Women and epilepsy: Sudanese experience

Epilepsy is equally prevalent in men and women. However; for women there are unique concerns related to hormone effects on seizures and the effects of seizures and antiepileptic drugs (AEDs) on reproductive health. Some AEDs reduce the efficacy of oral contraceptive agents; increasing the probability of unplanned pregnancies. Seizure frequency may change during pregnancy; seizures may cause pregnancy complications; and the treatment of a woman with epilepsy must consider all these issues. Objective: To study the clinical presentation of epilepsy among adult Sudanese females and to verify aspects of epilepsy specific to women. Methods: This is a cross sectional descriptive non intervention clinical based study; it was carried out in Elshaab Teaching Hospital and El-shiekh Mohamed Kheir charity clinic; from February-2008 to June- 2008. 630 female patients with epilepsy were included in the study. Results: The study showed that 72of the patients had generalized epilepsy and 28had partial epilepsy; primary epilepsy is more common than secondary epilepsy; 54of our patients had warning symptoms and 39.7had triggering factors; irregular menstrual cycle was observed in 28; 22of our patients had catamenial seizures; 7.1had increased frequency of seizures during pregnancy. Obstetric complications were common among our studied group. The incidence of infertility increased among our studied group. Conclusion: Women had differences in presentation and control of epilepsy that must be understood and considered when treating women with epilepsy

The Patterns of Clinical Presentations of Cerebellar Syndromes among Adult Sudanese Patients

Cerebellar syndromes are one of the commonest neurological diseases.Objectives:To study the patterns of clinical presentations of cerebellar syndromes and to identify the possible causes.Methods:This is a prospective hospital based; cross-sectional study. One hundred adult Sudanese patients with cerebellar syndromes were included in the study during the period from January 2006 January 2007.Results:The most common age group affected was 18 - 25 years.Male to female ratio was 1.5:1unsteadiness on walking was the most common symptom (83).Gait-ataxia was the most common sign (83). Cerebrovascular disease was the most common etiology (25).Conclusion:Cerebellar syndromes are not rare in Sudan.However; they were diagnosed more commonly at the central regions of the country probably because of more awareness of patients and better facilities for diagnosis.The age of onset; the male predominance; the presentation and clinical findings were not different from reported literature.This also goes for the common causes apart from alcohol which is a strikingly rare as a cause in this study and could be accounted for the implementation of Elshariya (Islamic laws) Laws in Sudan