Clinical and electro-clinical classification of epileptic seizures in WestUganda.

When compared to that of industrialised countries, the prevalence of epilep sy in developing countries has generally been found to be higher and in som e areas extremely high rates of up to 57 cases per 1000 inhabitants have be en reported. they reasons for this difference are still widely unknown and detailed epidemiological as well as clinical data are scarce, especially fr om rural Africa. The present study was conducted in western Uganda, in an a rea of high epilepsy prevalence, known to be endemic for onchocerciasis. Th e seizures of all 91 epilepsy patients diagnosed in this area over the peri od of two years were classified according to the criteria of the Internatio nal League against Epilepsy, Based on seizure description alone, the predom inant seizure was classified as generalised in 57 patients (63%), as partia l in 22 (24%) and unclassified in 12 (13%). An EEG record was analysed in 5 5 out of 91 patients, showing focal epileptiform activity (EA) in 12 multif ocal EA in 9 and primarily generalised EA in 6 patients. When in addition t o clinical information, the EEG results in the 27 patients with EA were tak en in consideration for seizure classification, the proportion of partial s eizures increased to 78% (n = 21); inversely the proportion of generalised seizures fell to 22% (n = 6). The predominance of partial seizures would be compatible with a localised brain lesion as a frequent cause for epileptic seizures in the study area. The findings further corroborate recent observ ations from several African countries of an association between epilepsy an d onchocerciasis.