Prenatal and Perinatal Pathology

Poor prenatal or perinatal care resulting in brain damage of the child is often claimed to be a reason for the high prevalence of epilepsy in the tropics.3,31 Unfortunately, very few studies in the tropics define inclusion criteria for this category. In studies in developed countries the presence of prenatal and perinatal events do not appear to be associated with the occurrence of childhood epilepsy when children with cerebral palsy and mental retardation are excluded.32 The USA Collaborative...

Table 1 Common sources of misinterpretation of scalp EEGs

Electrode artifacts Myogenic artifacts ECG and pulse artifacts Benign epileptiform variants Benign sporadic sleep spikes Wicket waves 14 and 6 Hz positive spikes 6 Hz spike-waves Rhythmic temporal theta burst of drowsiness Subclinical rhythmic electroencephalographs discharge of adults Atypical responses to photic stimulation Bifrontal delta activity on hyperventilation Posterior slow waves of youth Breach activity tropical world. In India, there are no defined minimum standards for EEG...

Special Issues in Developing Countries

Thomas Introduction Epilepsy is one of the most common chronic disorders affecting women of child-bearing age and 3 to 5 of every 1000 births are to mothers with epilepsy.1 Women with epilepsy (WWE) in developing countries have many concerns and face many social and cultural taboos related to the diversity in ethnic, racial, religious, economic, educational, and cultural spheres. In addition, in developing countries child-bearing for WWE has not always been acceptable...

Hasan Aziz and Zarin Mogal

Epilepsy is a worldwide problem with a major impact on the personal, family, and social life of the affected individual and also on the society. The reported prevalence rates of epilepsy in various epidemiological studies vary from 1.5 to 19.5 per 1,000 population with higher prevalence rates in developing countries.1-5 The average accepted prevalence rate is 5 per 1000.2 Stigmatization, low literacy, sub-optimal employment, and social and economical marginalization are the commonly faced...

Screening Questionnaire

Diagnosis of epilepsy is fundamentally a clinical judgment. Clinical history should elicit details of seizure semiology, seizure provoking factors, and seizure frequency in the preceding five years.7 At times there can be discrepancy in the diagnosis of epilepsy when it is based only on a screening questionnaire. In a recent epidemiological survey in Togo of the 9,155 subjects screened by a screening questionnaire, 285 subjects (3.1 ) reported loss of consciousness, 263 (2.9 ) had seizures and...

Status Epilepticus in Developing Countries An Account

Pierre-Marie Preux, Mouhamadou Diagana and Michel Druet-Cabanac Status epilepticus is a common neurological emergency and is associated with a significant mortality. It may occur in association with epilepsy and in the context of acute central nervous system insults and the systemic illness.1 There is very few published data about status epilepticus in developing countries. Generalized tonic-clonic status epilepticus is readily recognized. But other forms of status epilepticus may not be...

Inspection

Inspection is the key step in the diagnostic evaluation as certain findings burn scars and amputations can give a clue to the epileptic nature of seizures. In developing countries due to high usage of unattended open fires, patients with epilepsy are at a higher risk of burns. Burns from falling into domestic fires are very common. When a patient with epilepsy falls into a fire or on a hot object he may be deserted by the entourage (Fig. 1). In India forehead of a child with febrile seizures is...

Developing Countries Perspective

Febrile seizure is the most common seizure disorder in childhood. Often the terms febrile convulsion and febrile seizure are used synonymously or interchangeably. In the newly proposed classification this seizure disorder has been recognized as a special syndrome and the term febrile seizures (FS) has been proposed.1,2 Epidemiological studies of FS are very few from the developing countries and show some differences not only in the incidence and prevalence rates but also in the clinical...

And Etiological Profile in Developing Countries

Acute symptomatic seizures are those caused or provoked by an acute medical or neurological insult1 and, in the aggregate are almost as common as febrile seizures or epilepsy.2 They make up 40 of all the newly diagnosed seizure disorders.3 Acute symptomatic seizures show clearly differentiated characteristics with regard to true epileptic seizures (1) a clearly identified causal association, (2) generally tend not to recur, (3) usually long-term antiepileptic drug (AED) treatment is not...

Neonatal Seizures Developing Countries Perspective

Seizures in the newborn period are a frequent clinical problem and represent the most distinctive signal of neurological disease. Neonatal seizures are usually related to specific illness requiring prompt therapy. Early diagnosis of underlying cause is important, as some of the risk factors are associated with high mortality or adverse neurological sequelae. Neonatal seizures show clearly differentiated characteristics from seizures in older children. Several unique characteristics of neonatal...

Nimal Senanayake

The impact of geographic, climatic, demographic, social, and economic characteristics in developing countries is adverse in terms of the frequency of epilepsy. Information is relatively limited, and actions have to be based frequently on dramatic numbers in Malawi between 1983 and 1986, 60 of psychiatric outpatients and 30 of all psychiatric and neurological cases were related to epilepsy.1 Most of the earlier epidemiological studies on epilepsy in developing countries derived the information...

References

Translation and analysis of a cuneiform text forming part of a Babylonian treatise on epilepsy. Med Hist 1990 34 185-98. 2. Pirkner EH. Epilepsy in the light of history. Ann Med Hist 1929 1 453-80. 3. McGrew RE. Encyclopedia of medical history. London Macmillan, 1985. 4. Kanner L. The folklore and cultural history of epilepsy. Medical Life 1930 37 167-214. 5. Bharucha EP, Bharucha NE. Epilepsy in ancient Indian medicine. In Rose FC, ed. Neuroscience across the...

Traditional Therapeutic Scarification on Patients with Epilepsy

A major problem of epilepsy in developing countries is its social implications. Prejudice against the disease is common and patients with epilepsy are marginalized and discriminated. Epilepsy is often concealed. The very pronunciation of the word falling disease as epilepsy is called is a taboo. Many regard epilepsy as supernatural. This negative attitude will have considerable biases in hospital and population-based studies. Patients often consult traditional doctors. Traditional scarification...

Effects of Early Treatment on Prognosis

Observations on the efficacy of treatment in patients with chronic epilepsy who had not previously received AED treatment have now been made in three different studies from developing countries.35-37 These studies, involving more than 1000 patients, have found that neither the duration of the condition nor the number of seizures before treatment were predictors of outcome. This finding offers some evidence against the view that unless treatment is given early, chronic epilepsy will develop. The...