Treatment of status epilepticus in a developing country

Status epilepticus (SE) is a condition requiring emergency care, which is often poorly managed in developing countries due to the lack of personnel, drugs, and insufficient technical and medical means. This study aims at determining the epidemiologic and etiologic characteristics and the difficulty...

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Bibliographic Details
Published in:Neurophysiologie clinique 2000-06, Vol.30 (3), p.165
Main Authors: Mbodj, I, Ndiaye, M, Sene, F, Salif Sow, P, Sow, H D, Diagana, M, Pierre Ndiaye, I, Gallo Diop, A
Format: Article
Language:fre
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Anticonvulsants - administration & dosage
Anticonvulsants - therapeutic use
Child
Child, Preschool
Developing Countries
Diazepam - administration & dosage
Diazepam - therapeutic use
Female
Humans
Male
Middle Aged
Phenobarbital - administration & dosage
Phenobarbital - therapeutic use
Senegal - epidemiology
Status Epilepticus - epidemiology
Status Epilepticus - etiology
Status Epilepticus - therapy
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Summary:Status epilepticus (SE) is a condition requiring emergency care, which is often poorly managed in developing countries due to the lack of personnel, drugs, and insufficient technical and medical means. This study aims at determining the epidemiologic and etiologic characteristics and the difficulty in treating SE under the existing medical practice conditions in a developing country such as Senegal. A retrospective study was therefore carried out based on SE medical files at the University Hospital of Dakar over the period January 1988 to December 1998, and included several hospital departments, i.e., paediatrics, infectious diseases and neurology. Over an 11-year period 697 cases were recorded; of these, 48.2% of patients were under 5 years of age. The seizures were generalized in 58.2% of cases, partial in 21.2%, partial secondarily generalized, or with an association of both clinical presentations in 20.6% of cases. The etiology was as follows: mainly infectious (67%), followed by resistant and/or unbalanced epilepsy (9.9%), epilepsy of vascular origin (8%), and various other causes. The overall mortality rate was 24.8%. A long period between the onset of clinical symptoms and hospital treatment was noted, with an average time lapse of 16.6 h before treatment. The drugs utilized were diazepam and phenobarbitol, administered by injection. The overall outcome could be improved by better management, i.e., better prevention and an efficient treatment of infectious diseases, a reduction in the time before treatment, and improved means of intensive care.
ISSN:0987-7053