Seizure control in children on follow-up at Kenyatta national hospital paediatric Neurology clinic
Background: Recent studies in both developed and developing countries have shown that after 2 to 5 years of successful treatment with anti-epileptic drugs, drugs can be withdrawn in about 70% of children without relapses. Objective: To determine prevalence of poorly controlled epilepsy and factors associated with poor seizure control among children on follow up at the Kenyatta National Hospital paediatric neurology clinic. Results: Two hundred and four children were recruited into the study. The median age of was 5 years (IQR; 8 months to 12 years). Up to 14.7% (30) of children recruited into the study were poorly controlled. Partial seizures were associated with a higher risk of poorly controlled epilepsy, OR=14.3[(95% CI, 5.3, 37.3), P <0.05]. A family history of epilepsy was also associated with a significantly increased risk of poor seizure control, OR=5[(95% CI, OR 1.4, 17.3), P <0.05]. The odds of having cerebral palsy among children with poorly controlled epilepsy was OR=12.3 [(95% CI, 4.3, 35.5), p<0.05] Conclusions: The prevalence of poorly controlled epilepsy was 14.7%. Partial seizures, increased number of pre-treatment seizures, family history of epilepsy and cerebral palsy independently predict the risk of poor seizure control. Recommendations: Children at risk of intractable epilepsy should be identifying early in the course of their presentation so that they can be followed up closely and their caregivers better prepared to cope with their child's condition.