. Subjects were identified by admission records. Parents/caregivers were invited to participate. A questionnaire on the demographics, knowledge, beliefs, and response of parents/caregivers during the child's current seizure episode was administered face to face. Data were analyzed for frequencies: groups were compared using chi-square analysis for categorical variables, Student's t-test for normally distributed data, and the Mann-Whitney U-test for data not normally distributed. RESULTS: There were fifty participants: 39 (78%) mothers, mean (SD) age - 33.8 (10.1) years. All sought medical care first. Twenty-two (44%) had plausible beliefs about the cause of seizures. Twenty-seven (54%) knew of appropriate actions during a seizure, 10 (20%) knew of appropriate precautions, and 11 (22%) responded appropriately during the seizure. Eleven (22%) reported receiving seizure education. Witnessing a previous seizure, education level, and seizure education were associated with knowledge of seizures (p<0.05). Socioeconomic status was higher in those with plausible beliefs about seizures and lower in those who took appropriate action during a seizure (p<0.05). CONCLUSION: Parents/caregivers of children with convulsive seizures have appropriate health-care seeking behavior, but most do not have appropriate knowledge about seizures. Few take appropriate action during the episode. A public education program is needed to improve parental knowledge of and response to convulsive seizures.

The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire was equivalent to clinical assessment in identifying children with epilepsy.

OBJECTIVES: To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. STUDY DESIGN AND SETTING: We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists' offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. RESULTS: The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P < 0.01). CONCLUSION: The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.

Menkes' kinky hair syndrome

We herein describe a case of Menke's syndrome in a Jamaican infant. The diagnosis was confirmed by low serum copper and ceruloplasmin levels. (AU)