Epilepsy in Lagos, Nigeria

Abstract

An epidemiological study of epilepsy in Nigeria is presented. The incidence of this symptom-complex is assessed at between 8 and 13 per 1000. A male preponderance is noted in the series of 117 patients studied and in other African series. It is likely that this is the result of unnatural selection since African men seem to seek medical attention more frequently than their women folk. Two peaks of age of onset are observed in the 13 months to 5 years and 11-20 years age groups. The late presentation at orthodox medical centres reflects the strong belief of evil spirit or 4 juju' as the cause of epilepsy and accordingly it is usually believed that the unorthodox medical practitioners ('native doctors') are best able to treat epilepsy. A family history of epilepsy is present in 12-8% of the 117 cases. Among the centrencephalic cases 16-1% had a family history of epilepsy whilst such a history was present in 9-1% of the symptomatic cases. Of the clinical types of centrencephalic epilepsies encountered in the sixty-two patients, grand mal accounted for sixty cases (51-2%). There was only one case of petit mal and one case of infantile spasm. Of the fifty-five cases of symptomatic epilepsy seventeen patients (30-9%) had focal (excluding temporal lobe) epilepsy: there were six patients (10-9%) with Jacksonian epilepsy, eleven (20%) with temporal lobe epilepsy, eleven (20%) with hemiconvulsion-hemiplegia-epilepsy syndrome and ten (18-1%) with secondary 'grand mal' epilepsies. The symptomatic cases accounted for 47% of the total series of 117 patients. It was possible to arrive at a diagnosis in thirty-three of the fifty-five cases (60% of symptomatic epilepsies. Extensive investigation into the role played by parasitic disease in the pathogenesis of this series of epileptic patients failed to produce a single case of parasitic epilepsy. The higher incidence of positive toxocara skin test in a number of the patients tested is noted but its significance is still unknown.