Pattern and Predictors of Epilepsy among Children with Cerebral Palsy in Jos, Nigeria

BACKGROUND

Cerebral Palsy (CP) is a chronic motor disorder that results from a permanent injury to the developing brain. Co-morbidity of CP and epilepsy could be devastating to a child if not identified early and managed appropriately.

AIM

To describe the pattern and predictors of epilepsy among children with CP in Jos, Nigeria.

METHODS

This cross sectional study was carried out in the pediatric neurology clinic of Jos University Teaching Hospital, Jos, Nigeria. Structured questionnaires and hospital records were used to document all relevant information of children with CP from January 2015 to December 2016.

RESULTS

A total of 162 subjects with CP were studied, epilepsy was seen in 75 (46.3%) of the subjects. The mean age at the onset of seizure was 1.52±0.43 years. Among those with epilepsy, 52 (69.3%) had their first seizure before 1 year of age while 26 (34.7%) had a history of neonatal seizures. The commonest type of epileptic seizure seen was generalized tonic-clonic seizures in 33 (44.0%) subjects, followed by focal seizures 30 (40.0%), myoclonic seizures 5 (6.7%) and epileptic spasms 3 (4.0%). Focal seizures were predominantly seen in spastic hemiplegic CP while generalized seizures predominated in other types of CP. Independent predictors of epilepsy were seizure in the first year of life, neonatal seizure and spastic CP (adjusted odds ratio 4.97, 2.45 and 8.85 respectively).

CONCLUSION

Co-morbidity with epilepsy is common among children with CP. Children with CP should be properly evaluated for epilepsy and appropriate treatment commenced if indicated.

Lassa fever outbreak in adolescents in North Central Nigeria: report of cases

BACKGROUND

Lassa fever (LF) is a viral haemorrhagic fever endemic to West Africa. The clinical presentation and course is variable, making diagnosis difficult.

AIM

To report the outbreak and identify the common clinical presentations of LF in paediatric patients in Jos, Plateau State, North Central, Nigeria.

METHODS

This was a retrospective review of patients managed for LF during the June-August 2017 outbreak. LF was suspected in cases with: fever of less than 3 weeks' duration that had not responded to antimalarials or antibiotics, myalgia, abdominal pain, prostration and history of contact with any person diagnosed with LF. LF was confirmed by a positive reverse transcriptase polymerase chain reaction test (RT-PCR).

RESULTS

Ten adolescents were studied. The common presenting complaints were fever (100%), prostration (90%) and headache (70%) while the commonest clinical signs were pyrexia (temperature >38.0^oC; 90%), prostration (80%) and abdominal tenderness (80%). Leukocytes were present in urine in 60%. Eight individuals recovered fully, one adolescent died and one developed intestinal perforation necessitating laparotomy.

CONCLUSION

In settings such as North Central Nigeria, LF should be suspected in any patient with fever that is unresponsive to antimalarials and antibiotics, especially in the presence of prostration, tachypnoea, tachycardia or abdominal tenderness. Early diagnosis and treatment is needed to reduce mortality from the disease and protect against transmission to health personnel.