Department of Neurology, National Hospital of Niamey, Niamey, Niger.
Department of Medicine and Medical Specialties, Regional Hospital Center of Tahoua, Tahoua, Niger.
Brain Behav. 2021 Aug;11(8):e2301. doi: 10.1002/brb3.2301. Epub 2021 Jul 21.
We aimed to evaluate epilepsy management at the regional hospital center (RHC) of Tahoua (Niger) to determine the intrahospital deficiencies to optimize to improve the management of people with epilepsy.
A descriptive retrospective study was carried out at the Psychiatric Unit of the RHC of Tahoua between January 1, 2016 and December 31, 2019. We collected from the registers of consultation all patients followed by nurse technicians in mental health for epilepsy whose diagnosis was made by nonspecialist physicians or internists. The study included patients with epilepsy who had a medical follow-up at least 6 months.
Of the 2022 patients seen during the period of the study, 246 patients were consulted for epilepsy with a hospital frequency of 12.2%. The mean age was 22.38 years, with a slight predominance of men (57.7%). Only generalized tonic-clonic seizures (95.1%) and focal-aware seizures (4.9%) were reported. The main etiologies were cerebral malaria (18.7%), bacterial meningitis (8.1%), and head trauma (4.9%). In 60.2% of cases, the etiology was undetermined, but the etiological diagnosis investigation was incomplete (CT scan not done). Only the first-generation antiepileptic drugs were used. Only 2.8% of the patients had drug-resistant epilepsy, and 97.2% of the patients had controlled seizures.
The study shows a predominance of infectious causes, particularly cerebral malaria. We found a high proportion of epilepsies with unknown etiologies with incomplete workup. The RHC of Tahoua should facilitate access to the CT scan for people with epilepsy to improve etiological diagnosis investigation.
评估塔霍瓦地区医院中心(RHC)的癫痫管理情况,确定院内不足之处,以优化癫痫患者管理。
在 2016 年 1 月 1 日至 2019 年 12 月 31 日期间,在塔霍瓦 RHC 的精神科病房进行了一项描述性回顾性研究。我们从咨询登记簿中收集了由护士技术员在心理健康方面为非专科医生或内科医生诊断为癫痫的患者的所有随访资料。研究包括至少有 6 个月医疗随访的癫痫患者。
在研究期间,共诊治了 2022 名患者,其中有 246 名患者因癫痫就诊,住院频率为 12.2%。平均年龄为 22.38 岁,男性略占优势(57.7%)。仅报告了全面强直阵挛发作(95.1%)和局灶性意识障碍发作(4.9%)。主要病因是脑疟疾(18.7%)、细菌性脑膜炎(8.1%)和头部外伤(4.9%)。在 60.2%的病例中,病因未确定,但病因诊断调查不完整(未行 CT 扫描)。仅使用了第一代抗癫痫药物。只有 2.8%的患者患有耐药性癫痫,97.2%的患者癫痫发作得到控制。
该研究表明,感染是主要病因,特别是脑疟疾。我们发现有很大比例的癫痫病因不明,且病因诊断调查不完整。塔霍瓦 RHC 应方便癫痫患者进行 CT 扫描,以改善病因诊断调查。