Article

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.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS