RESUMO
BACKGROUND: Epilepsy is a common neurological illness in Nigeria with a prevalence of 5-37 per 1000 in a rural population. Several studies suggest that the prevalence of epilepsy is higher in developing than developed countries due to the preponderance of more risk factors in the former. This study investigated the aetiological factors and precipitants of epileptic seizures among patients attending outpatient clinics of two tertiary hospitals in Kaduna State, Northern Nigeria from October 2008 to April 2013. PATIENTS AND METHODS: Two hundred and forty two consecutive adult patients with history of at least 2 unprovoked afebrile seizures were investigated for seizure patterns, aetiological and precipitating factors through history, physical examinations, laboratory tests and electroencephalography. RESULTS: The male to female ratio of study population was 3 (69%): 1(31%), with respective mean ages of 29.5±12.4and 30.7 ± 16.0years. Their respective mean ages of onset of first seizures were 18.6 ±14.0and 20.9 ±17.4 years. 88% of seizures were of focal origin (complex partial, 80%; simple partial, 8%). Although the causes and precipitants were unknown in 41% and 68% of cases respectively; head injury, neonatal asphyxia and psychoactive substance abuse were prominent aetiological factors. CONCLUSION: Although majority of epileptic seizures in Kaduna State, Northern Nigeria were of focal origin, majority of causes and precipitants remained largely unknown.
RESUMO
OBJECTIVES: Epilepsy is a complex chronic illness with variable treatment outcomes determined by factors specific to each affected person. We investigated prognostic factors for epileptic seizure outcome after 2 years of anti-epileptic drug (AED) monotherapy. MATERIALS AND METHODS: Two hundred and thirty-four AED naïve epilepsy patients were started on AED monotherapy and monitored for 2 years for seizure control. Patients on AED polytherapy were excluded. Prognostic factors investigated were socio-demographics characteristics, age of onset of epilepsy, etiology and precipitants of seizures, presenting seizure types, duration of epilepsy before initiation of AED, family support for treatment, compliance to AED, and clinic attendance. RESULTS: Patients were 160 (68.4%) males and 74 (31.6%) females, with mean ages of 26.2 ± 10.4 and 30.7 ± 16.0 years, respectively. Mean age of onset of epilepsy was 19.0 ± 15.0 years. None of the patients was treated with AED for first seizures, although 75% received traditional and spiritual therapy. Majority were single and of low socioeconomic background, and treatment was funded mainly by parents/guardians. About 88% presented with partial seizures, and carbamazepine was the commonest AED used followed by phenytoin sodium. At the end of 2 years of AED, 147 (63%) achieved complete seizure control, and significant prognostic factors were female sex, age older than 20 years at presentation, secondary and tertiary education attainment, being employed, family support, regular clinic attendance, AED compliance, and generalized epilepsy. CONCLUSIONS: Patients with epilepsy are more likely to achieve complete seizure control when they are older, educated, and employed or supported by family members to buy their AEDs and attend clinics regularly.