047 Convulsive epilepsy in a rural district of northern Tanzania: risk factors and classification. Issue 3 (9th February 2012)

• Record Type: Journal Article
• Authors: Hunter, E; Rogathe, J; Iqbal, A; Birchall, D; Whittaker, R; Jackson, M; Jusabani, A; Aris, E; Walker, R
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 83:Issue 3(2012)
• Page Start: e1
• Page End: e1
• Publication Date: 2012-02-09
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2011-301993.89
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Few community-based studies of epilepsy from sub-Saharan Africa (SSA) have included neuroimaging or neurophysiology. There have been only two case-control studies to define risk factors. Methods: We identified 291 people with epilepsy (PWE) in a rural population in Tanzania. All PWE were offered investigation with EEG and CT head scan. Epilepsy was classified according to ILAE criteria. PWE were compared with age- and sex-matched controls to define risk factors for epilepsy. Results: 216 PWE (74.2%) had EEGs and 200 (68.7%) had CTs. Investigations were abnormal in 38.9% of EEGs and 27% of CTs. All 291 PWE had convulsive epilepsy. Seizure onset was focal in 71.5%, generalised in 2.4%, and undefined in 26.1%. Epilepsy was classified as symptomatic (structural/metabolic) in 23.4%, idiopathic in 2.1%, and remained unclassified in 74.2%. Risk factors associated with epilepsy were a family history of epilepsy (OR 6.2; 95% CI 2.6 to 14.8), a history of childhood febrile convulsions (21.6; 2.9 to 159.5) and a history of perinatal complications (3.8; 1.3 to 11.2). Motor or cognitive impairment was also associated with epilepsy (35.8; 4.9 to 261.4 and 39.0; 9.5 to 160.7). On multivariable logistic regression, the strongest predictors of epilepsy in this population were family history, childhood febrile convulsions, and the presence of motor/ cognitive impairment. Conclusion: The high proportion of focal onset seizures and the association with childhood febrile convulsions and motor or cognitive impairment points to a significant burden of acquired epilepsy in this population. The association with family history warrants further study.