Clinical pattern of partial epilepsy in Sudanese patients

ABSTRACT

To study the pattern of clinical presentation of partial epilepsy among Sudanese epileptic patients attending Elshaab Teaching Hospital from May 2005 to March 2006. Seizures are categorized as partial [with the initial activation of a limited number of neurons in a part of one hemisphere] or generalized [with the initial activation of neurons throughout both hemispheres]. The study was conducted at Elshaab Teaching Hospital May 2005- March 2006. Fifty patients with partial were included in a prospective cross- sectional hospital-based-study. The mean age is 35.96 years. Male to female ratio was 1.41. Abdominal aura predominates in 12%, followed by autonomic symptoms in 8%, fear in 6%, anxiety and visual hallucination in 4%, olfactory hallucination, auditory hallucination and automatism in 2%. Postictal confusion was found in 16% followed by post ictal sleep and Todd's paralysis in 8%, headache in 6% and amnesia in 4%. Abnormal neurological signs found in 30%. Space occupying lesions in 22% and cerebrovascular accident in 20% are the commonest causes for partial epilepsy, followed by brain atrophy in 6%, and arterioveneous malformation in 2% as detected by MRI. EEG was found abnormal in 56% i.e. 42% focal discharge, 10% focal discharge with secondary generalization and 4% generalized discharge. Prodromal symptoms like abdominal pain nausea and vomiting were the commonest symptoms in partial epilepsy. Confusion, sleep, Todd's paralysis, headache and amnesia were the commonest post ictal symptoms. Brain MRI detected space-occupying lesions in most of the patients. Interictal epileptic focal discharges [IEDs] were detected in more than half of the studied population