The photoparoxysmal response (PPR) is defined as the occurrence of generalized spike, spike-wave or polyspike-wave discharges consistently elicited by intermittent photic stimulation (IPS). PPR is not well studied in Sub-Saharan African people. We prospectively studied the epidemiological, clinical, and EEG characteristics of PPR among consecutive patients recorded at the clinical neurophysiology unit of Fann University Hospital (Dakar, Senegal). Methods. Among 6,808 EEG recordings including 3,065 pathological EEGs, we collected 56 EEGs with PPR (0.8% of all recorded EEGs and 1.8% of anormal EEGs), from 31 women and 25 men (sex ratio: 0.8). The mean age was 13.3 years (range: 8 months to 59 years). Results. The peak of photosensitivity was found in the range of 6 to 10 years. Of the PPR cases, 12 had clinical manifestations during IPS. Generalized epilepsy was diagnosed in 23 (41%) patients and 18 (32%) had focal epilepsies. The most epileptogenic stimulation frequencies were between 12 and 24 Hz (range: 1-28 Hz). PPR were mainly triggered during eye closure (64%), and 41 patients (73% of PPR cases) were classified as Type 4 (Waltz classification). Conclusions. Our results confirm lower rates of photosensitivity in African Sub-Saharan people compared with others. Although the current data do not support a role of short-term ambient light levels, subject to consistent data from larger cohorts, it may be interesting to study the probable epigenetic-mediated protective role of sunshine against photosensitivity.

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Background Post-traumatic epilepsy is defined as the onset of at least one seizure beyond the first week following a traumatic brain injury (TBI). High prevalence of TBI in our setting may contribute to the burden of epilepsy in adult population. This is a retrospective review of medical records of patients admitted from January 1st, 2010 to December 31st, 2019) at Douala General Hospital. We included patients aged ≥ 18 years with seizure onset at least one week after TBI. Incomplete files and previously known epilepsy were excluded. Data on sociodemography, clinical and para-clinical features, treatment and outcome were analysed using R software version 36.2. Results We finally included 65 patients with post-traumatic epilepsy among 993 medical records of epilepsy. The mean age was 35.1 ± 12.6 years, with 64.6% of male. Road traffic accident was the main aetiology of brain trauma (78.5%), resulting in haemorrhagic contusions (21.5%), sub-dural haematoma (15.4%), and diffuse axonal lesions (15.4%) mainly. Seizure onset was within 2 years post-trauma in 73.8% of cases. Generalized tonic–clonic seizures were the commonest seizure’s type. Electroencephalogram was abnormal in 81%, including 47% of focal discharges. Antiepileptic drugs were mainly sodium valproate, carbamazepine, and phenobarbital. Seizure freedom was obtained in 67.7% of cases. Conclusions Post-traumatic epilepsy is a heterogeneous, frequent and often disabling complication of traumatic brain injury. Road traffic accident is the main cause of brain trauma. It affects a young and active population. About half of cases presented GTCS. With antiepileptic drugs, more than two-thirds of patients become seizure-free.

Highlights In Cameroon, the most common cause of CSE was stroke followed by infection. Despite resource limitations, developing countries can effect protocols for CSE. Despite limited antiseizure medications, outcomes were similar in Cameroon to multicenter outcomes.

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