title: Profile of childhood epilepsy in Bangladesh.
abstract: Very little is known about childhood epilepsies in Bangladesh. This study was conducted within a national children's hospital in Dhaka city to provide baseline information on diagnosis and clinical outcomes of 151 children (98 males, 53 females, age range between 2 months to 15 years, median age of 3 years). Participants who presented with recurrent unprovoked seizures were followed up in an epilepsy clinic for at least 1 year. Of presenting families, 68.3% were from middle-income and lower-income groups. A history of perinatal asphyxia and neonatal seizures was present in 46.4% and 41.1% of participants respectively. Generalized, partial, and unclassifiable epilepsy were found in 63.6%, 25.2%, and 11.2% respectively. Severe outcome (malignant) epilepsy syndromes were diagnosed in 14.6%. Symptomatic epilepsy was found in 61%. Poor cognitive development was present in 72.8% and poor adaptive behaviour in 57%. Poor seizure remission occurred in 50.3%. Factors most predictive of poor seizure remission were: multiple types of seizures, poor cognition at presentation, high rates of seizures, associated motor disability, and EEG abnormalities. The study suggests that most children presenting at tertiary hospitals for seizure disorders come late and with associated neurodevelopmental morbidities. Specialized services are needed closer to their homes. The process for establishing early referral and comprehensive management of childhood epilepsies in Bangladesh requires further study.
authors.affiliation: Child Development and Neurology Unit, Dhaka Shishu (Children's) Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh. parvez@bangla.net
authors.forename: Selina H
authors.initials: SH
authors.lastname: Banu
authors.forename: Naila Z
authors.initials: NZ
authors.lastname: Khan
authors.forename: Mahmuda
authors.initials: M
authors.lastname: Hossain
authors.forename: Anisa
authors.initials: A
authors.lastname: Jahan
authors.forename: Monwara
authors.initials: M
authors.lastname: Parveen
authors.forename: Narsis
authors.initials: N
authors.lastname: Rahman
authors.forename: Stewart H
authors.initials: SH
authors.lastname: Boyd
authors.forename: Brian
authors.initials: B
authors.lastname: Neville
mesh_terms: D000293:Adolescent; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012075:Remission, Spontaneous; D012720:Severity of Illness Index; D013577:Syndrome