Convulsions Among the Chamorro People of Guam, Mariana Islands

Stanhope, John M.; Brody, Jacob A.; Brink, Edward W.; Morris, Charles E.

doi:10.1093/oxfordjournals.aje.a121397

Cited by 70 publications

(41 citation statements)

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“…The cumulative incidence (lifetime prevalence) of febrile seizures in children aged ≤6 years is 2-5% in American and European studies 2,3 and is up to 8% in Japan and 14% in Mariana Islands and Guam. 14,22 Prevalence was higher in boys than in girls in one Japanese study, 23 whereas in an American study, it was significantly higher in African American children compared to white children. 24 There are no population-based data on the burden of febrile seizures in sub-Saharan resource-limited countries, and febrile seizures in one study 4 are indeed acute symptomatic seizures because malaria was reported as the most important underlying cause.…”

Section: Burden Of Acute Symptomatic Seizures and Febrile Seizuresmentioning

confidence: 78%

Prevalence, causes, and behavioral and emotional comorbidities of acute symptomatic seizures in Africa: A critical review

et al. 2017

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SummarySeizures with fever includes both febrile seizures (due to nonneurological febrile infections) and acute symptomatic seizures (due to neurological febrile infections). The cumulative incidence (lifetime prevalence) of febrile seizures in children aged ≤6 years is 2–5% in American and European studies, but there are no community‐based data on acute symptomatic seizures in Africa. The incidence of acute symptomatic seizures in sub‐Saharan Africa is more than twice that in high‐income countries. However, most studies of acute symptomatic seizures from Africa are based on hospital samples or do not conduct surveys in demographic surveillance systems, which underestimates the burden. It is difficult to differentiate between febrile seizures and acute symptomatic seizures in Africa, especially in malaria‐endemic areas where malaria parasites can sequester in the brain microvasculature; but this challenge can be addressed by robust identification of underlying causes. The proportion of complex acute symptomatic seizures (i.e., seizures that are focal, repetitive, or prolonged) in Africa are twice that reported in other parts of the world (>60% vs. ∼30%), which is often attributed to falciparum malaria. These complex phenotypes of acute symptomatic seizures can be associated with behavioral and emotional problems in high‐income countries, and outcomes may be even worse in Africa. One Kenyan study reported behavioral and emotional problems in approximately 10% of children admitted with acute symptomatic seizures, but it is not clear whether the behavioral and emotional problems were due to the seizures, shared genetic susceptibility, etiology, or underlying neurological damage. The underlying neurological damage in acute symptomatic seizures can lead not only to behavioral and emotional problems but also to neurocognitive impairment and epilepsy. Electroencephalography may have a prognostic role in African children with acute symptomatic seizures. There are significant knowledge gaps regarding acute symptomatic seizures in Africa, which results in lack of reliable estimates for planning interventions. Future epidemiological studies of acute symptomatic seizures should be set up in Africa.

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Section: Burden Of Acute Symptomatic Seizures and Febrile Seizuresmentioning

confidence: 78%

Prevalence, causes, and behavioral and emotional comorbidities of acute symptomatic seizures in Africa: A critical review

et al. 2017

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“…There are a number of sources of inaccuracy (see Sander and Shorvon, 1987) and underreporting is common. In developing countries, however, where medical records are much less complete, this approach will usually grossly underestimate the numbers of epileptics (Stanhope et al, 1972), and should not normally be used in a comprehensive survey. A more useful method is to apply a screening questionnaire in a community or selected population, and then to examine persons giving a positive response to the screen (Lessell et al, 1962;Mathai et al, 1968;Dada, 1970~;Gomez et al, 1978;Chiofalo et al, 1979;Osuntokun et al, 1982;Proano, 1984;Li et al, 1985;Marino et al, 1987;Osuntokun et al, 1987).…”

Section: Methodological Difficulties In Studies In Developing Countriesmentioning

confidence: 99%

Epilepsy in Developing Countries: A Review of Epidemiological, Sociocultural, and Treatment Aspects

1988

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In this report, aspects of epilepsy that differ in developing and in developed countries are reviewed. This is inevitably an incomplete and impressionistic survey, because data on many aspects in developing countries are scarce, and because it is difficult to generalise meaningfully about the enormous diversity of countries and populations that make up the developing world. Epidemiological studies of prevalence and incidence are reviewed with an emphasis on the problems inherent in work in this area in developing countries. Data concerning seizure type, aetiology, and severity of seizures in the Third World are contrasted with those from developed countries. Sociocultural aspects of epilepsy have been poorly studied, and yet are fundamental to effective medical management. The social effects of epilepsy and the local perceptions of cause and of treatment are discussed from work in Africa, Asia, and South America. The principles and success of treatment in the Third World may differ considerably in developing and developed countries. In the Third World, medical manpower is scarce, and epilepsy is managed essentially by primary care resources, without specialised investigations or personnel. The principles of drug therapy may not be understood by patients, and the supply of drugs is often erratic; and these are major reasons for poor compliance with treatment. World Health Organisation (WHO) initiatives have stressed the extensive use of paramedical personnel and of an essential drugs list, but this emphasis may be misdirected, and in practice neither proposal has achieved much success. The recommendation that phenobarbital be extensively used in the Third World, because of its cheapness and efficacy, is also of doubtful merit, as there are well-known and major drawbacks to the widespread use of this drug. Computations of treatment gap figures in three developing countries suggest that between 80-94% of patients with active epilepsy are not receiving anticonvulsant therapy, and cost is only one of a number of reasons for this. The key to improvements in medical treatment lie with a better understanding of the patients' cultural concepts of epilepsy and its treatment, improved drug supply and availability, and efforts to improve education amongst general practitioners and other primary care medical personnel.

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“…In some populations, a considerably higher proportion of children will experience this type of convulsion (Stanhope et al, 1972;Tsuboi, 1988). Although it is true that the peak incidence of febrile illness is during these years, the convulsive response to fever seems unique to early childhood.…”

Section: Acute Symptomatic Seizures In Association With Febrile Illnessmentioning

confidence: 99%

Seizure Disorders: The Changes With Age

1992

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Summary: Age has a profound influence on our approach to the convulsive disorders. Age is a variable which is an important determinant for risk factors for epilepsy. Age, as a surrogate of brain maturation, is a determinant of the specific characteristics of the seizure disorder in those with epilepsy, and age‐related changes in these manifestations can be identified. Age is a determinant for the occurrence of acute symptomatic seizures in several types of metabolic or central nervous system insults. Age is a determinant for prognosis, whether one considers remission, medication withdrawal in those entering remission, relapse following prolonged remission, or mortality. Last, age per se seems to be a risk factor for epilepsy independent of other factors. This seems particularly true for partial seizures.

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Convulsions Among the Chamorro People of Guam, Mariana Islands

Cited by 70 publications

References 0 publications

Prevalence, causes, and behavioral and emotional comorbidities of acute symptomatic seizures in Africa: A critical review

Prevalence, causes, and behavioral and emotional comorbidities of acute symptomatic seizures in Africa: A critical review

Epilepsy in Developing Countries: A Review of Epidemiological, Sociocultural, and Treatment Aspects

Seizure Disorders: The Changes With Age

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