Epilepsy at the General Hospital, Port-of-Spain - abstract

ABSTRACT

In 1987, the discharge diagnosis on 264 patients admitted to 5 medical wards at the General Hospital, Port-of Spain was fits/epilepsy/seizures. This prompted us to review the cases of epilepsy attending the Neurology Clinic at the institution over a 3-month period, May-August, 1988. There were 182 cases aged 8 to 80 years. Common seizure patterns were tonic/clonic 124 (685), and complex partial become generalized 37 (21 percent). Monotherapy was used in 117 (64 percent), 2 drugs in 51 (28 percent), and 3 drugs in 6 (3 percent) patients. The most commonly used drug was dilantin, drugs included phenobarbitone in 49 cases, mostly in combination and tegretol in 42 cases (21 cases each, singly and in combination). The commonest combination was dilantin and phenobarbitone in 31 cases (17 percent). Antiepileptic drug (AED) levels were done on 297 Specimens from 107 patients and, overall, 117 (39 percent) were in the therapeutic range. Only 59 patients (32 percent) were in good control, i.e. there were no seizures in the 6 months prior to the visit. Epilepsy is not satisfactorily controlled in these patients. This partly reflects lack of compliance, lack of regular supplies of medication, supervision by staff not well-informed in the management of epilepsy, frequent change of clinic staff and lack of awareness of the nature of the illness by patients (AU)