Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon
Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon
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DOI：
10.1016/j.yebeh.2018.11.008
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发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Njamnshi, Alfred K.
中科院分区：
文献类型：
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作者：
Siewe, Joseph F. N.;Ngarka, Leonard;Njamnshi, Alfred K.
背景：在包括喀麦隆在内的几个盘尾丝虫病流行国家，癫痫的发病率很高。然而，关于癫痫(PWE)患者的临床表现知之甚少。一项以社区为基础的研究描述了喀麦隆部分盘尾丝虫病流行村的癫痫发作谱，并记录了盘尾丝虫病相关癫痫(OAE)患者的相关病史。方法：我们在喀麦隆的5个盘尾丝虫病流行村进行了挨家挨户的调查，并招募了所有同意的PWE癫痫患者，采用两步法诊断癫痫，包括填写标准化的5项问卷，然后由神经科医生确认疑似病例。与盘尾丝虫病相关的癫痫的定义是？.2在盘尾丝虫病流行区居住至少3年的既往健康人在3-18岁之间开始无明显原因的癫痫发作。验证了PWE使用伊维菌素的情况。记录癫痫病史、既往相关病史、家族史以及神经学表现。结果：5个村共招募PWE患者156人。癫痫的发病年龄模式为10~14岁。93.2%的患者符合耳声发射的诊断标准。受试者有以下一种或多种发作类型：全身性强直-圆锥发作(89.1%)、缺席(38.5%)、点头(21.8%)、局灶性非运动性发作(7.7%)和局灶性运动性发作(1.9%)。1例(0.6%)确诊为“Nakalanga综合征”。超过一半(56.4%)的先天癫痫患者每月至少发作一次。在一个村庄，562%的PWE患者有盘尾丝虫病皮损。结论：喀麦隆盘尾丝虫病流行村的癫痫患者具有广泛的临床谱，包括点头发作和Nakalanga特征。绝大多数参与者符合OAE的诊断标准，这表明更好的盘尾丝虫病控制可以防止新病例。这些地区的癫痫管理算法必须进行调整，以反映不同的癫痫发作类型。(C)2018年由Elsevier Inc.出版。
Background: A high prevalence of epilepsy has been observed in several onchocerciasis-endemic countries, including Cameroon. However, little is known on the clinical presentations of the affected persons with epilepsy (PWE). A community-based study was conducted with the aim of describing the spectrum of seizures in selected onchocerciasis-endemic villages in Cameroon and documenting relevant medical history in patients with onchocerciasis-associated epilepsy (OAE).Methods: We carried out door-to-door surveys in 5 onchocerciasis-endemic villages in Cameroon and recruited all consenting PWE Epilepsy was diagnosed using a 2-step approach consisting of the administration of a standardized 5-item questionnaire followed by confirmation of the suspected cases by a neurologist. Onchocerciasis-associated epilepsy was defined as ?.2 seizures without an obvious cause, starting between the ages of 3-18 years in previously healthy persons having resided for at least 3 years in an onchocerciasis-endemic area. Ivermectin use by PWE was verified. Seizure history, relevant past medical, and family history, as well as neurological findings, were noted.Results: In all, 156 PWE were recruited in the 5 villages. The modal age group for epilepsy onset was 10-14 years. The diagnostic criteria for OAE were met by 93.2% of the PWE. Participants had one or more of the following seizure types: generalized tonic-conic seizures (89.1%), absences (38.5%), nodding (21.8%), focal nonmotor (7.7%), and focal motor seizures (1.9%). One case (0.6%) with the "Nakalanga syndrome" was identified. More than half (56.4%) of PWE had at least one seizure per month. In one village, 562% of PWE had onchocercal skin lesions.Conclusion: People with epilepsy in onchocerciasis-endemic villages in Cameroon present with a wide clinical spectrum including nodding seizures and Nakalanga features. A great majority of participants met the diagnostic criteria for OAE, suggesting that better onchocerciasis control could prevent new cases. Epilepsy management algorithms in these areas must be adjusted to reflect the varied seizure types. (C) 2018 Published by Elsevier Inc.