EVALUATION OF EPILEPSY MANAGEMENT IN A DEVELOPING-COUNTRY - A PROSPECTIVE-STUDY OF 407 PATIENTS

407 patients (248 men, 159 women) of epilepsy attending the neurology clinic were evaluated to find out the profile of epilepsy, cost-effect iveness of various investigations, therapeutic regimens and efficacy o f referring physicians in a developing country. At the time of onset o f seizures 67.2% of patients were in the second and third decade. Gene ralised tonic clonic seizures were the commonest seizure type seen. Sp ecific aetiology was established in 20.8% cases only. Neurocysticercos is was the commonest cause observed. The main source of referral (50.1 %) was general practitioners. Referral diagnosis was incomplete in 52. 8% of the cases. Investigations did not alter the diagnosis in 62.5% c ases. The EEG was useful in the management of 15.1% cases of epilepsy. The skull x-ray and chest x-ray were abnormal in 1.7% and 2% cases re spectively. CT scan revealed abnormality in 39.4% cases. Most of the p atients were treated with monotherapy. Phenytoin, phenobarbitone and c arbamazepine were the common drug used. Out of 246 cases who were star ted on anticonvulsant therapy prior to referral, the choice of drug wa s wrong in 78 (31.7%) cases and dose was inappropriate in 121 (49.2%) cases. It was concluded that most important factor for cost effective management of epilepsy is proper clinical evaluation and education of general physicians in this direction.