Epilepsy in children in Benin City, Nigeria

Sykes, R. M.

doi:10.1179/027249302125001598

Cited by 25 publications

(25 citation statements)

References 34 publications

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“…1 This is in agreement with the general observation of higher incidences of epilepsy and other neurological disorders in males. 5 The generally acknowledged likelihood of a male child being brought to the hospital for medical attention than the female has been speculated as a probable reason for this finding especially in the developing countries. 4 Most of the children came from within Zaria metropolis or the immediate vicinity with only a small proportion travelling long distances to reach the clinic.…”

Section: Discussionmentioning

confidence: 99%

Pattern of neurological disorder presenting at a paediatric neurology clinic in Nigeria

2007

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Background: Neurological diseases account for more than 20% of the world's disease burden with majority of affected people living in Africa. However there is a paucity of literature on neurological disease in Africa. Methods: A retrospective review of 114 children with neurological problem seen at a paediatric neurological clinic in a 2-year. Results: Delayed developmental milestone, convulsion and inability to walk were the 3 most common reasons for referral to our Paediatric neurology clinic. Cerebral palsy (55.3%), Seizure disorder (26.3%) and postmeningitic complications (6.2%) were the common neurological disorder seen at our neurology clinic. The Paediatric outpatient department (POPD) of our hospital was the main source of referral for most cases (83.2%) and 71.1% of all patients resides within Zaria metropolis. The default rate from follow-up was higher among children with cerebral palsy compared to children with seizure disorder (58.7% vs. 13.3%, P< 0.001). Conclusion: Lack of adequate facilities for proper rehabilitation of children with cerebral palsy could have been the main reason for the high default rate from follow-up. Key words: Children, neurological disordersRésumé Introduction: La maladie neurologique constitue plus de 20% de problème de la maladie mondiale avec la majorité du peuple impliqué vivant en Afrique. Méthodes: Une rétrospective de 114 enfants avec des problèmes neurologiques vus au centre médical neurologique pédiatrique pendant 2 ans. Résultats: Développement rétardé d'événement important, convulsion et l'impulssance de marcher étaient les trois raisons les plus ordinaires pour envoyer un malade dans un centre médical neurologique pédiatrique. Palsie cérébrale (55,3%), Trouble d'attaque (26,3%) et des complications postmeningitique (6,2%) étaient des troubles neurologiques ordinaires vus dans notre centre médical neurologique. Le service pédiatrique des consultation externes (SPCE) de notre hôpital était la source majeur de renvoy pour la plupart des cas (83,2%) et 71,1% de tous les patients qui habitent dans un rayon de la métropole du Zaria. Le taux de défaut à partir du soins post-hospitalier était élevé parmi des enfants avec la palsie cérébrale par rapport aux enfants avec le trouble d'attaque (58,7% Vs 13,3%, P < 0,001). Conclusion: La pénurie des aménagements adéquats pour une rééducation propre pour des enfants atteints de la palsie cérébrale pourrait être la raison majeure pour un faux de défaut élevé à partir des soins post-hospitalier.

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Section: Discussionmentioning

confidence: 99%

Pattern of neurological disorder presenting at a paediatric neurology clinic in Nigeria

2007

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“…In a hospital in urban Nigeria where 90% of 344 children with epilepsy were treated with phenobarbital, 50.6% achieved complete seizure control and only 2 patients stopped the drug because of intolerable side effects (Sykes, 2002). However, 94 (27%) patients were lost to follow‐up after one or two visits to the hospital, making it difficult to draw valid conclusions.…”

Section: Efficacymentioning

confidence: 99%

Current position of phenobarbital in epilepsy and its future

2012

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SUMMARYThis article reviews the current position of phenobarbital using articles published since 2000 and speculates on its likely future contribution to epilepsy care. Over the last decade there have been no major double-blind randomized placebo-controlled or comparative trials with phenobarbital. Previous studies have suggested that phenobarbital is as effective in monotherapy as phenytoin and carbamazepine. Several observational studies undertaken in developing countries over the last decade have confirmed its efficacy and safety for the common epilepsies. This was particularly so in the substantial demonstration project undertaken in rural China under the auspices of the World Health Organization in partnership with the International League Against Epilepsy and International Bureau for Epilepsy. Phenobarbital is still widely used for neonatal and childhood seizures and for drug-resistant convulsive and nonconvulsive status epilepticus. Recent data have confirmed in a prospective cohort of women taking phenobarbital as monotherapy that the drug can be associated with a range of congenital defects in exposed infants. Much effort has gone into exploring the apparent contradiction of higher withdrawal rates due to cognitive and behavioral side effects in studies undertaken in developed countries but not in those sited in the developing world. A raft of data over the last 10 years, including a systematic review, showed no important differences between the tolerability of phenobarbital compared to that with other antiepileptic drugs. Finally, cognitive test scores and mood ratings in 136 people with epilepsy receiving phenobarbital for a year were similar to those in 137 age-, sex-, and education-matched controls in a number of Chinese villages. Indeed, there were some cognitive gains in the patients possibly due to improved seizure control. Phenobarbital is still the most cost-effective pharmacologic treatment for epilepsy. All these data predict a healthy future for phenobarbital, particularly in helping to close the treatment gap in low-and middle-income countries during its second century of clinical use.

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“…This drug has been successfully used to treat epilepsy by primary health workers in rural Africa and this is likely to continue. Good seizure control was reported in 52.9% of children with epilepsy by Sykes 67 in Benin City, Nigeria but the response to medication was less satisfactory for children under one year. In a study that assessed the effectiveness of anticonvulsant therapy among 175 Nigerian patients with epilepsy, phenobarbital was the single most commonly prescribed agent due to economic considerations, availability and favourable seizure control 68 .…”

Section: Drug Therapymentioning

confidence: 99%