Banu Selina H, Khan Naila Z, Hossain Mahmuda, Jahan Anisa, Parveen Monwara, Rahman Narsis, Boyd Stewart H, Neville Brian
Child Development and Neurology Unit, Dhaka Shishu (Children's) Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
Dev Med Child Neurol. 2003 Jul;45(7):477-82. doi: 10.1017/s0012162203000884.
Very little is known about childhood epilepsies in Bangladesh. This study was conducted within a national children's hospital in Dhaka city to provide baseline information on diagnosis and clinical outcomes of 151 children (98 males, 53 females, age range between 2 months to 15 years, median age of 3 years). Participants who presented with recurrent unprovoked seizures were followed up in an epilepsy clinic for at least 1 year. Of presenting families, 68.3% were from middle-income and lower-income groups. A history of perinatal asphyxia and neonatal seizures was present in 46.4% and 41.1% of participants respectively. Generalized, partial, and unclassifiable epilepsy were found in 63.6%, 25.2%, and 11.2% respectively. Severe outcome (malignant) epilepsy syndromes were diagnosed in 14.6%. Symptomatic epilepsy was found in 61%. Poor cognitive development was present in 72.8% and poor adaptive behaviour in 57%. Poor seizure remission occurred in 50.3%. Factors most predictive of poor seizure remission were: multiple types of seizures, poor cognition at presentation, high rates of seizures, associated motor disability, and EEG abnormalities. The study suggests that most children presenting at tertiary hospitals for seizure disorders come late and with associated neurodevelopmental morbidities. Specialized services are needed closer to their homes. The process for establishing early referral and comprehensive management of childhood epilepsies in Bangladesh requires further study.
在孟加拉国，人们对儿童癫痫的了解非常有限。本研究在达卡市的一家国立儿童医院开展，旨在提供151名儿童（98名男性，53名女性，年龄在2个月至15岁之间，中位年龄为3岁）的诊断和临床结果的基线信息。出现反复无诱因癫痫发作的参与者在癫痫门诊接受了至少1年的随访。在前来就诊的家庭中，68.3%来自中等收入和低收入群体。分别有46.4%和41.1%的参与者有围产期窒息和新生儿癫痫发作史。全身性、部分性和无法分类的癫痫分别占63.6%、25.2%和11.2%。被诊断为严重结局（恶性）癫痫综合征的占14.6%。症状性癫痫占61%。72.8%的儿童存在认知发育不良，57%存在适应性行为不良。癫痫发作缓解情况不佳的占50.3%。最能预测癫痫发作缓解情况不佳的因素包括：多种类型的发作、就诊时认知能力差、癫痫发作频率高、伴有运动障碍以及脑电图异常。该研究表明，大多数因癫痫疾病到三级医院就诊的儿童就诊较晚，且伴有相关的神经发育疾病。需要在他们家附近提供专门服务。在孟加拉国建立儿童癫痫早期转诊和综合管理的流程需要进一步研究。
