Singh, G;
Singhal, S;
Sharma, S;
Paul, BS;
Bansal, N;
Chaudhary, A;
Sharma, S;
... Sander, JW; + view all
(2020)
Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India.
Epilepsia Open
10.1002/epi4.12439.
(In press).
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Abstract
Objectives: To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India. / Methods: The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness. / Results: The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug‐resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years. / Significance: Existing classifications schemes should be better suited to field conditions in resource‐limited communities in low‐ and middle‐income countries. The finding of drug‐resistant epilepsy in nearly at least a third in a community‐based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up.
| Type: | Article |
|---|---|
| Title: | Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/epi4.12439 |
| Publisher version: | https://doi.org/10.1002/epi4.12439 |
| Language: | English |
| Additional information: | Copyright © 2020 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | classification, epileptic syndromes, etiology, perinatal accidents, prevention |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10114611 |
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