study of epilepsy prevalence among pediatric patients in 48mh dr. noura ali noureldeen (mbbs, arab...
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Study of epilepsy prevalence among pediatric patients in
48MH
Dr. Noura Ali Noureldeen(MBBS, Arab Board)
Introduction:
Epilepsy is a chronic neurological disorder .
One seizure does not signal epilepsy (up to 10% of people have one seizure during their lifetimes).
Epilepsy is defined by two or more unprovoked seizures.
Around 50 million people worldwide have epilepsy.
Nearly 90% of the people with epilepsy are found in developing regions.
Introduction:
Three fourths of affected people in developing countries do not get the treatment they need.
An Indian study calculated that the total cost per epilepsy case was US$ 344 per year.
The discrimination and social stigma that surround epilepsy worldwide are often more difficult to overcome than the seizures themselves.
Introduction:
Epilepsy increases a person's risk of premature death by about two to three times compared to the general population.
Estimated proportion of the general population with active epilepsy at a given time is between 4 to 10 per 1,000 people.
The most common type: six out of ten people with the disorder –is called idiopathic epilepsy.
The aim of the study
To study the prevalence of epilepsy among pediatric patients.
To find out all pediatric patients who had active epilepsy with seizures or seizure free by AEDs either admitted or not.
Patients& Methods:Inclusion criteria:
•Patients who are included in this study were all children neonate- adolescents from pediatric outpatient clinic at 48MH.
• Active epilepsy (with seizures or who is seizure free by AEDs).
Exclusion criteria:
•Patients who are:
followed by their neurosurgeonfrom emergency departmentHistory of previous epilepsy.
Patients& Methods
Retrospective studyFrom 1st Jan. 2012- 30th jun. 2012: 6 months duration The information in this study was obtained from the computerized medical records of 48 MH which contains age, , sex , type, causes, regimen , no. of visits were recorded.
The clinical data are stored by means of oxford medical information system(OMIS) and read codes for diseases that are cross referenced to international classification of disease(ICD) last edition of WHO.
Results
Type of cases
No. %
POPD case 4274Epilepsy cases 128 2.9
Table 1: the rate of epilepsy among pediatric patients
Epilepsy cases No. %Total 128
Female 50 39Male 78 61
Table 2: Total number of epilepsy cases in 48MH OPD
Age group No. %
Total 128 <1year 19 14.81-5 years 57 44.5
6-10 years 25 19.5
>10 years 27 21.2
Table 5: Prevalence of epilepsy according to age group
<1y1-5y5-10y>10y
Chart 2: Prevalence of epilepsy according to age group
Epilepsy cases No. %Total 128
Primary 80 62.5Secondary 48 37.5
Table 3: Type of epilepsy among patients according to cause.
Secondary epilepsy cases
No. %
Total 48CP 16 33
Kernicterus 2 4 Postmeningitis 11 23Degenerative 2 4
Accidents 2 4Others 13 27
Table 4: Causes of secondary epilepsy in pediatric patients
Chart 1: Causes of secondary epilepsy in pediatric patients
F/up No. %
Total 128One visit 19 14.8Tow visits 62 48.4
Regular (>3) 47 36.7
Table 6: Parent’s attitude toward medical care
Type of management
Number %
Total 128Monotherapy 113 88.2Multitherapy 15 11.7
Table 7: modality of therapy
Discussion
Discussion:
Total no. of pt are 128 in 6 months duration.Prevalence of epilepsy among pediatric
disorders is 2.99% The male: female ratio is 1.6:1.
Discussion:
Epilepsy make 44% of CNS cases .Cerebral palsy compose 41% of CNS cases.Secondary epilepsy form 37% of epilepsy cases.
Discussion:
33% of 2ry epilepsy due to cerebral palsy mostly hpoxic-ischemic encephalopathy.
23% of 2ry epilepsy due to post-meningeal sequelae.
27% of 2ry epilepsy due to syndromes ,metabolic disorders & TORCH.
Discussion:
44% of epileptic patients are between 1-5 years.88% of pediatric patients are controlled by monotherapy.
36% of the family follow the doctor’s advice.
Conclusion
Conclusion:
Epilepsy incidence is similar to the studies of WHO in developing countries.
Secondary epilepsy means a big defect in the primary health care in Yemen.
Monotherapy is effective, easy, safe, cheaper than multitherapy.
Recommendation
Recommendations
Offering epilepsy society .
Education& development of pediatrician’s knowledge in the field of Neurology.Decreasing secondary epilepsy by:Improving vaccination programs .Improving perinatal care.
Units for the management of epilepsy in every hospitals.
Activation of the international organizations role in epilepsy.
