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Predictors of early seizure remission in Nigerian children with newly diagnosed epilepsy.

Abstract

BACKGROUND
It is important to predict as soon as possible after diagnosis and starting treatment, the likely clinical course of childhood-onset epilepsy, both in terms of seizure control and even more pertinently, seizure intractability. Little is known about the factors predictive of seizure control in African children.
METHODS
All consecutive cases of newly-diagnosed childhood epilepsy seen over a period of two years in the Paediatric Neurology clinic, University College Hospital, Ibadan, Nigeria were prospectively followed for a period of three years to determine seizure outcomes. Remission was defined as being seizure-free for at least two consecutive years.
RESULTS
A total of 170 children were enrolled but 54 defaulted and were excluded from further analysis. Twenty nine (25%) attained remission while 20 (17.2%) showed signs of intractability. The remaining 67 (57.8%) showed some response to anti-epileptic drug (AED) therapy. Primary generalized epilepsy was found to be significantly associated with seizure remission and successful discontinuation of AED. Factors associated with reduced likelihood of seizure remission were remote symptomatic/cryptogenic aetiology, slow waves on electroencephalography (EEG), high seizure frequency of at least one attack/ month at presentation, failure of response to the initial AED and presence of associated neurological deficits. On logistic regression, high seizure frequency and presence of slow waves on EEG remained independent negative predictors of seizure remission.
CONCLUSION
About one-quarter of Nigerian children with newly diagnosed epilepsy attain early seizure remission within the first three years ofAED therapy. The major predictors of poor seizure control and failure of seizure remission include high seizure frequency at presentation and presence of slow waves on EEG.

Authors

Lagunju IA, Asinobi A

Institution

Department of Paediatrics, University College Hospital and College of Medicine, University of Ibadan Ibadan, Nigeria. ilagunju@yahoo.co.uk

Source

African journal of medicine and medical sciences 40:3 2011 Sep pg 239-45

MeSH

Age Factors
Anticonvulsants
Child
Child, Preschool
Cohort Studies
Electroencephalography
Epilepsy
Female
Hospitals, Teaching
Humans
Infant
Logistic Models
Male
Nigeria
Predictive Value of Tests
Probability
Prognosis
Recurrence
Risk Factors
Treatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22428519