Seizure disorders among relatives of Kenyan children with severe falciparum malaria

Versteeg, A. C.; Carter, J. A.; Dzombo, Judith Tumaini; Neville, Brian; Newton, Charles R.

doi:10.1046/j.1365-3156.2003.00965.x

Cited by 25 publications

(20 citation statements)

References 10 publications

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“…In studies of other CNS infections, the prevalence of epilepsy increases up to 20 years after infection, with the prevalence doubling between 5 and 15 years after the infection (21), so the prevalence in our cohort also may increase over time. However, previous studies in Kenya suggested that people with epilepsy have a higher risk of death (24,25), which may reduce the effect.…”

Section: Discussionmentioning

confidence: 99%

“…Our results suggest that an association occurs between malaria and epilepsy but give no indication regarding causality. A preexisting susceptibility to epilepsy may result in a propensity to develop seizures during malaria (25). Alternatively, cerebral damage from severe malaria may result in an increased risk of epilepsy, or a combination of these factors may exist.…”

Section: Discussionmentioning

confidence: 99%

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Increased Prevalence of Epilepsy Associated with Severe Falciparum Malaria in Children

Neville²,

et al. 2004

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Summary:Purpose: Multiple, prolonged, generalized, or focal seizures are common in children with severe malaria, with or without coma. In other contexts, such seizures have been associated with the development of epilepsy. The relation between falciparum malaria and epilepsy is undetermined; thus we measured the prevalence and characteristics of epilepsy in children with a history of severe malaria.Methods: We took a detailed epilepsy history from the parents of 487 children (aged 6-9 years) to compare the prevalence of epilepsy between three exposure groups: children with a history of cerebral malaria (CM), malaria and complicated seizures (M/S), or those unexposed to either complication. Each child had an EEG and was classified as having active, inactive, or no epilepsy.Results: An increased prevalence of epilepsy was seen in children previously admitted with CM [9.2%; OR, 4.4; 95% confidence interval (CI), 1.4-13.7] or M/S (11.5%; OR, 6.1; 95% CI, 2.0-18.3) compared with the unexposed group (2.2%). The most commonly reported seizure types were tonic-clonic (42%), focal becoming secondarily generalized (16%), and both (21%). Twenty-six percent of the active epilepsy group initially had EEG abnormalities.Conclusions: These results suggest that children exposed to CM or M/S have an increased propensity for epilepsy relative to children unexposed to these complications. The prevalence of epilepsy associated with CM is similar to that reported after other severe encephalopathies. The prevalence associated with M/S is more than twice that reported after complicated febrile seizures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increased Prevalence of Epilepsy Associated with Severe Falciparum Malaria in Children

Neville²,

et al. 2004

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“…Despite this finding, family studies in children from this community do provide strong evidence to support a genetic risk factor for acute seizures (Versteeg et al, 2003). It is likely that there are other susceptibility genes.…”

Section: Discussionmentioning

confidence: 99%

Haptoglobin HP2-2 genotype, α-thalassaemia and acute seizures in children living in a malaria-endemic area

Idro¹,

Williams²,

Gwer³

et al. 2008

Epilepsy Research

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SummaryPolymorphisms of the haptoglobin (HP) gene and deletions in α-globin gene (α-thalassaemia) are common in malaria-endemic Africa. The same region also has high incidence rates for childhood acute seizures. The haptoglobin HP2-2 genotype has been associated with idiopathic generalized epilepsies and altered iron metabolism in children with α-thalassaemia can potentially interfere with neurotransmission and increase the risk of seizures. We investigated the hypothesis that the HP2-2 genotype and the common African α-globin gene deletions are associated with the increased risk of seizures. 288 children aged 3–156 months admitted with acute seizures to Kilifi District Hospital (Kenya), were matched for ethnicity to an equal number of community controls. The proportion of cases (72/288 [25.0%]) and controls (80/288 [27.8%]) with HP2-2 genotype was similar, p = 0.499. The allele frequency of HP2 gene in cases (49.3%) and controls (48.6%) was also similar, p = 0.814. Similarly, we found no significant difference between the proportion of cases (177/267 [66.3%]) and controls (186/267 [69.7%]) with deletions in α-globin gene (p = 0.403). Among cases, HP2-2 polymorphism and deletions in α-globin gene were neither associated with changes in the type, number or duration of seizures nor did they affect outcome. We conclude that the HP2-2 polymorphism and deletions in α-globin gene are not risk factors for acute seizures in children. Future studies should examine other susceptibility genes.

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“…In addition, the proportions of the types of epilepsy with grand mal being the most common type of seizures were similar to the findings from the Nigerian study and also to the observations made in Ethiopia and Uganda 2,3 . However the reporting of the predominance of grand mal epilepsy was not consistent in the studies on children as the findings by Kotsopoulos's 6 and et al in USA who found partial seizures to be more frequent in children than grand mal epilepsy. It is not immediately clear why grand mal prevailed over partial seizures in our setting and in other African based reports 2,3,9 .…”

Section: Discussionmentioning

confidence: 69%

“…Post febrile convulsions were found to be frequent especially among preterm babies in Finland 5 . Some of the febrile seizures were related to infections such as severe malaria and persisting after the initial episodes of malaria, a study observed in Kenya 6 . The second commonest neurological disorder in many settings is cerebral palsy whose global prevalence is about 2.5 per 1000 live births 1,7,8,9,10 .…”

Section: Introductionmentioning

confidence: 99%

Pattern of neurological diseases as seen in outpatient children: the experiences from Orotta Referral Hospital Asmara, Eritrea.

Ogbe¹,

Nyarangó²,

Mufunda³

2010

Jrnl Erit Med Assoc

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Objective: To determine the pattern of neurological diseases in children. Methods: This was a prospective cohort study of paediatric patients reporting to the Paediatric Neurological Clinic at Orotta Referral Hospital with neurological diseases. The systematic evaluation of patients was carried out from 2002 to 2005. Results: Altogether 736 children with age ranging from 3 months to 15 years being 61% boys and 39% girls, presented with different neurological disorders. Although the cases may have presented with more than one diagnosis (29.6%), the most frequent neurological diseases were epilepsy (25.9%), cerebral palsy(C/P) (19.3%) and post febrile neurological diseases (12.5%) and others. Out of all epileptic cases, grand mal(GTCS) (74%), partial seizures (5.6%), akinetic attacks(drop attacks) (5.6%) and petit mal (absence siezures) (3.2%) were the commonest types of epilepsy. In the majority of epilepsy (63.5%) no cause was found. There was no gender difference in all neurological disorders studied. Discussion and Conclusion: Epilepsy is a common disease in children. The prevailing enigma that epilepsy is rare in children is an unfounded myth making it imperative for appropriate index of clinical suspicion whenever a paediatric patient presents with unusual clinical pattern. The increased number of epileptic cases at first attendance with age calls for aggressive treatment at the early stages when neurological deficits are likely to occur as the disease may have spontaneously permanent remission. The high number of cases with cerebral palsy and post febrile illness neurological diseases necessitates urgent preventive measures and appropriate management in the country.

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Seizure disorders among relatives of Kenyan children with severe falciparum malaria

Cited by 25 publications

References 10 publications

Increased Prevalence of Epilepsy Associated with Severe Falciparum Malaria in Children

Increased Prevalence of Epilepsy Associated with Severe Falciparum Malaria in Children

Haptoglobin HP2-2 genotype, α-thalassaemia and acute seizures in children living in a malaria-endemic area

Pattern of neurological diseases as seen in outpatient children: the experiences from Orotta Referral Hospital Asmara, Eritrea.

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