Abstracts

Since May 2005 an Epilepsy Monitoring Unit (EMU) has been in place at the CURE Children[apos]s Hospital of Uganda (CHU) in Mbale, Uganda, East Africa. Children are pre screened in regionalized clinics prior to evaluation at CHU comprehensive epilepsy program, the first such program in East Africa. The program is dedicated to the evaluation and treatment of pharmacoresistant temporal lobe epilepsy., Prescreening relies on identifying the stereotypical signs and symptoms of temporal lobe epilepsy. Treatment candidates must have intractable epilepsy, seizure frequency over 1 per month, and a history of two of the following:
-febrile convulsions
-typical aura
-typical semiology of stare and/or automatisms
Patients less than 6 years of age or multiple extra-temporal intracranial lesions were excluded.
EEG and CTimaging are done at CHU. The data are transferred for analysis to WVU. Epilepsy surgery is performed at CHU., 30 patients have been evaluated at CHU. Seizure frequency ranged between 30/day to 2/month with a mean of 2.2 seizures/day. 25 patients presented an aura. Essentially all patients had a history of malaria. 27 had febrile convulsions.
To date, 19 patients have completed an evaluation in the comprehensive program. EEG recording has shown: Left temporal (5), right temporal (2), frontal (2), bitemporal (2), multifocal (3), generalized (4), and non-epileptic (1). CT showed scar in 4 cases. Four patients had convincing temporal lobe epilepsy and underwent surgery at CHU., Epilepsy prevalence has been estimated to be 20 per 1000 in one region of Eastern Africa, 10 times the prevalence in developed countries making intractable epilepsy a significant public health problem in the region. Malaria was essentially universal in the population screened and we suspect cerebral malaria as an important cause of intractable epilepsy. One case of [ldquo]non-epileptic spell[rdquo] was identified (5% in the population studied)., (Supported by USAID, American Schools and Hospitals Abroad.)