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|Title: ||Clinical and electroencephalographic profiles of patients with Epilepsy in Mulago Hospital Medical Neurology Clinic|
|Authors: ||Muwonge, Matovu Stephen|
|Issue Date: ||Jun-2002 |
|Publisher: ||Makerere University|
|Abstract: ||Background: Epilepsy is a common neurological problem in Uganda and specifically in the neurology clinic of Mulago hospital. Whereas knowledge of seizure types and aetiology are important in the management of patients with epilepsy, there is no recent information describing them in the patients seen in Mulago hospital. Studies regarding these factors were done in the late sixties and early seventies when the classification system, investigative capabilities as well as aetiological factors were likely to have been different.
Objectives: The objectives of the study was to describe the seizure types as well as EEG abnomalities in patients attending the medical neurology clinic with a diagnosis of epilepsy. It was also aimed at describing the prevalence of a particular antecedent factors, which are thought to constitute a risk for development of secondary epilepsy.
Design: A descriptive cross sectional study was carried out on patients attending the neurology outpatient clinic with a diagnosis of epilepsy who were deemed to have active epilepsy. Consenting patients had history taken, physical examination done and laboratory investigations namely, full blood count, ESR, random blood sugar and serum VDRL. An EEG was also done on all the patients. Main outcome measures were seizure type, EEG diagnosis and probable aetiology.
Results: Of the 97 patients studied, 92 (95%) patients had seizures that could be classified according to the ICES (1981) system. Seventy (74%) of these had partial seizures, with partial onset secondary generalized seizures constituting 59 (61%) of the total. Primary generalized seizures were found in 22 (23%) of the study subjects. An interictal epileptiform pattern on EEG was seen in 41(42%) patients, with a further 8 (8.2%) having supportive non-epileptiform abnormalities. Focal epileptiform discharges constituting 29(30%) were the commonest abnormalities and of these, the temporal lobe was the most common focus, constituting 16(55%) of the focal epileptiform discharges. Forty-two (43.3%) of the 97 patients had antecedent events of possible aetiological significance with childhood febrile seizures 26(27%) being the most common followed by head trauma 11(11%).
Conclusion: 1. Partial seizures are the most common type of seizures in patients with epilespsy attending Mulago hospital neurology clinic and contribute 74%. 2. Interical EEG records are abnormal in about 51% of patients attending the medical neurology clinic of Mulago hospital. 3. About 43% of patients with epilepsy in the neurology clinic of Mulago hospital have identifiable antecedent events of possible aetiological significance, with childhood febrile convulsions being the most common, followed by head trauma.|
|Description: ||A dissertation submitted in partial fulfillment for the award of the Degree of Master of Medicine (Internal Medicine) of Makerere University.|
|Appears in Collections:||Theses & Dissertations (Sch. of Med.)|
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