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Abdel Baky A, Al Refaei A, El Melegy E, Tantawi H, Mansour L, Mohamed M, El Rashidy O, Hassanein S, Omar T, Elsayeh A, ElGazzar H, Amer YS, Abd Elmaksoud M. Adapting Evidence-Based Practice Guidelines for Emergency Management of Seizures in Children Beyond the Neonatal Period. Pediatr Neurol 2024; 157:14-18. [PMID: 38838593 DOI: 10.1016/j.pediatrneurol.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/12/2024] [Accepted: 05/04/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The presented evidence-based clinical practice guideline (CPG) is proposed as a National CPG where we adapted the international recommendations for the emergency management of seizures in children beyond the neonatal period to suit the health care in Egypt. The quality of evidence and the strength of recommendations are indicated. This study aimed to standardize the treatment of acute epileptic seizures and to provide an easy-to-apply acute treatment protocol that will allow immediate and appropriate seizure control. METHODS This is part of a larger program by the Egyptian Pediatric Clinical Practice Guidelines Committee (EPG) in collaboration with the staff of pediatric departments of 15 Egyptian universities and the National Research Centre. EPG was affiliated later to the Supreme Council of the Egyptian University Hospitals aiming to define the topics of, assign authors to, and assist in the adaptation of pediatric evidence-based CPGs according to a national strategic plan (http://epg.edu.eg). The committee is guided by a formal CPG adaptation methodology: the "Adapted ADAPTE." RESULTS The Egyptian Childhood Seizure Group (ECSG) reviewed the results of the Appraisal of Guidelines for Research and Evaluation II assessment and decided to adapt the recommendations of three source CPGs: American Epilepsy Society, Italian League Against Epilepsy, Neurocritical Care Society, and Neurologic & Psychiatric Society of Zambia. Eight implementation tools were included. A comprehensive set of multifaceted CPG implementation strategies was provided for the clinicians, patients, nurses, and other relevant stakeholders contextualized to the national settings. CONCLUSIONS Our experience with this adaptation methodology provides useful insight into its national utilization in Egypt.
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Affiliation(s)
- Ashraf Abdel Baky
- Pediatrics Department, Ain Shams University, Cairo, Egypt; Pediatrics Department, Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | - Ashraf Al Refaei
- Child Health and Pediatric Neurology, National Research Center, Cairo, Egypt
| | - Ebtesam El Melegy
- Consultant Pediatric Neurology, Neuromotor System Institute Cairo, Cairo, Egypt
| | - Hayam Tantawi
- Pediatric Nursing, Faculty of Nursing Ain Shams University, Cairo, Egypt
| | - Lobna Mansour
- Pediatric Neurology, Faculty of Medicine Cairo University, Cairo, Egypt
| | - Moustafa Mohamed
- Pediatric Neurology, Faculty of Medicine Cairo University, Cairo, Egypt
| | - Omnia El Rashidy
- Pediatric Neurology, Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sahar Hassanein
- Pediatric Neurology, Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Omar
- Neurology Unit, Pediatrics Department, Alexandria University, Alexandria, Egypt
| | - Abdelsattar Elsayeh
- Pediatric Neurology Unit, Pediatrics Department, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt
| | - Hammouda ElGazzar
- Fellow in Pediatrics, General Organization of Teaching Hospitals, El Beheira, Egypt
| | - Yasser Sami Amer
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt; Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia; Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia; Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia; Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Marwa Abd Elmaksoud
- Neurology Unit, Pediatrics Department, Alexandria University, Alexandria, Egypt.
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Beghi E, Giussani G, Costa C, DiFrancesco JC, Dhakar M, Leppik I, Kwan P, Akamatsu N, Cretin B, O'Dwyer R, Kraemer G, Piccenna L, Faught E. The epidemiology of epilepsy in older adults: A narrative review by the ILAE Task Force on Epilepsy in the Elderly. Epilepsia 2023; 64:586-601. [PMID: 36625133 DOI: 10.1111/epi.17494] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/21/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023]
Abstract
In an aging world, it is important to know the burden of epilepsy affecting populations of older persons. We performed a selective review of epidemiological studies that we considered to be most informative, trying to include data from all parts of the world. We emphasized primary reports rather than review articles. We reviewed studies reporting the incidence and prevalence of epilepsy that focused on an older population as well as studies that included a wider age range if older persons were tabulated as a subgroup. There is strong evidence that persons older than approximately 60 years incur an increasing risk of both acute symptomatic seizures and epilepsy. In wealthier countries, the incidence of epilepsy increases sharply after age 60 or 65 years. This phenomenon was not always observed among reports from populations with lower socioeconomic status. This discrepancy may reflect differences in etiologies, methods of ascertainment, or distribution of ages; this is an area for more research. We identified other areas for which there are inadequate data. Incidence data are scarcer than prevalence data and are missing for large areas of the world. Prevalence is lower than would be expected from cumulative incidence, possibly because of remissions, excess mortality, or misdiagnosis of acute symptomatic seizures as epilepsy. Segmentation by age, frailty, and comorbidities is desirable, because "epilepsy in the elderly" is otherwise too broad a concept. Data are needed on rates of status epilepticus and drug-resistant epilepsy using the newer definitions. Many more data are needed from low-income populations and from developing countries. Greater awareness of the high rates of seizures among older adults should lead to more focused diagnostic efforts for individuals. Accurate data on epilepsy among older adults should drive proper allocation of treatments for individuals and resources for societies.
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Affiliation(s)
- Ettore Beghi
- Laboratory of Neurological Disorders, Department of Neuroscience, Mario Negri Institute of Pharmacological Research, Scientific Institute for Research and Health Care, Milan, Italy
| | - Giorgia Giussani
- Laboratory of Neurological Disorders, Department of Neuroscience, Mario Negri Institute of Pharmacological Research, Scientific Institute for Research and Health Care, Milan, Italy
| | - Cinzia Costa
- Section of Neurology, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Jacopo C DiFrancesco
- Department of Neurology, Istituto di Ricovero e Cura a Caraterre Scientifico, San Gerardo Foundation, University of Milan-Bicocca, Monza, Italy
| | - Monica Dhakar
- Department of Neurology, Brown University, Providence, Rhode Island, USA
| | - Ilo Leppik
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Naoki Akamatsu
- Division of Neurology, Neuroscience Center, Fukuoka Samo Hospital, International University of Health and Welfare, Fukuoka, Japan
| | - Benjamin Cretin
- Neuropsychology Unit, Department of Neurology of the University Hospitals of Strasbourg, Strasbourg, France
| | - Rebecca O'Dwyer
- Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, USA
| | | | - Loretta Piccenna
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Edward Faught
- Department of Neurology, Emory University, Atlanta, Georgia, USA
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Sayed NM, Aldin MTK, Ali SE, Hendi AE. Cognitive functions and epilepsy-related characteristics in patients with generalized tonic–clonic epilepsy: a cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-023-00293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Abstract
Background
Epilepsy is a brain disorder affecting nearly 65 million people worldwide. It is characterized by sudden, transient, and uncontrolled episodes of brain dysfunction secondary to hypersynchronous abnormal discharge of cortical neuronal cells resulting in motor, sensory, and behavioral manifestations. Cognitive deterioration can occur in approximately 70–80% of epileptic patients with a variety of epilepsy-related characteristics being implicated. This study aimed to assess cognitive functions in a sample of patients with generalized tonic–clonic epilepsy and determine its relation to different epilepsy-related characteristics. It was designed as a case–control cross-sectional study in which 106 participants were enrolled and divided into two groups: a case group of fifty-three patients diagnosed with generalized tonic–clonic epilepsy and a control group including fifty-three healthy subjects. Sociodemographic and epilepsy-related characteristics and a variety of cognitive functions were assessed for both groups.
Results
Epileptic patients were significantly suffering from impairment in attention, memory, visuospatial (P = 0.001), and language functions (P = 0.018) compared to the healthy control group.
Conclusions
Epileptic patients are significantly suffering from cognitive impairment with a variety of contributing epilepsy-related characteristics.
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Bakri AH, Hassan MH, Ahmed AEA, Alotaibi G, Halim PR, Abdallah AAM, Rashwan NI. Serum Levels of Growth-Associated Protein-43 and Neurotrophin-3 in Childhood Epilepsy and Their Relation to Zinc Levels. Biol Trace Elem Res 2023; 201:689-697. [PMID: 35349008 PMCID: PMC9849170 DOI: 10.1007/s12011-022-03213-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Epilepsy is one of the most common neurological disorders, and it places a significant economic strain on the healthcare system around the world. Although the exact mechanism of epilepsy has yet to be illustrated, various pathogenic cascades involving neurotransmitters and trace elements have been reported. We aimed to investigate the serum levels of growth-associated protein-43 (GAP-43) and neurotrophin-3 (NT-3) among cohort of Egyptian children with epilepsy and correlate these biomarkers with their zinc levels. METHODS This case-control study included 50 pediatric patients with epilepsy who were comparable with 50 controls. Neurological assessment and electroencephalogram (EEG) were done to all included children. Biochemical measurements of serum GAP-43 and NT-3 using enzyme linked immunosorbent assays (ELISA), and total antioxidant capacity (TAC) and zinc using colorimetric assays, were performed to all participants. RESULTS There was significantly frequent positive parental consanguinity among cases with significantly frequent generalized onset seizures (94%) than simple partial seizure (6%). There were significantly lower serum GAP-43 and zinc levels with significantly higher TAC among cases vs. the controls, p˂0.05 for all. There was no significant difference in the serum levels of NT-3 among epileptic children vs. the controls, p = 0.269. Serum Zn was positively correlated with GAP-43 level among epileptic children (r = 0.381, p = 0.006). Serum GAP-43 in diagnosing childhood epilepsy at cut-off point ≤ 0.6 ng/mL showed 78% sensitivity, 62% specificity, positive predictive value (PPV) = 50.6%, negative predictive value (NPP) = 84.9% with AUC = 0.574. CONCLUSION GAP-43 can be considered a sensitive good negative biomarker in childhood epilepsy which correlated positively with the zinc status.
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Affiliation(s)
- Ali Helmi Bakri
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
| | - Ahmed El-Abd Ahmed
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ghallab Alotaibi
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Shaqra, Saudi Arabia
| | - Pola Rafat Halim
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | | | - Nagwan I Rashwan
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
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Idris A, Alabdaljabar MS, Almiro A, Alsuraimi A, Dawalibi A, Abduljawad S, AlKhateeb M. Prevalence, incidence, and risk factors of epilepsy in arab countries: A systematic review. Seizure 2021; 92:40-50. [PMID: 34418747 DOI: 10.1016/j.seizure.2021.07.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/03/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the prevalence, incidence, and risk factors of epilepsy in Arab countries. METHODS In this systematic review, electronic databases including PubMed, ProQuest Public Health and Cochrane Library were searched to identify relevant English articles published until April 2020. The search was conducted to cover all 22 Arab countries. Studies were eligible for inclusion if they assessed any of these epidemiological parameters of epilepsy: prevalence, incidence, and/or risk factors and focused on at least one of the Arab countries. The quality of the studies was evaluated using standardized quality assessment tools. RESULTS Twenty-nine articles met the inclusion criteria. Out of the 22 Arab countries, only 11 were found to have published studies reporting on the epidemiology of epilepsy. The median lifetime prevalence of epilepsy in Arab countries was found to be 6.9 per 1000. The median incidence is 89.5 per 100000. The most frequently identified risk factors were parental consanguinity, family history of epilepsy, and a history of perinatal infections/insults. CONCLUSION The prevalence and incidence of epilepsy varies in Arab countries. The most frequently reported risk factor is parental consanguinity. The lack of epidemiological studies on epilepsy in half of the Arab countries calls for more studies on this aspect to identify the burden and risk factors of epilepsy in this region.
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Affiliation(s)
- Anas Idris
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Alyaman Almiro
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Anas Alsuraimi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ahmad Dawalibi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Mashael AlKhateeb
- Department of Neurosciences, King Faisal Specialty Hospital, and Research Center, Riyadh, Saudi Arabia.
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Al-Malt AM, Abo Hammar SA, Rashed KH, Ragab OA. The effect of nocturnal epileptic seizures on cognitive functions in children with idiopathic epilepsy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cognitive impairment is a common finding epileptic children. Studies have linked nocturnal epileptic discharges to delayed cognitive abilities in children.
Objective
The study aims to evaluate the effect of nocturnal epileptic seizures on cognitive functions in children with idiopathic epilepsy.
Patients and methods
The study was conducted on 70 children with idiopathic generalized or benign focal epilepsy. Based on seizures semiology, they were classified into cases either with nocturnal epileptic seizures (NES) (n = 40) or with diurnal epileptic seizures (DES) (n = 30). Patients receiving antiepileptic drugs (AEDs) that affect cognitive function, patients with intelligence quotient (IQ) below 70, and those having other neurological or psychiatric disorders' were excluded. All patients were subjected to neurological examination, brain magnetic resonance imaging (MRI), and electroencephalography. Cognition was assessed using Wechsler Intelligence scale for children (WISC) to measure IQ, Wisconsin card sorting test (WCST) (computerized version), Trail Making Test, and Digit spans test.
Results
There was no significant difference between both groups regarding age, sex, age of epilepsy onset, or seizure frequency. There was a significant difference in almost all cognitive variables including digit forward, digit backward, processing speed, verbal IQ, WCST perseverative responses, WCST failure to maintain set, Trail Making Test A (error), Trail Making Test B (Time), and Trail Making Test B (error). There was no significant difference regarding the associated sleep disturbances between the studied groups.
Conclusion
Children with idiopathic epilepsy suffering from predominant nocturnal seizure have overt and subtle cognitive functions impairments compared to children with predominant diurnal seizure.
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Vaughan KA, Lopez Ramos C, Buch VP, Mekary RA, Amundson JR, Shah M, Rattani A, Dewan MC, Park KB. An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy. J Neurosurg 2019; 130:1127-1141. [PMID: 30215556 DOI: 10.3171/2018.3.jns171722] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 03/12/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Epilepsy is one of the most common neurological disorders, yet its global surgical burden has yet to be characterized. The authors sought to compile the most current epidemiological data to quantify global prevalence and incidence, and estimate global surgically treatable epilepsy. Understanding regional and global epilepsy trends and potential surgical volume is crucial for future policy efforts and resource allocation. METHODS The authors performed a systematic literature review and meta-analysis to determine the global incidence, lifetime prevalence, and active prevalence of epilepsy; to estimate surgically treatable epilepsy volume; and to evaluate regional trends by WHO regions and World Bank income levels. Data were extracted from all population-based studies with prespecified methodological quality across all countries and demographics, performed between 1990 and 2016 and indexed on PubMed, EMBASE, and Cochrane. The current and annual new case volumes for surgically treatable epilepsy were derived from global epilepsy prevalence and incidence. RESULTS This systematic review yielded 167 articles, across all WHO regions and income levels. Meta-analysis showed a raw global prevalence of lifetime epilepsy of 1099 per 100,000 people, whereas active epilepsy prevalence is slightly lower at 690 per 100,000 people. Global incidence was found to be 62 cases per 100,000 person-years. The meta-analysis predicted 4.6 million new cases of epilepsy annually worldwide, a prevalence of 51.7 million active epilepsy cases, and 82.3 million people with any lifetime epilepsy diagnosis. Differences across WHO regions and country incomes were significant. The authors estimate that currently 10.1 million patients with epilepsy may be surgical treatment candidates, and 1.4 million new surgically treatable epilepsy cases arise annually. The highest prevalences are found in Africa and Latin America, although the highest incidences are reported in the Middle East and Latin America. These regions are primarily low- and middle-income countries; as expected, the highest disease burden falls disproportionately on regions with the fewest healthcare resources. CONCLUSIONS Understanding of the global epilepsy burden has evolved as more regions have been studied. This up-to-date worldwide analysis provides the first estimate of surgical epilepsy volume and an updated comprehensive overview of current epidemiological trends. The disproportionate burden of epilepsy on low- and middle-income countries will require targeted diagnostic and treatment efforts to reduce the global disparities in care and cost. Quantifying global epilepsy provides the first step toward restructuring the allocation of healthcare resources as part of global healthcare system strengthening.
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Affiliation(s)
- Kerry A Vaughan
- 1Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Christian Lopez Ramos
- 2University of California San Diego School of Medicine, La Jolla, California
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Vivek P Buch
- 1Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rania A Mekary
- 3Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, MCPHS University, Boston
- 4Cushing Neurosurgical Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School
| | - Julia R Amundson
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- 6Miller School of Medicine, University of Miami, Florida
| | - Meghal Shah
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- 7Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Abbas Rattani
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- 8Meharry Medical College, School of Medicine, Nashville; and
| | - Michael C Dewan
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- 9Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kee B Park
- 5Global Neurosurgery Initiative/Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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Owolabi LF, Owolabi SD, Taura AA, Alhaji ID, Ogunniyi A. Prevalence and burden of epilepsy in Nigeria: A systematic review and meta-analysis of community-based door-to-door surveys. Epilepsy Behav 2019; 92:226-234. [PMID: 30690324 DOI: 10.1016/j.yebeh.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Studies on prevalence of epilepsy in Nigeria yielded figures ranging between 3.1 and 37 per 1000, giving one of the widest variations in prevalence of epilepsy world over. In order to accurately estimate clinical and public health impacts of epilepsy in Nigeria, robust and reliable epidemiological data are required for an appropriate estimation of logistical, economical, and social impacts of epilepsy. OBJECTIVE The objectives of the study were to determine, using meta-analysis, the prevalence of epilepsy by pooling data from community-based door-to-door surveys conducted in various parts of Nigeria, explore the existing variation in prevalence of epilepsy in Nigeria along geopolitical regions and settlement setting of the country, and then evaluate the burden of epilepsy in Nigeria. METHODS Prevalence estimates were derived from a random effects meta-analysis of observational studies reporting the prevalence of epilepsy in Nigeria. The derived estimate for the prevalence of epilepsy was applied to the total populations in Nigeria to give an estimated burden of epilepsy in Nigeria. RESULT Nine community-based door-to-door surveys, with quality data from different regions in Nigeria, were included. I-squared (I2) heterogeneity was 88.5%. Random effects model (REM) estimate of overall prevalence of epilepsy from the studies was 8 per 1000 (95% confidence interval (95% CI): 6-10). The prevalence was highest (11 per 1000) in the south western part of the country. It was also higher among the rural (15 per 1000 people) than the urban (6 per 1000) dwellers. The burden of epilepsy in Nigeria, based on the prevalence estimate was 1,280,000 persons (95% CI: 960,000-1,600,000 persons). CONCLUSION In Nigeria, the estimated prevalence of epilepsy is 8 per 1000 people indicating a substantial burden of the disease in the country.
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Affiliation(s)
- Lukman Femi Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
| | | | - Aminu Abdullahi Taura
- Department of Psychiatry, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | | | - Adesola Ogunniyi
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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9
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Subki AH, Mukhtar AM, Al-Harbi RS, Alotaibi AK, Mosaad FG, Alsallum MS, Jan MMS. The Impact of Pediatric Epilepsy on Children and Families: A Multicenter Cross-Sectional Study. Clin Pract Epidemiol Ment Health 2018; 14:323-333. [PMID: 30972132 PMCID: PMC6407654 DOI: 10.2174/1745017901814010323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/02/2018] [Accepted: 11/19/2018] [Indexed: 11/22/2022]
Abstract
Background and Objectives: Epilepsy is considered one of the most prevalent causes of morbidity in children. The aim of this study is to determine how epilepsy impacts the lives of children with epilepsy and their families. Methods: A translated version of the “Impact of Pediatric Epilepsy Scale” (IPES) questionnaire was completed by the 80 mothers of children with epilepsy, recruited at three hospitals in Jeddah, Saudi Arabia This is a validated self-administered questionnaire used to assess the impact of epilepsy on the lives of the child and family, as well as the quality of life (QoL) of the child. Results: The mean age of children epilepsy was 6.32 years (SD = 3.22). The mean IPES score was 6.28 (SD = 8.42) and the mean child’s QoL was 2.85 (SD= 0.83). 87.5% of the mothers rated their child’s QoL as low. IPES score was significantly associated with cause of seizure (β=0.259; 95%-CI= 0.263 - 10.334; p = 0.039). Child’s QoL was significantly associated with frequency of seizure (β=0.251; 95%-CI= 0.016 - 0.568; p= 0.039) and child’s nationality (β=-0.270; 95%-CI -0.252, -0.013; p= 0.031). Conclusions: Pediatric epilepsy may have a greater impact on the lives of the child and the family when it is not comorbid with cerebral palsy. Quality of life tends to be lower for non-Saudi children, and children with more frequent seizures. Therefore, these groups may need more support in managing the impact that epilepsy has on their daily functioning and quality of life.
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Affiliation(s)
- Ahmed Hussein Subki
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdel Moniem Mukhtar
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rakan Salah Al-Harbi
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Faisal Ghazi Mosaad
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Saad Alsallum
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed M S Jan
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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10
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Thurman DJ, Begley CE, Carpio A, Helmers S, Hesdorffer DC, Mu J, Touré K, Parko KL, Newton CR. The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy. Epilepsia 2018; 59:905-914. [PMID: 29637551 PMCID: PMC7004820 DOI: 10.1111/epi.14068] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 02/05/2023]
Abstract
Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke. Applying consistent criteria, we assessed the quality of each study and extracted data on measures of risk from those with adequate quality ratings, summarizing findings across studies as medians and interquartile ranges. Among higher-quality population-based studies, the median prevalence of active epilepsy across all ages was 11.1 per 1000 population in lower- and middle-income countries (LMIC) and 7.0 per 1000 in high-income countries (HIC). Perinatal brain insults were the largest attributable fraction of preventable etiologies in children, with median estimated fractions of 17% in LMIC and 15% in HIC. Stroke was the most common preventable etiology among older adults with epilepsy, both in LMIC and in HIC, accounting for half or more of all new onset cases. TBI was the attributed cause in nearly 5% of epilepsy cases in HIC and LMIC. CNS infections were a more common attributed cause in LMIC, accounting for about 5% of all epilepsy cases. Among some rural LMIC communities, the median proportion of epilepsy cases attributable to endemic neurocysticercosis was 34%. A large proportion of the overall public health burden of epilepsy is attributable to preventable causes. The attributable fraction for perinatal causes, infections, TBI, and stroke in sum reaches nearly 25% in both LMIC and HIC. Public health interventions addressing maternal and child health care, immunizations, public sanitation, brain injury prevention, and stroke prevention have the potential to significantly reduce the burden of epilepsy.
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Affiliation(s)
- David J. Thurman
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Charles E. Begley
- Health Science Center at Houston School of Public Health, University of Texas, Houston, TX, USA
| | - Arturo Carpio
- Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador
| | - Sandra Helmers
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Dale C. Hesdorffer
- Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Jie Mu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Kamadore Touré
- Department of Neurology, Fann University Hospital, Dakar, Senegal
| | - Karen L. Parko
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Charles R. Newton
- Kenya Medical Research Institute–Wellcome Trust Collaborative Program, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
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Alshahawy AK, Darwish AH, Elsaid Shalaby S, Mawlana W. Prevalence of idiopathic epilepsy among school children in Gharbia Governorate, Egypt. Brain Dev 2018; 40:278-286. [PMID: 29295801 DOI: 10.1016/j.braindev.2017.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 12/05/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Epilepsy is one of the most common neurological disorders among children. Data about its prevalence in Egypt is limited. Our aim was to study the prevalence of idiopathic epilepsy among school children in Gharbia governorate, Egypt. SUBJECTS AND METHODS A Cross-sectional school-based survey study was conducted; a validated screening questionnaire was distributed among urban and rural primary and preparatory school children. Students with suspected epilepsy were subjected to clinical evaluation, Electroencephalogram (EEG), and neuroimaging. RESULTS 9545 students completed the questionnaire, of whom 69 children proved to have idiopathic epilepsy. The lifetime prevalence of idiopathic epilepsy among school students aged 6-14 years was 7.2/1000. Higher prevalence was reported in males (7.7/1000) and in children from urban areas (8.25/1000). Generalized seizures were observed in 56.5% of the children with epilepsy, whereas focal seizures were present in 43.5%. Thirty-four (49.27%) children were diagnosed with specific childhood epileptic syndrome: 25 children had benign childhood epilepsy with centrotemporal spikes and nine children had typical childhood absence epilepsy. Treatment gap is around 12.5% in the studied children. Family history of epilepsy and parental consanguinity were evident in 73.9% and 21.7% of the epileptic children, respectively. The odds ratio for idiopathic epilepsy in children with family history of epilepsy was 23.9. CONCLUSION The prevalence of idiopathic epilepsy among school students aged 6-14 years in Gharbia Governorate was 7.2/1000. The reported prevalence is similar to the prevalence of epilepsy in other Arab countries, but lower than the prevalence in Upper Egypt and in most developing countries.
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Affiliation(s)
- Azza Kamal Alshahawy
- Pediatric Neurology Unit, Department of Pediatrics, Tanta University Hospital, Faculty of Medicine, Tanta, Egypt
| | - Amira Hamed Darwish
- Pediatric Neurology Unit, Department of Pediatrics, Tanta University Hospital, Faculty of Medicine, Tanta, Egypt.
| | - Safynaz Elsaid Shalaby
- Department of Public Health and Community Medicine, Tanta University Hospital, Faculty of Medicine, Tanta, Egypt
| | - Wegdan Mawlana
- Pediatric Cardiology Unit, Department of Pediatrics, Tanta University Hospital, Faculty of Medicine, Tanta, Egypt
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Guekht A, Zharkinbekova N, Shpak A, Hauser WA. Epilepsy and treatment gap in urban and rural areas of the Southern Kazakhstan in adults. Epilepsy Behav 2017; 67:98-104. [PMID: 28142100 DOI: 10.1016/j.yebeh.2016.11.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE There are no data in the English literature about the epidemiology of epilepsy in the large countries in the Asian region of the former Soviet Union. This paper presents the results of epidemiological studies of active epilepsy in the population 14years of age and older in the Province of South Kazakhstan. METHODS The study population consisted of 306.44 thousand persons: 139.42 in the urban Enbekshinskiy district of the city of Shymkent and 167.02 in the rural Sairam district. To collect patient's data, multiple medical sources were used. For each person with epilepsy (PWE), a questionnaire was completed by members of the research team. Clinical profiles, seizure type, clinical syndrome, etiology, seizure frequency, therapy, educational level, and social status were abstracted. RESULTS Overall, 1351 PWE were identified: 459 in the urban district and 892 in the rural district. The age-adjusted prevalence of epilepsy was 3.14/1000 (CI95%: 2.86-3.45) in the urban district and 4.95/1000 (CI95%: 4.62-5.30) in the rural district. Prevalence for men was higher than for women. Focal seizures predominated in both regions. Traumatic brain injury was the most frequently identified cause of epilepsy. The other important antecedents were pre/perinatal disorders, CNS infection, and cerebrovascular disease. Half of PWE experienced more than 12seizures per year. Substantial social impacts of epilepsy were observed: 44% of PWE received disability pensions from the government; only 15.5% were employed. About a quarter of all PWE were not taking AEDs at the time of the record review. For those on treatment, regimens were frequently suboptimal. CONCLUSION In the first study performed according to the guidelines for epidemiologic studies on epilepsy of ILAE in the Asian part of the former Soviet Union, poor seizure control and a substantial treatment gap were identified. The need for improvement of epilepsy care was highlighted, especially in the rural regions.
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Affiliation(s)
- Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department of Moscow, 43, Donskaya ul., Moscow 115419, Russian Federation; Department of Neurology, Neurosurgery and Medical Genetics, Russian National Research Medical University, 8, Leninsky Prospekt, bl.8, Moscow 119049, Russian Federation.
| | - Nazira Zharkinbekova
- Department of Neurology, Neurosurgery and Medical Genetics, Russian National Research Medical University, 8, Leninsky Prospekt, bl.8, Moscow 119049, Russian Federation; Shymkent Regional Clinical Hospital, 4, Mailykozha Str., Shymkent, South Kazakhstan Province 160050, Kazakhstan.
| | - Alexander Shpak
- The S. Fyodorov Eye Microsurgery Federal State Institution, 59A, Beskudnikovsky Blvd, Moscow 127486, Russian Federation.
| | - W Allen Hauser
- Department of Neurology, Epidemiology and Sergievsky Center, Columbia University, 630, West 168 St., New York, NY 10032, USA.
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Fiest KM, Sauro KM, Wiebe S, Patten SB, Kwon CS, Dykeman J, Pringsheim T, Lorenzetti DL, Jetté N. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology 2016; 88:296-303. [PMID: 27986877 DOI: 10.1212/wnl.0000000000003509] [Citation(s) in RCA: 986] [Impact Index Per Article: 123.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 10/12/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To review population-based studies of the prevalence and incidence of epilepsy worldwide and use meta-analytic techniques to explore factors that may explain heterogeneity between estimates. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed. We searched MEDLINE and EMBASE for articles published on the prevalence or incidence of epilepsy since 1985. Abstract, full-text review, and data abstraction were conducted in duplicate. Meta-analyses and meta-regressions were used to explore the association between prevalence or incidence, age group, sex, country level income, and study quality. RESULTS A total of 222 studies were included (197 on prevalence, 48 on incidence). The point prevalence of active epilepsy was 6.38 per 1,000 persons (95% confidence interval [95% CI] 5.57-7.30), while the lifetime prevalence was 7.60 per 1,000 persons (95% CI 6.17-9.38). The annual cumulative incidence of epilepsy was 67.77 per 100,000 persons (95% CI 56.69-81.03) while the incidence rate was 61.44 per 100,000 person-years (95% CI 50.75-74.38). The prevalence of epilepsy did not differ by age group, sex, or study quality. The active annual period prevalence, lifetime prevalence, and incidence rate of epilepsy were higher in low to middle income countries. Epilepsies of unknown etiology and those with generalized seizures had the highest prevalence. CONCLUSIONS This study provides a comprehensive synthesis of the prevalence and incidence of epilepsy from published international studies and offers insight into factors that contribute to heterogeneity between estimates. Significant gaps (e.g., lack of incidence studies, stratification by age groups) were identified. Standardized reporting of future epidemiologic studies of epilepsy is needed.
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Affiliation(s)
- Kirsten M Fiest
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Khara M Sauro
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Samuel Wiebe
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Scott B Patten
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Churl-Su Kwon
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Jonathan Dykeman
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Tamara Pringsheim
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Diane L Lorenzetti
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada
| | - Nathalie Jetté
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
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Khedr EM, Fawi G, Abbas MAA, Abo El-Fetoh N, Zaki AF, Gamea A, Al Attar G. Prevalence of neuromuscular disorders in Qena governorate/Egypt: population-based survey. Neurol Res 2016; 38:1056-1063. [DOI: 10.1080/01616412.2016.1243640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eman M. Khedr
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Gharib Fawi
- Faculty of Medicine, Department of Neuropsychiatry, Sohag University, Sohag, Egypt
| | | | - Noha Abo El-Fetoh
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Ahmed F. Zaki
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ayman Gamea
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ghada Al Attar
- Faculty of Medicine, Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
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15
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Talat MA, Ahmed A, Mohammed L. Serum levels of zinc and copper in epileptic children during long-term therapy with anticonvulsants. ACTA ACUST UNITED AC 2016; 20:341-5. [PMID: 26492112 PMCID: PMC4727616 DOI: 10.17712/nsj.2015.4.20150336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To evaluate the serum levels of zinc and copper in epileptic children during the long-term treatment of anticonvulsant drugs and correlate this with healthy subjects. Methods: A hospital-based group matched case-control study was conducted in the Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt between November 2013 and October 2014. Ninety patients aged 7.1±3.6 years were diagnosed with epilepsy by a neurologist. The control group was selected from healthy individuals and matched to the case group. Serum zinc and copper were measured by the calorimetric method using a colorimetric method kit. Results: The mean zinc level was 60.1±22.6 ug/dl in the cases, and 102.1±18 ug/dl in the controls (p<0.001). The mean copper level was 180.1±32.4 ug/dl in cases compared with 114.5±18.5 ug/dl in controls (p<0.001). Conclusion: Serum zinc levels in epileptic children under drug treatment are lower compared with healthy children. Also, serum copper levels in these patients are significantly higher than in healthy people. No significant difference in the levels of serum copper and zinc was observed in using one drug or multiple drugs in the treatment of epileptic patients.
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Affiliation(s)
- Mohamed A Talat
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E-mail:
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16
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El-Tallawy HN, Farghaly WM, Rageh TA, Shehata GA, Metwally NA, Badry R, Sayed MA, Abdelwarith AM, Kandil MR, Hamed MA, Mohamed KO, Tohamy AM. Spectrum of epilepsy - prevalence, impact, and treatment gap: an epidemiological study from Al-Quseir, Egypt. Neuropsychiatr Dis Treat 2016; 12:1111-8. [PMID: 27257380 PMCID: PMC4874633 DOI: 10.2147/ndt.s87765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Epidemiology continues to be an important research tool in the study of epilepsy and related disorders, providing a better understanding of the frequency, causes, and natural history of the disorder. OBJECTIVE To estimate the prevalence of epilepsy in Al-Quseir, Red Sea Governorate, Egypt, and its magnitude of treatment gap. METHODS The study was part of a door-to-door study, including every door, to screen all inhabitants in Al-Quseir (33,818 inhabitants) by three specialists of neurology and 15 female social workers (for demographic data collection) using a standardized screening questionnaire. All suspected cases were subjected to detailed history, clinical examination, and electroencephalogram. Neuroimaging studies and estimation of serum drug level were done in select cases if needed. RESULTS The study revealed that the lifetime prevalence rate of epilepsy in Al-Quseir is 5.5/1,000, with the highest peak during early childhood, while that of active epilepsy is 3.3/1,000 population. The annual incidence rate is 48/100,000, and the age-specific incidence rate has a U-shaped pattern with two peaks of incidence in early infancy and elderly life. Localization-related epilepsy is the most frequently encountered type (58.8%). The treatment gap of epilepsy in Al-Quseir is 83.8%. CONCLUSION The lifetime prevalence of epilepsy in Al-Quseir city, Red Sea Governorate, was 5.5/1000.
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Affiliation(s)
| | | | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Nabil A Metwally
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | - Reda Badry
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Ahmed M Abdelwarith
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | | | | | | | - Amal M Tohamy
- Department of Neurology, Assiut University, Assiut, Egypt
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Bhalla D, Lotfalinezhad E, Timalsina U, Kapoor S, Kumar KS, Abdelrahman A, Giagante B, Tripathi M, Srivastava K, Irmansyah I. A comprehensive review of epilepsy in the Arab world. Seizure 2015; 34:54-9. [PMID: 26724591 DOI: 10.1016/j.seizure.2015.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 12/05/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE We conducted a comprehensive review of the epidemiology of epilepsy in the Arab world. METHODS Epidemiological literature about epilepsy from 22 countries of the Arab League was searched in French and English using several keywords (specific and wider) and combinations, individually for each country. The search was conducted on Google first and then on PubMed. The results are presented as counts, proportions, and medians along with 95% confidence intervals (CI). Unpaired t-test with unequal variance and regressions were performed, altogether and individually, for lifetime and active epilepsy prevalence as well as incidence. RESULTS Google provided 21 prevalence, four camp and nine incidence estimates while PubMed provided ten such estimates; none of them was identified by Google. No epidemiological data about epilepsy was found from 10/22 countries. Excluding pediatric studies, 13 prevalence estimates from six countries were identified. Including pediatric studies, 21 estimates from nine countries were found. Median lifetime and active epilepsy prevalence were 7.5/1000 (95% CI 2.6-12.3, range 1.9-12.9) and 4.4/1000 (95% CI 2.1-9.3, range 2.1-9.3), respectively, excluding pediatric studies (1984-2014, N=244081). Median incidence was 56.0/100,000 (n=9, N=122484, 95% CI 13.7-147.9, range 10.4-190). CONCLUSION The fact that no epidemiological data about epilepsy is available in the public domain for almost one half of all Arab countries offers opportunities for future research. This thorough review of existing literature demonstrates a prevalence of epilepsy three times higher than previously reported for this region. The median incidence is similar to other regions of the world, e.g. North America. Google yielded additional valuable sources not indexed in PubMed and provided pertinent references more quickly.
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Affiliation(s)
- Devender Bhalla
- Nepal Interest Group of Epilepsy and Neurology, Kathmandu, Nepal; Faculté de Medecine, Université de Limoges, Limoges, France; Iranian Epilepsy Association, Tehran, Iran.
| | - Elham Lotfalinezhad
- Iranian Epilepsy Association, Tehran, Iran; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Saloni Kapoor
- All India Institute of Medical Sciences, Delhi, India
| | | | | | - Brenda Giagante
- Department of Neurosciences, El Cruce Hospital, Buenos Aires, Argentina
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Hawley SR, Ablah E, Hesdorffer D, Pellock JM, Lindeman DP, Paschal AM, Thurman DJ, Liu Y, Warren MB, Schmitz T, Rogers A, St Romain T, Hauser WA. Prevalence of pediatric epilepsy in low-income rural Midwestern counties. Epilepsy Behav 2015; 53:190-6. [PMID: 26588587 DOI: 10.1016/j.yebeh.2015.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/13/2015] [Indexed: 11/15/2022]
Abstract
Epilepsy is one of the most common disabling neurological disorders, but significant gaps exist in our knowledge about childhood epilepsy in rural populations. The present study assessed the prevalence of pediatric epilepsy in nine low-income rural counties in the Midwestern United States overall and by gender, age, etiology, seizure type, and syndrome. Multiple sources of case identification were used, including medical records, schools, community agencies, and family interviews. The prevalence of active epilepsy was 5.0/1000. Prevalence was 5.1/1000 in males and 5.0/1000 in females. Differences by age group and gender were not statistically significant. Future research should focus on methods of increasing study participation in rural communities, particularly those in which research studies are rare.
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Affiliation(s)
- Suzanne R Hawley
- Wichita State University, Department of Public Health Sciences, 1845 Fairmount Box 43, Wichita, KS 67260-0043, USA
| | - Elizabeth Ablah
- University of Kansas School of Medicine-Wichita, Department of Preventive Medicine and Public Health, 1010 N. Kansas, Wichita, KS 67214, USA
| | - Dale Hesdorffer
- Columbia University, 680 West 168 Street, New York, NY 10032, USA
| | - John M Pellock
- Virginia Commonwealth University, Department of Neurology, P.O. Box 980599, Richmond, VA 23298, USA
| | - David P Lindeman
- University of Kansas Life Span Institute at Parsons, 2601 Gabriel, Parsons, KS 67357, USA
| | - Angelia M Paschal
- The University of Alabama, Department of Health Science, Box 870311, Tuscaloosa, AL 35487-0311, USA
| | - David J Thurman
- Emory University, School of Medicine 201 Dowman Dr. Mailstop 1930-001-1AN, Atlanta, GA 30322, USA
| | - Yi Liu
- Columbia University, 680 West 168 Street, New York, NY 10032, USA
| | - Mary Beth Warren
- University of Kansas Area Health Education Center, 1501 S. Joplin, Pittsburg, KS 66762, USA
| | - Terri Schmitz
- University of Kansas Area Health Education Center, 1501 S. Joplin, Pittsburg, KS 66762, USA
| | - Austin Rogers
- University of Kansas School of Medicine-Wichita, Department of Preventive Medicine and Public Health, 1010 N. Kansas, Wichita, KS 67214, USA
| | | | - W Allen Hauser
- Columbia University, 680 West 168 Street, New York, NY 10032, USA.
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Epilepsy prevalence in Al-Manial Island, Egypt. A door-to-door survey. Epilepsy Res 2015; 117:133-7. [PMID: 26454046 DOI: 10.1016/j.eplepsyres.2015.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 07/26/2015] [Accepted: 08/05/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Epidemiologic studies of epilepsy are lacking from the majority of the Arab countries; although there are significant needs for such studies. This study was conducted on a sample of Al-Manial Island, Cairo city, one of the highest cities in population density in the world. PARTICIPANTS AND METHODS A community-based, door to door, cross-sectional study using multistage random sample including 512 families (1751 individuals). The study extended from March 2009 to September 2012 and involved three main stages; the preparatory stage, the field work stage and the stage of establishing epilepsy diagnosis and classifying confirmed epileptic patients. RESULTS The lifetime point prevalence of epilepsy among inhabitants of Al-Manial island was 6.9/1000 inhabitants while the prevalence of active epilepsy was 5.1/1000 inhabitants. The age distribution showed bimodal peaks in adolescents and in elderly with equal sex ratio (6/855 vs 6/896). Focal seizures were the commonest type (58.3%) and the treatment gap was 66.7%. CONCLUSION The prevalence of epilepsy among inhabitants of Al-Manial Island go in agreement with most global studies. High treatment gap detected in our study indicates that proper management of epilepsy requires a multi-factorial approach.
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Community-based epidemiological study of epilepsy in the Qena governorate in Upper Egypt, a door-to-door survey. Epilepsy Res 2015; 113:68-75. [DOI: 10.1016/j.eplepsyres.2015.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/15/2015] [Accepted: 03/28/2015] [Indexed: 11/18/2022]
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21
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Ismail AM, Babers GM, El Rehany MA. Brain-derived neurotrophic factor in sera of breastfed epileptic infants and in breastmilk of their mothers. Breastfeed Med 2015; 10:277-82. [PMID: 26057553 DOI: 10.1089/bfm.2015.0008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human milk contains leukocytes expressing brain-derived neurotrophic factor (BDNF), which may facilitate epileptogenesis. Our study aimed to estimate levels of BDNF in the sera of breastfed infants with idiopathic epilepsy and in breastmilk of their mothers and to assess its value as a marker of epilepsy severity. PATIENTS AND METHODS Thirty breastfed infants <2 years of age with idiopathic epilepsy and 15 control healthy breastfed infants were recruited for the study. Patients were subjected to thorough medical history, clinical examination, and assessment of disease severity. Routine laboratory and radiological investigations, including, liver, renal, and thyroid screen, brain magnetic resonance imaging, and measurement of serum and breastmilk BDNF levels, were performed. RESULTS Serum BDNF levels of epileptic infants and milk BDNF levels of their mothers were significantly higher than values for controls (p=0.0001). They were positively correlated with age, weight, length, and head circumference of epileptic children. Also, serum and milk BDNF levels were significantly increased with increased duration of illness and frequency of seizures. There was a significant positive correlation between serum and breastmilk levels of BDNF and significantly higher levels in severe cases of epilepsy. CONCLUSIONS Serum and milk BDNF levels are higher in epileptic infants than in controls and may be used as a marker of disease severity.
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Affiliation(s)
- Ahlam M Ismail
- 1 Pediatrics Department, Faculty of Medicine, South Valley University , Qena, Egypt
| | - Gihan M Babers
- 2 Pediatrics Department, Faculty of Medicine , Minia University, Minia, Egypt
| | - Mahmoud A El Rehany
- 3 Biochemistry Department, Faculty of Pharmacy, Deraya University , Minia, Egypt
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Consanguinity and epilepsy in Oran, Algeria: A case-control study. Epilepsy Res 2015; 111:10-7. [PMID: 25769368 DOI: 10.1016/j.eplepsyres.2014.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/27/2014] [Accepted: 12/30/2014] [Indexed: 01/23/2023]
Abstract
PURPOSE The goal of this case-control study was to identify the significance of consanguinity and other risk factors for epilepsy in Oran, Algeria. METHODS Unrelated epileptic patients upwards of 16 years, who attended the Neurology Department between October 2013 and March 2014 were included in the study. Controls, matched for age and sex, were selected among non-epileptic patients attending the same department during the same period. The risk factors evaluated were: consanguinity, family history of epilepsy, perinatal complications, infection of the central nervous system, mental retardation, neurological impairment, history of febrile seizures, severe head trauma, cerebrovascular diseases, and addiction. RESULTS 101 cases and 202 controls participated in the study. Multivariate logistic regression identified five factors significantly associated with epilepsy: first-degree of consanguinity (odds ratio (OR)=2.15), history of epilepsy in first-degree relatives (OR=4.03), antecedent of febrile seizures (OR=5.38), severe head injury (OR=2.94) and mental retardation (OR=9.32). CONCLUSION Consanguinity, family history of epilepsy, history of febrile seizures, severe head trauma and mental retardation are risk factors for epilepsy. The implementation of a strategy for prevention and awareness of the impact of consanguineous marriages as well as genetic counseling for couples with a family history of epilepsy are needed.
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