Medical History and Clinical Characteristics of People with Epilepsy Attending Two Tertiary Hospitals in Southeast Nigeria: A Review of 150 Adults
Asian Journal of Research and Reports in Neurology,
The key to accurate classification of epilepsies is the accurate characterization of seizure types and clinical history. Accurate clinical characterization of seizures is important in selecting candidates who are more likely to benefit from radio-imaging. Few studies have addressed the clinical characteristic of seizures in people living with epilepsy (PWE) in southeast Nigeria. A total of 150 cases of epilepsy were reviewed with a male to female ratio of 1.7:1. P=0.96. The mean age of the patients was 33.6(16.4) years. The peak age group of the patients was 20-29 years with a smaller peak after 50 years. The mean age-of-onset was 30.9(15.3) years, earlier in females than males. P=0.01. The peak age onset was 0-9 years. More than half of the PWE (54%) reported that seizures could occur at any time of the day while 4(2.7%) said they had seizures on awakening. Seventy (46.7%) could never predict the onset of seizures. Sixty-eight(45.3%) had experienced multiple seizures within a week in the past and 54(36%) had experienced prolonged seizures lasting more than 10 minutes. Overall, 78(52%) reported a history of bodily injury but only 12(8%) considered their injury as severe. The commonest medication used 114(76%). In conclusion, there is second peak of age-of-onset after 50 years in epilepsy patients attending a hospital clinic in southeast Nigeria. About 46.7% could predict the onset of seizures. PWE also reported high rates of possible status epilepticus and seizure clusters, high rates of injury.
- age of onset
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Nwani PO, Nwosu MC, Asomugha LA, Enwereji KO, Arinzechi EO, Ogunniyi AO. Epidemiology of active epilepsy in a suburban community in Southeast Nigeria: A door-to-door survey. Niger J Clin Pract 2015;18:527-33.
Ezeala-Adikaibe B A, Orjioke C, Ekenze O, Ijoma U, Onodugo O, Molokwu O et al. Prevalence of active convulsive epilepsy in an urban slum in Enugu South East Nigeria. Seizure 2016;35:100– 105
Ettore Beghi. The Epidemiology of Epilepsy. Neuroepidemiology 2020;54: 185–191.
Fiest K, Sauro K, Wiebe S, Patten S, Kwon C, Dykeman J et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology 2017;88(3):296-303.
Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
Onwuekwe IO, Ezeala-Adikaibe B. Prevalence and Distribution of Neurological Disease in a Neurology Clinic in Enugu, Nigeria. Ann Med Health Sci Res. 2011;1(1): 63–67.
Fadare JO, Sunmonu TA, Bankole IAB, Adekeye KA, Abubakar SA. Medication adherence and adverse effect profile of antiepileptic drugs in Nigerian patients with epilepsy Neurodegener Dis Manag. 2018;8(1):25-36.
Danesi M A, Adetunji J B. Use of Alternative Medicine by Patients with Epilepsy: A Survey of 265 Epileptic Patients in a Developing Country. Epilepsia. 1994; 35(2):34-51.
Ezeala-Adikaibe BA, Achor JU, Nwabueze AC, Agomoh AO, Chikani MO, Ekenze OS et al. Knowledge, attitude and practice of epilepsy among community residents in Enugu, South East Nigeria Seizure. 2014;23:882–888
Espinosa-Jovela C, Toledano R, Aledo-Serranob A, García-Morales I, Gil-Nagel A. Epidemiological profile of epilepsy in low income populations. Seizure. 2018; 56:67-72.
Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord. 2015 ;17(2):117-23.
Onwuekwe IO, Onodugo OD, Ezeala-Adikaibe BA, Aguwa EN, Ejim EC, Ndukuba K et al. Pattern and presentation of epilepsy in Nigerian Africans: a study of trends in the southeast. Trans R Soc Trop Med Hyg. 2009;103(8):785-789.
Enwereji K, Nwosu M, Ogunniyi A, Nwani P, Asomugha AL, Enwereji E. Epidemiology of stroke in a rural community in Southeastern Nigeria. Vasc Health Risk Manag. 2014;10:375-388.
Ekenze, O, Ezeala-Adikaibe B A, Onodugo O D, Chime P, Orjioke O, Mbadiwe N C, et al. The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria. Open J Prev Med. 2019;9: 51-67.
Cochran WG. Sampling Techniques, 2nd Ed., New York: John Wiley and Sons, Inc;1963.
Ogunrin O. Epilepsy in Nigeria – A review of etiology, epidemiology and management. Benin J Postgrad Med. 2006;8(1):27-5.
Ogunrin O A, Obiabo O Y, Obehigie E. Risk factors for epilepsy in Nigerians – a cross‐sectional case–control study Acta Neurologica Scand; 2013.
Ogunrin OA, Adeyekun AA. Profile of Post-traumatic Epilepsy in Benin City, Nigeria. West Afri J Med. 2010;29(3):153-7
Ojinnaka NC, Akpan MU, Aronu AE. Posttraumatic Epilepsy among Epileptic Children Seen in a Pediatric Neurology Clinic in Enugu, Nigeria-A Descriptive Study. J Epilepsy. 2016;2:105.
Ogunrin OA, Adeyekun A, Adudu P. Etiologies of epilepsy and health-seeking itinerary of patients with epilepsy in a resource poor setting: Analysis of 342 Nigerian Africans. Seizure 2013;22:572–576.
Onwuchekwa RC, Echem RC. An epidemiologic study of traumatic head injuries in the emergency department of a tertiary health institution. J Med Trop. 2018;20:24-29.
Shour AR , Holmes B, Ameh EA, Olaomi OO, Anguzu R , Cassidy LD. Motor vehicle accident is a risk factor for traumatic head injury among children in Abuja: analysis of the first trauma registry in Nigeria. Pan Afr Med J. 2019;33:215.
Adeleye AO, Ogun MI. Clinical Epidemiology of Head Injury from Road-Traffic Trauma in a Developing Country in the Current Era. Front. Neurol. 8:695.
Wahab KW. The Burden of Stroke in Nigeria Int J Stroke. 2008;3(4):290-292.
Osuntokun BO. Epilepsy in the Developing Countries The Nigerian Profile. Epilepsia.1972;13: 107-111.
Manford M, Fish R, Shorvon D. An analysis of clinical seizure patterns and their localizing value in frontal and temporal lobe epilepsies. Brain. 1996;119 :17-40.
Di Bonaventura C, Giallonardo AT, Fattouch J, Manfredi M. Symptoms in focal sensory seizures Clinical and electroencephalographic features. Seizure. 2005; 14:1—9
Whitehouse W. Febrile convulsions/seizures and related epileptic syndromes. In Gonzalo A, Antonio V (Eds). Introduction to Epilepsy. Cambridge University Press: PA. 2012;156- 157
Shorvon S. Handbook of Epilepsy Treatment. 3rd ed. Wiley-Blackwell Oxford. 2010;69-70.
Hilger E, Zimprich F, Pataraia E, Aull-Watschinger s, Jung R, Baumgartner C, Bonelli S. Psychoses in epilepsy: A comparison of postictal and interictal psychoses. Epilepsy Behav. 2016;60:58-62.
Chaudhury S, Rohatgi S, Murthy PS, Soren S, Bakhla AK, Kiran C. A clinical study of post-ictal psychoses. Saudi J Health Sci. 2015;4:99-103.
Sánchez S, Rincon F. Status Epilepticus: Epidemiology and Public Health Needs. J. Clin. Med. 2016;5(8):71
Kariuki S M, Kakooza-Mwesige A, Wagner RG, Chengo E, White S, Kamuyu G, et al. For the SEEDS Writing Group. Prevalence and factors associated with convulsive status epilepticus in Africans with epilepsy. Neurology 2015; 84(5):1838-1845
Newton CR, Kariuki SM. Status epilepticus in sub-Saharan Africa: new findings. Epilepsia 2013;54(suppl 6):50–53.
Boschini LP, Tyson A F, Samuel JC, Kendig C E, Mjuweni S, Varela C et al. The Role of Seizure Disorders in Burn Injury and Outcome in Sub-Saharan Africa. J Burn Care Res. 2014;25(6):e406-e412.
Ezeala-Adikaibe B A, Achor J U, Onwukwe J, Ahamefule A. Seizure related injuries among outpatients in two tertiary hospitals in South East Nigeria. Ann Trop Med Public health 2012;5:340-343.
Lagunju I A, Oyinlade A O, Babtunde OD. Seizure-related injuries in children and adolescents with epilepsy. Epilepsy Behav. 2016;54:131-134
Mukuku O, Nawej P, Bugeme M, Nduu F, Mawaw PM, Luboya ON, Epidemiology of Epilepsy in Lubumbashi, Democratic Republic of Congo. Neurol Res Int ; 2020. ID 5621461.
Bhalla K, Harrison JE, Shahraz S, Fingerhut LA; Global Burden of Disease Injury Expert Group. Availability and quality of cause-of-death data for estimating the global burden of injuries. Bull World Health Organ. 2010;88:831–838.
Ogundele SO, Dawodu CO. Adherence to Anti-Epileptic Drugs at a Tertiary Health Center in a Developing Country- a Cross-Sectional Study. Inter J scien Res. 2013;2:2277 – 8179.
Nwani PO, Asomugha LA, Arinze EO, Ewereji KO, Nwosu MC, Oguniyi A. Patterns of antiepileptic drug use and seizure control among people with epilepsy in a suburban community in southeast Nigeria. Afri J Neurol Sci. 2012;31:21.
Jang M, Sakadi F, Tassiou NR, Abass CF, Grundy SJ, Woga A, et al. Impact of Poorly Controlled Epilepsy in the Republic of Guinea Epilepsy Project Seizure. 2018;61:71–77.
Achor JU, Nwefoh EC, Ezeala-Adikaibe BA, Ezeruigbo CFS, Agomoh AO. Anti epileptic drug prescription in a psychiatric hospital outpatient clinic in Southeast Nigeria. Open Journal of Psychiatry. 2017;7:294- 306.
Ogboi SJ, Babajide F, Ademola O, Ogunrin O, Agu U. Evaluation of Factors Influencing Medication Adherence in Patients with Epilepsy in Rural Communities of Kaduna State, Nigeria. Neuroscience Med. 2011;2:299-305.
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