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Nasir M, Abebaw E, Ahmed M, Ketema DB. Clinical Characteristics, Treatment Outcome and Associated Factors of Epilepsy Among Children at Hospitals of North-West Ethiopia. Pediatric Health Med Ther 2023; 14:385-404. [PMID: 37927397 PMCID: PMC10625381 DOI: 10.2147/phmt.s436022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023] Open
Abstract
Background Epilepsy is an important cause of neurological morbidity in children and adolescents. Clinical parameters are the main diagnostic tools, especially in developing countries. Although cost-effective treatments for epilepsy are available, studies have shown that uncontrolled seizures can occur in many patients. Objective To assess clinical characteristics, treatment outcomes, and associated factors for controlled epilepsy among children with epilepsy who underwent follow-up at the Debre Markos Comprehensive Specialized Hospital, North-west Ethiopia from October 28, 2020, to April 28, 2021. Methods An institutional-based retrospective cohort study was conducted from October 28, 2020, to April 28, 2021. A total of 385 participants who fulfilled the inclusion criteria were included in the study. A pretested, structured, interviewer-administered questionnaire with a chart review was used to collect data. The data were entered into the Epi-data software version 4.4.2.1 and then exported to the Stata version 14 statistical package for analysis. Descriptive statistics were used to describe the sociodemographic and clinical characteristics, treatment profiles, and treatment outcomes of patients with epilepsy. Bivariate and multivariate analyses were used to identify factors associated with treatment outcomes. Results The most frequent type of seizure among the 385 respondents was Generalized-tonic-clonic seizures (88.1%). The proximate cause of seizures was identified in 15% of patients, of whom 45 had a perinatal history (8.8%), head injury (3.6%), and CNS infection (2.3%). One-third of patients had poor seizure control. Caregiver relationship (father AOR=0.58; 95th CI:0.35,0.97) and poor adherence (AOR=2.97; 95th CI:1.82, 4.86) were significantly associated with treatment outcome. Conclusion One-third of children with epilepsy have poor seizure control. Poor adherence to treatment is implicated in poor control. Counseling caregivers on proper treatment and adherence to anti-epileptic medication is recommended to improve treatment outcome in children.
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Affiliation(s)
- Mohammed Nasir
- Pediatrics Department, Hawassa University, Hawassa, Ethiopia
| | - Ermias Abebaw
- Pediatrics Department, ALERT Comprehensive Specialized Hospital, Addis Ababa, Ethiopia
| | - Muluken Ahmed
- Pediatrics Department, Arba Minch University, Arba Minch, Ethiopia
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Haddad N, Shaheen Y, Abunaib M, Melikyan G, El Sotouhy A, Wahbeh F, Nauman A, Al-Maadid F, Soliman M, Mesraoua B, Elkhider H, Mahfoud Z. Neurocysticercosis in non-endemic regions: The experience of Qatar. Front Neurol 2023; 14:1173909. [PMID: 37153684 PMCID: PMC10156967 DOI: 10.3389/fneur.2023.1173909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Objective To describe the occurrence and features of Neurocystircercosis (NCC) in Qatar. Background Qatar has a mixed population of natives and expats. NCC is not endemic to the region, but clinical practice suggests its occurrence in large numbers. Design/ methods A database was created to summarize information retrospectively collected on patients with NCC seen through the national health system (HMC) between 2013 and 2018. We identified demographic and disease related variables (clinical manifestations, investigative findings, treatment and outcome) for all patients. Results Out of 420 identified NCC patients, 393 (93.6%) were men, and 98.3% were immigrants from NCC endemic countries such as Nepal (63.8%) and India (29.5%). Eighty percent of patients presented with seizures, with the majority (69%) experiencing generalized tonic-clonic seizures. Five percent presented with status epilepticus. Headaches, the second most common complaint, were reported in 18% of subjects. On imaging, 50% had a single lesion while 63% included pathology at the calcified stage. The lesions were parenchymal in 99.5% of cases, predominantly in the frontal lobe (59%). Thirteen percent were diagnosed incidentally on imaging, mainly in the form of isolated calcified non enhancing lesions. Albendazole was received by 55% of patients, and phenytoin was the most prescribed anti-seizure drug (57%). When long term follow up was available, 70% of the patients presenting with seizures were completely seizure free. Conclusion NCC is prevalent in Qatar, mainly within the large Southeast Asian immigrant population. NCC is currently a significant contributor to the epilepsy burden in Qatar, often with a good outcome regarding seizure control. NCC with intraparenchymal single lesion shares a large proportion of our cohort.
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Affiliation(s)
- Naim Haddad
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
- *Correspondence: Naim Haddad,
| | - Yanal Shaheen
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Mohammed Abunaib
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
| | - Gayane Melikyan
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed El Sotouhy
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
| | - Farah Wahbeh
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Areej Nauman
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Fatima Al-Maadid
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Mohamed Soliman
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Boulenouar Mesraoua
- Department of Neurology, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
| | - Hisham Elkhider
- Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Population Health Sciences, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Woo S, Nah S, Kim M, Kim S, Lee D, Moon J, Han S. Risk of Epilepsy in Children Presenting to Emergency Departments with Their First Afebrile Seizure: A Retrospective Multicenter Study. Children (Basel) 2022; 9:children9111741. [PMID: 36421191 PMCID: PMC9689254 DOI: 10.3390/children9111741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Seizure is one of the most common neurologic disorders in pediatric emergency department visits. Early detection of epilepsy development in children with afebrile seizures is important. We identified predictors of epilepsy development in children with their first afebrile seizure. In this retrospective multicenter study, we enrolled pediatric patients aged 1 month to 18 years who presented with afebrile seizures at the emergency department from January 2017 to December 2020. Multivariable logistic regression analysis was performed to identify factors associated with epilepsy development. A total of 417 pediatric patients were enrolled, 161 (38.6%) of whom developed epilepsy. From the multivariable logistic regression analysis, older age at onset (2−5 years, odds ratio [OR] 2.611, p = 0.010; 11−15 years, OR 3.138, p = 0.003; 16−18 years, OR 4.292, p = 0.002), longer seizure duration of more than 10 min (OR 4.869, p = 0.006), two or more seizures (OR 2.378, p = 0.004), lethargy (OR 2.341, p = 0.021), and a lactate level > 2.27 mg/dL (OR 4.205, p < 0.001) were significant predictors for the development of epilepsy in children experiencing their first afebrile seizure.
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Affiliation(s)
- Seungho Woo
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Sangun Nah
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Minsol Kim
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Sangil Kim
- Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Dongwook Lee
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea
| | - Jieun Moon
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Sangsoo Han
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
- Correspondence:
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Bekele F, Gezimu W. Treatment outcome and associated factors among epileptic patients at ambulatory clinic of Mettu Karl Comprehensive Specialized Hospital: A cross-sectional study. SAGE Open Med 2022; 10:20503121221125149. [PMID: 36172566 PMCID: PMC9511297 DOI: 10.1177/20503121221125149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/21/2022] [Indexed: 01/22/2023] Open
Abstract
Objective The study was aimed to assess the magnitude and associated factors of 2-year seizure-free status of epileptic patients at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Methods A retrospective cross-sectional study was conducted at MKCSH from 12 February 2020 to 11 August 2020. Treatment outcome was measured in terms of seizure control status and seizure frequency. Accordingly, good treatment outcome was declared if the patients had a 2-year seizure-free status and poor if the patient had episodes of seizure in the last 2 years. The pharmaceutical care network Europe guideline was used to assess the presence of medication-related problems. Multivariable logistic regression was used to analyze the variables by using crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence interval (CI). Finally, the predictors of epilepsy treatment outcome were declared if a P-value was ⩽0.05. Results Over the study period, more than half of the participants (172 (57.7%)) were males. The median age of participants was 29 and majorly distributed to 18-30 classes. More than one-fourth of the patients were suffering from absent seizure 85 (28.5%) and general tonic-clonic seizure 83 (27.9%). The most commonly prescribed medication was Phenobarbitone which accounts 34 (11.41%), whereas Valproic acid 8 (2.68%) was the least prescribed. Overall, less than half 131 (43.96%) of patients developed poor treatment outcomes. The predictors of treatment outcomes were having head the injury (AOR = 5.7; 95% CI: 3.18, 10.31), family history of epilepsy (AOR = 5.6; 95% CI: 3.07, 10.46) and the presence of drug therapy problems (AOR = 5.2; 95% CI: 2.79, 9.69). Conclusion The magnitude of poor epilepsy treatment outcome was found to be high. The predictors of epilepsy treatment outcome were the history of head injury, family history of epilepsy and drug therapy problems. Therefore, to improve the treatment outcome of epileptic patients, health care providers should pay close attention to the identified factors. Besides this, the clinical pharmacy service should be implemented to minimize any medication-related problems.
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Affiliation(s)
- Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Wubishet Gezimu
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
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Benini R, Asir N, Yasin A, Mohamedzain AM, Hadid F, Vasudeva DM, Saeed A, Zamel K, Kayyali H, Elestwani S. Landscape of Childhood Epilepsies – A Multi-Ethnic Population-based Study. Epilepsy Res 2022; 183:106936. [DOI: 10.1016/j.eplepsyres.2022.106936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/08/2022] [Accepted: 04/23/2022] [Indexed: 11/24/2022]
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Iqbal J, Ahmad S, Al-Awadhi M, Masud A, Mohsin Z, Abdulrasoul AY, Albenwan K, Alenezi N, AlFarsi F. A Large Case Series of Neurocysticercosis in Kuwait, a Nonendemic Arabian Gulf Country in the Middle East Region. Microorganisms 2021; 9:1221. [PMID: 34199952 DOI: 10.3390/microorganisms9061221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 12/31/2022] Open
Abstract
Neurocysticercosis (NCC), a leading global cause of severe progressive headache and epilepsy, in developed or affluent countries is mostly diagnosed among immigrants from poor or developing Taenia solium taeniasis-endemic countries. Taeniasis carriers in Kuwait are routinely screened by insensitive stool microscopy. In this study, enzyme-linked immunoelectrotransfer blot (EITB) was used as a confirmatory test for NCC. Screening was performed on 970 patients referred for suspected NCC on the basis of relevant history and/or ring-enhancing lesions on computed tomography and/or magnetic resonance imaging during a 14-year period in Kuwait. Demographic data and clinical details were retrieved from laboratory or hospital records. EITB was positive in 150 subjects (15.5%), including 98 expatriates mostly originating from taeniasis-endemic countries and, surprisingly, 52 Kuwaiti nationals. The clinical details of 48 of 50 NCC cases diagnosed during 2014–2019 were available. Most common symptoms included seizures, persistent headache with/without fever, and fits or loss of consciousness. Cysticercal lesions were located at various brain regions in 39 of 48 patients. Multiple members of 3 families with NCC were identified; infection was linked to domestic workers from taeniasis-endemic countries and confirmed in at least 1 family. Our data show that NCC is predominantly imported in Kuwait by expatriates originating from taeniasis-endemic countries who transmit the infection to Kuwaiti citizens.
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Dayapoglu N, Ayyıldız Nİ, Şeker D. Fear of negative evaluation and the concealment of their disease by epilepsy patients. Epilepsy Behav 2020; 113:107539. [PMID: 33242777 DOI: 10.1016/j.yebeh.2020.107539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The fear of being negatively evaluated and subjected to social stigma causes people with epilepsy to conceal their disease. This study aims to explore the fear of negative evaluation and disease concealment in epilepsy patients in northern Turkey. METHOD This descriptive, cross-sectional study was conducted between November 2019 and March 2020 with 109 epilepsy patients who applied to a neurology outpatient clinic in northern Turkey. The study data were collected using a descriptive questionnaire, the Brief Fear of Negative Evaluation Scale (BFNE) and the Concealment of Epilepsy Scale (CES). RESULTS The mean score of participants on the CES was 46.93 ± 9.55, while the mean score on the BFNE was 31.19 ± 4.86. Participants' tendency to conceal their disease increased with the age of the participant (p < 0.001). At the same time, it was found that individuals who had more than one seizure a week had a greater tendency to conceal their disease compared with the other participants (p < 0.01). No significant relationship was found between the descriptive characteristics of people with epilepsy and their fear of negative evaluation (p > 0.05). However, a negative significant relationship was found between participants' fear of negative evaluation and their tendency to conceal their disease (r = -0.32, p < 0.01). CONCLUSION In this study, it was found that people with epilepsy had high levels of fear of negative evaluation by society and a strong tendency to conceal their disease. As the patients' age and seizure frequency increased, their tendency to conceal their disease also increased. Surprisingly, as concealment of their disease increased, participants' fear of negative evaluation decreased.
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Affiliation(s)
- Nuray Dayapoglu
- Department of Medical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey.
| | - Neşe İşcan Ayyıldız
- Department of Medical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
| | - Demet Şeker
- Department of Medical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
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8
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Mesraoua B, Deleu D, Al Hail HJ, Melikyan G, Abdalhalim Ali M, Haddad N, Mohamed Ali YO, Elsheikh L, Ayyad A, Perkins J, Palomo GA, Asadi-Pooya AA. Prevalence and Incidence of Drug-Resistant Temporal Lobe Epilepsy in Qatar. J Cent Nerv Syst Dis 2020; 12:1179573520935031. [PMID: 32636694 PMCID: PMC7323268 DOI: 10.1177/1179573520935031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 04/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Information on the epidemiology of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS) from Qatar and the developing countries is scarce. To acquire knowledge on the incidence and prevalence of drug-resistant TLE-HS in Qatar, we designed this analytical and extrapolative systematic review of the existing literature. Material and methods: We searched the electronic database PubMed from 1947 until April, 2018, using the following search terms in the title: “epilepsy” OR “temporal lobe” OR “hippocampal sclerosis” AND “epidemiology” OR “incidence” OR “prevalence.” Relevant original studies, reviews, and their references, were included. We extrapolated from the previous international literature to estimate the epidemiology of drug-resistant TLE-HS in Qatar. Results: The estimated Qatar incidence of epilepsy varies from 50 to 61 per 100 000 persons per year, and the estimated prevalence of epilepsy is 6.54 per 1000 population; the estimated incidence of TLE varies from 9.5 to 11.6 patients per 100 000 population per year and the estimated prevalence of TLE is 1.76 patients per 1000 people, with 4721 patients having TLE in Qatar. Finally, the reviewed studies also helped in making an estimate of the Qatar prevalence of drug-resistant TLE-HS to be between 0.3 and 0.6 cases per 1000 people (804-1609 current patients) and the Qatar incidence of drug-resistant TLE-HS (2.3-4.3 cases per 100 000 people, per year) with 62 to 116 new patients per year. Conclusion: Our study suggests that 804 to 1609 current patients (with 62-116 additional patients per year) in Qatar are suffering from drug-resistant TLE-HS; emphasis should be placed on the surgical aspect of the current Qatar Comprehensive Epilepsy Program.
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Affiliation(s)
- Boulenouar Mesraoua
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Dirk Deleu
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Hassan J Al Hail
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Gayane Melikyan
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | | | - Naim Haddad
- Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Yasir Osman Mohamed Ali
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Lubna Elsheikh
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ali Ayyad
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Jon Perkins
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Gonzalo Alarcon Palomo
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.,Neurology, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Ali A Asadi-Pooya
- Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.,Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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Dako-Gyeke M, Donkor MD. Experiences and perspectives of stigmatization and discrimination against people with epilepsy in Accra, Ghana. Epilepsy Behav 2018; 87:101-107. [PMID: 30126758 DOI: 10.1016/j.yebeh.2018.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
A qualitative research approach was utilized to investigate experiences and perspectives of people with epilepsy (PWE) and key informants. Twenty participants (14 PWE and 6 key informants) were purposively selected as participants for the study and in-depth interviews were conducted. The interviews were audio-recorded, transcribed, and analyzed to identify emerging themes that addressed objectives of the study. The findings indicated that PWE and key informants included in this study perceived epilepsy as a spiritual, curable, and medical condition. Besides, it was found that for fear of being infected by epilepsy, some people stigmatized and discriminated against PWE. Additionally, the study provided evidence that PWE were stigmatized and discriminated against in employment and intimate relationships with the incidence of seizures being the major reason. Furthermore, the study revealed that PWE adopted various strategies (concealment, not responding to demeaning comments made by people, involvement in religious activities, and joining support groups) to manage stigma and discrimination. The findings suggest the need for public education about epilepsy in order to modify people's beliefs and views about the disease. Moreover, the provision of counseling services would help enhance the psychosocial wellbeing of PWE.
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Affiliation(s)
- Mavis Dako-Gyeke
- Department of Social Work, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra, Ghana.
| | - Michael Donald Donkor
- Department of Social Work, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra, Ghana
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Wilkins SS, Mesraoua B, Palomo GA, Al Hail H, Salam A, Melikyan G, Azar N, Haddad N, Uthman B, Siddiqi M, Elsheikh L, Ali M, Alrabi A, Shuaib A, Deleu D, Asadi-Pooya AA. Characteristics of patients with confirmed epilepsy and psychogenic nonepileptic seizures in Qatar. Epilepsy Behav 2018; 85:218-221. [PMID: 29980425 DOI: 10.1016/j.yebeh.2018.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Middle Eastern country of Qatar opened its first epilepsy monitoring unit (EMU) in late 2015. This study compared demographic and clinical characteristics of patients with confirmed epilepsy to those of patients with confirmed psychogenic nonepileptic seizures (PNES). METHODS Data were collected via retrospective chart review on 113 patients admitted for evaluation to the Qatar national health system EMU between November 2015 and May 2017. RESULTS Seventy-one patients had a confirmed diagnosis (20 had PNES, 46 had epilepsy, 5 had both PNES and epilepsy). Evaluation in 33 patients was inconclusive, and 9 had other medical conditions. Patients with PNES were significantly more likely to be primary Arabic speakers (p = 0.003), and this difference was not explained by education or employment status. The most common referral request in patients with PNES was for recurrent/refractory seizures (p = 0.011), and there was a trend for patients with PNES to have more frequent seizures compared with patients with epilepsy (daily to several per week versus several times a month or less, p = 0.051). Depression was identified in 47% of patients with epilepsy and 65% of patients with PNES, and patients with PNES had higher mean depression scores on the PHQ-9 than patients with epilepsy (p = 0.014). Patients with PNES experienced significantly more fatigue (p = 0.021). Seventy percent of patients with PNES and 50% of patients with epilepsy reported sleep problems. CONCLUSIONS The characteristics of patients with epilepsy and PNES at the EMU in Qatar were generally similar to those found worldwide. Patients with PNES more often suffered from frequent depression, sleep problems, and fatigue than those with epilepsy, but these were significant concerns for both groups.
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Affiliation(s)
| | - Boulenouar Mesraoua
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Gonzalo Alarcón Palomo
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Hassan Al Hail
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Abdul Salam
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Gayane Melikyan
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Nabil Azar
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Naim Haddad
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Bassim Uthman
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | | | | | - Musab Ali
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | | | | | - Dirk Deleu
- Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medicine-Qatar, PO Box 24144, Education City, Doha, Qatar
| | - Ali A Asadi-Pooya
- Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
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11
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Bhattacharya S, Singh A. Beliefs of a traditional rural Indian family towards naturalistic and faith healing for treating epilepsy: a case study. BMJ Case Rep 2018; 2018:bcr-2018-225405. [PMID: 29914907 PMCID: PMC6011541 DOI: 10.1136/bcr-2018-225405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 11/04/2022] Open
Abstract
In this case study, we describe our experiences with a rural poor family from north India that initially contacted faith healers for treatment of their child who was having symptoms suggestive of epilepsy, but the seizures continued even after this. The family migrated to a city, where they started allopathic treatment, but eventually they had to discontinue it as there was no apparent relief. Again, they went back to their native village and restarted the treatment from the faith healer.This case study highlights the fact that in spite of the significant development of medical science, many questions pertaining to epilepsy treatment are still unanswered. Such dissatisfaction with the allopathic treatment of epilepsy is very common. Complexity of the disease and high cost of modern medication, side effects of drugs, efficient but heavy treatment protocols and unpredictable outcome are responsible for continued practice of people consulting faith healers for treatment of epilepsy. However, these remain unnoticed and undocumented.
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Affiliation(s)
- Sudip Bhattacharya
- Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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12
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Sahu PS, Lim YAL, Mahmud R, Somanath SD, Tan CT, Ramachandran CP. Needs of exploring the burden of recent onset seizures due to neurocysticercosis and challenges in southeast Asia focusing on scenario in Malaysia. ASIAN PAC J TROP MED 2017; 10:332-340. [PMID: 28552103 DOI: 10.1016/j.apjtm.2017.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/10/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022] Open
Abstract
Seizures due to neurocysticercosis (NCC) is a neglected human-to-human transmitted disorder and an emerging problem worldwide. A substantial portion of recent onset seizures is known to be attributed to NCC in Taenia solium (T. solium) endemic areas where populations which neither raise pigs nor eat pig meat are also at risk. High prevalence of NCC causing epilepsy has been reported in the underdeveloped areas of Southeast Asia (SEA) however, only fragmentary information on its incidence is available in countries like Malaysia. In Malaysia T. solium infection was previously thought to be infrequent due to Muslim population majority and the religious prohibition of consuming pork, but it is not totally absent. There is an evident lack of knowledge and awareness of the actual burden, routes of transmission, and the impact of NCC in this region. The problem is assumed to be more prevalent particularly in cities because of the frequent inflow of possibly T. solium infected individuals or carriers among those who migrate from neighboring endemic countries to Malaysia. The issue of imported cases that are likely to be emerging in Malaysia is highlighted here. An accurate quantification of regional burdens of epilepsy due to NCC in Malaysia is warranted considering the disease emergence in its neighboring countries. It is suggested that the importance of NCC be recognized through quantification of its burden, and also to collect epidemiological data for its subsequent elimination in line of World Health Organization's mission for control of cysticercosis as a neglected tropical disease. In this review the need as well as a strategy for neuro-care center screening of epilepsy cases, and various issues with possible explanations are discussed. It is also proposed that NCC be declared as a reportable disease which is one of the eradicable public health problems in SEA.
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Affiliation(s)
- Priyadarshi S Sahu
- Division of Pathology, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia.
| | - Yvonne A L Lim
- Department of Parasitology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Rohela Mahmud
- Department of Parasitology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Sushela D Somanath
- Division of Pathology, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Chong T Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - C P Ramachandran
- Programme Review Group, Neglected Tropical Diseases-WHO-Western Pacific Region, Kuala Lumpur, Malaysia
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