Seizure-related death in children with epilepsy

Children with epilepsy have a significantly higher rate of death than the general population. The cause of premature death among epileptics is contributed by the underlying cause, coexisting neurologic compromise and the epilepsy itself. Mortality directly related to seizures in paediatric epilepsy is the subject of this review. Seizure-related deaths in epileptics arise from status epilepticus, aspiration pneumonia, as well as sudden and unexpected death in epilepsy (SUDEP). Epilepsy per se enhances the risks of accidents and suicide. Children with epilepsy who are otherwise neurologically intact and with normal neuroimaging findings have an exceedingly low risk of seizure-related death. Poor compliance to antiepileptic drugs (AED) , poor ly co nt rol led (intractable and refractory) seizures, impaired cognition, structural/ metabolic aetiology and antiepileptic drug polypharmacy tend to carry poor prognosis. Therefore, parents need to be appropriately advised about the risk of seizurerelated premature death. Early identification, compliance with AED prescription, and treatment of comorbid conditions can reduce mortality risk and improve health outcomes in children with epilepsy. Children with intractable types of epilepsy may benefit from medical marijuana and neurosurgery

Epilepsy pattern and clinic compliance in Sierra Leonean epileptics

Two hundred and twenty patients with epilepsy attending the neurologic clinic at Connaught Hospital were reviewed. Male predominance; greater prevalence of primary generalised seizures and low family history are consistent with reports from other African countries. Similarly the majority of patients had idiopathic epilepsy. Only 35 per cent of patients attented clinic for six months and 12 per cent for two years. Cultural attitudes; cost of medication and distance from clinic may contribute to the low level of clinic attendance. It is suggested that integrating the follow up and treatment of epileptics into primary health care programmes will make a greater impact on epilepsy control