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Prediction of seizure outcome in childhood epilepsies in countries with limited resources: a prospective study
Author(s) -
BANU SELINA H,
KHAN NAILA Z,
HOSSAIN MAHMUDA,
FERDOUSI SAADIA,
BOYD STEWART,
SCOTT ROD C,
NEVILLE BRIAN
Publication year - 2012
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2012.04325.x
Subject(s) - epilepsy , pediatrics , psychomotor learning , medicine , seizure types , referral , cognition , psychiatry , family medicine
Aim To identify predictors of seizure control in newly presenting children with epilepsy in countries with limited resources. Method Three hundred and ninety children (273 males, 117 females) aged 2 months to 15 years with newly diagnosed epilepsy were enrolled prospectively at first visit to the multidisciplinary clinic at the children’s hospital in Dhaka, Bangladesh. Data about seizures, motor disability, psychomotor development, and electroencephalography were obtained. Regular monitoring of antiepileptic drug treatment was continued at least for one year. Associations between seizure control and potential predictors were determined by multivariate analysis. Results Three hundred and ninety children were enrolled in 6 months, of whom over 60% were from low‐income families, 60% had onset at under 1 year, 74% had more than one seizure per week, 69% a single‐seizure type, and 38% a history of delayed onset of breathing at birth. Cognitive deficits (IQ<70; 58%) and/or motor (significant limitation of daily living activities; 47%) deficits were common. After 1 year of regular treatment, seizure control was good (seizure freedom) in 53%, and poor (at least one seizure in the last 3mo of follow‐up) in 47%. The predictors of poor seizure control were an IQ<70, associated motor disability, multiple seizure types, and a history of cognitive regression (1.9 times more likely to have poor seizure control). Interpretation Seizure control can be predicted using three clinical factors (motor disability, cognitive impairment, and multiple seizure types) at the first clinic visit. Such predictors assist the development of referral plans and management guidelines for childhood epilepsies in resource‐poor countries.