Reported incidence of Cluster Seizures in Persons with Epilepsy. Experience from Two Tertiary Hospitals in Enugu South East Nigeria

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Birinus A Ezeala-Adikaibe
Fintan Ekochin
Ernest Nwazor
Obinna D Onodugo
Orah-Chidimma Okpala
Bibiana Oti
Nkeiruka C Mbadiwe
Pauline Onodugo

Keywords

Repetitive Seizures, Cluster Seizures, Status Epilepticus, Epilepsy, Nigeria

Abstract

Background: Repetitive seizures are neurological emergencies which may occur in people with epilepsy. Ascertaining the incidence of these episodes of such seizures in the community is wrought with many challenges and few reports exist in sub-Saharan Africa, a region with a high burden of epilepsy. The aim of this study was to describe the caregiver reported frequency of acute recurrent seizures in people with epilepsy attending a neurology outpatient clinic in Enugu.


Methodology: This cross-sectional study was performed in the medical out-patient clinics in Enugu Nigeria. Data were collected using a structured questionnaire from an existing epilepsy register. Cluster seizures were defined as frequent repetitive seizures (two or more) occurring more than usual within a week. Epilepsy was defined based on ILAE criteria.


Results: A total of 73(45.3%) reported a lifetime history of cluster seizures; similar in males 39(48.1%) and females 34(45.9%). P=0.73. About 36.4% and 38.2% of PWE who had a history of traumatic brain injury and stroke had also experienced at least one SC. A large proportion of PWE with SC also had experienced status epilepticus in the past.  Seizure cluster was correlated with older age of onset, having various forms of seizures and longer seizure freedom


Conclusions: The reported lifetime history of cluster seizures among people with epilepsy attending a tertiary hospital clinic is high. This may suggest both poor seizure control and severity. Careful patient education will improve both adherence and emergency management of epilepsy to reduce the morbidity of epilepsy in the community.

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