Post-traumatic epilepsy in Cameroon: a retrospective study in a referral hospital

• Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Psychiatry and Neurosurgery, 2023-01, Vol.59 (1), p.1-6
• Main Authors: Motah, Mathieu, Gams Massi, Daniel, Assonfack Sinju, Franklin, Magnerou, Annick Mélanie, Bila Lamou, Eric Guemekane, Nkouonlack, Cyrille, Doumbe, Jacques, Esene, Ignatius, Siysi, Verla Vincent, Eyenga, Victor-Claude, Mapoure, Yacouba Njankouo
• Format: Article
• Language: English
• Subjects: Cameroon; Convulsions & seizures; Epilepsy; Medical records; Post-traumatic epilepsy; Road traffic accident; Traffic accidents & safety; Trauma; Traumatic brain injury
• ISSN: 1110-1083; 1687-8329
• DOI: 10.1186/s41983-022-00602-6

BackgroundPost-traumatic epilepsy is defined as the onset of at least one seizure beyond the first week following a traumatic brain injury (TBI). High prevalence of TBI in our setting may contribute to the burden of epilepsy in adult population. This is a retrospective review of medical records of patients admitted from January 1st, 2010 to December 31st, 2019) at Douala General Hospital. We included patients aged ≥ 18 years with seizure onset at least one week after TBI. Incomplete files and previously known epilepsy were excluded. Data on sociodemography, clinical and para-clinical features, treatment and outcome were analysed using R software version 36.2.ResultsWe finally included 65 patients with post-traumatic epilepsy among 993 medical records of epilepsy. The mean age was 35.1 ± 12.6 years, with 64.6% of male. Road traffic accident was the main aetiology of brain trauma (78.5%), resulting in haemorrhagic contusions (21.5%), sub-dural haematoma (15.4%), and diffuse axonal lesions (15.4%) mainly. Seizure onset was within 2 years post-trauma in 73.8% of cases. Generalized tonic–clonic seizures were the commonest seizure’s type. Electroencephalogram was abnormal in 81%, including 47% of focal discharges. Antiepileptic drugs were mainly sodium valproate, carbamazepine, and phenobarbital. Seizure freedom was obtained in 67.7% of cases.ConclusionsPost-traumatic epilepsy is a heterogeneous, frequent and often disabling complication of traumatic brain injury. Road traffic accident is the main cause of brain trauma. It affects a young and active population. About half of cases presented GTCS. With antiepileptic drugs, more than two-thirds of patients become seizure-free.