Tetinou Djifack Francklin
Department of Neurosurgery, Cameroon
Title: Etiology and comorbidities on epileptics children at the yaounde gyneco-obstetrics and pediatrics hopital
Biography
Biography: Tetinou Djifack Francklin
Abstract
Objectives
Epilepsy etiologies in underdeveloped countries are much more symptomatic, compare to in developed country where they are largely idiopathic. Several comorbidities occur on epileptic children due to brain damage and antiepileptic drugs. These comorbidities worsen the prognosis of these children on varying degrees. The main comorbidities are mental retardation, psychiatric disorders and malnutrition. Very few studies in Cameroon to date have been devoted to comorbidities in children with epilepsy. Faced with this lack of data, we proposed to conduct this study whose objective was to describe the etiologies and mains comorbidities in children with epilepsy followed at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital.
Methods
In this cross-sectional study, we interviewed a consecutive sample of 159 children with epilepsy and their parents at the Yaoundé Gyneco-Obstetrics and Pediatrics Hospital. The study was conducted from January 15 to May 14, 2019. The data were recorded and analyzed by the WHO anthro software with which we calculated patient z-scores and Epi info version 3.5.3. Chi 2 and Fischer Exact tests were used to measure the association between epileptic syndromes and comorbidities on the one hand, and between the etiologies of epilepsy and comorbidities. Logistical regression has eliminated the confounding factors. The Odd Ratio expressed with its 95% confidence interval was used to determine the degree of association between variables.
Results
The average age was 6 years. Anoxo-ischemic encephalopathy was the main cause of epilepsy (28%), followed by status epilepticus (6.9) and severe malaria (6,3).
Mental retardation was the main comorbidity (52%) followed by cerebral palsy (31%), attention deficit hyperactivity (30%), malnutrition (24%), depression (9.4%). Malnutrition was most pronounced in children with epileptic encephalopathy (34%). West syndrome increased by 22 and 18 the risk of having mental retardation (P -0.000), and cerebral palsy (P - 0,000), respectively. Others epileptics encephalopathies were also associated with cerebral palsy (OR - 13.3; and malnutrition (OR - 3.59; P-0.04). Anoxo-ischemic encephalopathy was the main etiology of epilepsy and it increased by 11 the risk of having cerebral palsy (P -0.000) and by 2.3 and 5 the risk of malnutrition (P-0.03) and mental retardation (P-0.000) respectively.
Conclusion
The main etiology of childhood epilepsy is anoxo-ischemic encephalopathy. Comorbidities in children with epilepsy are a real public health problem with mental retardation, attention deficit hyperactivity, malnutrition and depression as the main comorbidities. We recommend that the Ministry of Public Health combat perinatal asphyxia, which is the main cause of epilepsy, by strengthening the national health policy focused on emergency obstetric and neonatal care. To doctors, to strengthen the follow-up of these children and look for mental retardation, attention deficit hyperactivity, and malnutrition in children with epilepsy and especially in those with epileptic encephalopathy.