Assadeck Hamid, Toudou-Daouda Moussa, Mamadou Zakaria, Moussa-Konate Mahadi, Hassane-Djibo Fatimata, Douma-Maiga Dijbo
Department of Neurology, National Hospital of Niamey, Niamey, Niger.
Department of Medicine and Medical Specialties, Faculty of Medicine and Pharmacy, Abdou Moumouni University, Niamey, Niger.
J Neurosci Rural Pract. 2019 Oct;10(4):571-575. doi: 10.1055/s-0039-1700308. Epub 2019 Nov 11.
The aim of this study is to evaluate the management of epilepsy in the elderly at a tertiary referral center in Niger to obtain a comprehensive understanding to determine the intrahospital deficiencies to improve and to make recommendations in terms to improve the management of epilepsy in the elderly in Niger. We conducted a retrospective study at the Neurology Outpatient Clinic of the National Hospital of Niamey (Niger) over a period of 5 years from May 2013 to May 2018, collecting all cases of patients aged 60 years or over diagnosed with epilepsy by neurologists. From the registers of consultation, we collected and analyzed for each patient the demographic, clinical, etiological, and therapeutic data, as well as the outcomes during follow-up visits. Of the 4,576 patients of all ages seen during the period of our study, we included 62 patients aged 60 years or over diagnosed with epilepsy with a hospital frequency of 1.35%. The mean age of patients was 65.82 ± 5.72 years (range: 60 and 83 years) with a predominance of the male sex (sex ratio at 1.6). Patients aged 60 to 64 years were the most represented (43.5%). Generalized tonic-clonic seizures were the most frequent (41.9%), followed by focal to bilateral tonic-clonic seizures (25.8%). All patients underwent electroencephalogram. Only 30 patients (48.4%) underwent brain imaging, and mainly brain computed tomography scan. The etiologies included poststroke epilepsy (25.8%), brain tumors (3.2%), cerebral toxoplasmosis (3.2%), and cerebral meningioma (1.6%). We found 41 cases (66.1%) of epilepsy without definite etiology and with an incomplete workup. Carbamazepine and phenobarbital were the only two antiepileptic drugs (AEDs) used. The present study shows limited access to newer generation AEDs and diagnostic tests of epilepsy in Niger. Considerable efforts should be made to facilitate for people living with epilepsy the accessibility to diagnostic tests and the newer generation AEDs to improve the quality of epilepsy management in Niger.
本研究的目的是评估尼日尔一家三级转诊中心对老年癫痫患者的管理情况，以全面了解情况，确定医院内部存在的不足之处，从而加以改进，并就改善尼日尔老年癫痫患者的管理提出建议。我们于2013年5月至2018年5月期间，在尼亚美（尼日尔）国家医院的神经科门诊进行了一项回顾性研究，收集了所有由神经科医生诊断为癫痫的60岁及以上患者的病例。从会诊记录中，我们收集并分析了每位患者的人口统计学、临床、病因学和治疗数据，以及随访期间的结果。在我们研究期间就诊的所有年龄段的4576名患者中，我们纳入了62名60岁及以上被诊断为癫痫的患者，医院就诊频率为1.35%。患者的平均年龄为65.82±5.72岁（范围：60至83岁），男性占主导（性别比为1.6）。60至64岁的患者占比最大（43.5%）。全身强直阵挛发作最为常见（41.9%），其次是局灶性至双侧强直阵挛发作（25.8%）。所有患者均接受了脑电图检查。只有30名患者（48.4%）进行了脑部成像检查，主要是脑部计算机断层扫描。病因包括中风后癫痫（25.8%）、脑肿瘤（3.2%）、脑弓形虫病（3.2%）和脑膜瘤（1.6%）。我们发现41例（66.1%）癫痫患者病因不明且检查不完整。卡马西平和苯巴比妥是仅使用的两种抗癫痫药物（AEDs）。本研究表明，在尼日尔，新一代抗癫痫药物和癫痫诊断检查的可及性有限。应做出相当大的努力，以便癫痫患者能够更容易获得诊断检查和新一代抗癫痫药物，从而提高尼日尔癫痫管理的质量。
