Childhood secondary (Symptomatic) epilepsy, seizure control, and intellectual handicap in a nontropical region of South Africa

Purpose: To determine the prevalence of secondary (symptomatic) epilepsy an d to ascertain levels of seizure control and intellectual function in a cli nic population of children drawn from a poor community in a temperate regio n of South Africa. Methods: Detailed review of the records of every child with recurrent seizu res who attended a special epilepsy outpatient clinic during 1995. Results: A total of 1,017 children was studied. In 432 (43%), there was his toric, clinical, and radiologic evidence to suggest that epilepsy was sympt omatic of underlying brain damage or defect. Acceptable seizure control was maintained with a single standard anticonvulsant drug (AED) in 65% of case s. In the 6 months preceding the study, 37% of the subjects had remained se izure foe. Forty-seven percent of the study population were considered to b e of subnormal intelligence, Conclusions: In a children's hospital outpatient population in the Western Cape region of South Africa, the prevalence of secondary epilepsy is higher than is found in developed countries. There is need within the community f or preventive measures aimed at reducing the prevalence of perinatal insult s, meningitis, tuberculosis, neurocysticercosis, and cerebral trauma.