Clinico-Electroencephalography Pattern and Determinant of 2-year Seizure Control in Patients with Complex Partial Seizure Disorder in Kano, Northwestern Nigeria.

BACKGROUND

Complex partial seizures (CPS) may present with milder symptoms mimicking normal function of an adult person making the diagnosis delayed or often missed. There is a need for an in-depth training in epileptology to understand the various pattern of electro-clinical presentation of CPS. Ability to predict seizure control on first diagnosis can be very useful in the management of patients with CPS. However, there is a paucity of data on CPS in North-western Nigeria.

AIM

This study aimed to describe the clinical and EEG characteristics of CPS and evaluate independent determinant of 2-year seizure control among adults with partial epilepsy in Kano, North-western Nigeria.

SUBJECTS AND METHODS

Out of all patients diagnosed with epilepsy (PWE) at the adult neurology clinic of two tertiary hospitals in Kano over a period of 4½ years, those with CPS were prospectively studied. Diagnosis of CPS was based on both clinical and EEG findings. Patients were followed-up for a minimum period of 2-year to determine their seizure control status. Data were analyzed using STATA version 10.

RESULTS

Total of 158 (105 males, 53 females) were enrolled. Their age ranged between 15 and 85 (median = 30.5) years. Sixty six (66/158,41.7%) had aura and 64 of them (64/158, 41.1%) had automatism. The most common aura and automatism were abnormal epigastric sensation and oro-alimentary respectively. Twenty eight (28/158, 18%) had associated behavioral manifestations. EEG abnormality was recorded in 56 (56/158, 53.9%). Adequate seizure control was achieved in 55% (70/128) on anti-epileptic drugs (AEDs). Duration of epilepsy, before the commencement of AEDs was identified as an independent determinant of 2-year seizure control.

CONCLUSION

Abnormal epigastric sensation and oroalimentary automatism were the most common clinical complaint. Duration epilepsy over 3 years or less was identified as an independent predictor of 2-year seizure control.