Dataset Information
Improving epilepsy control among children with cerebral palsy in rural Bangladesh: a prospective cohort-based study.
Ontology highlight
ABSTRACT: Objective
To define the prevalence and seizure subtypes among children with cerebral palsy (CP) in rural Bangladesh and explore barriers to optimum epilepsy control.Design
Prospective cohort study.Setting
The study was conducted in Shahjadpur, a rural subdistrict of Bangladesh.Participants
Children (<18 years) with CP and epilepsy identified using the Bangladesh CP Register (BCPR) in the study site.Methods
Assessments were conducted in three focused epilepsy clinics overseen by a paediatric neurologist between December 2016 and January 2018, with intervening phone and video-conference follow-ups. Details of event type, frequency and medication compliance were collected. Antiepileptic drugs (AEDs) were prescribed based on seizure type, family income, comorbidity and medication availability.Results
23.4% (170/726) of the BCPR cohort had a clinical diagnosis of epilepsy of whom 166 were assessed. Following the focused epilepsy clinics, 62.0% (103/166) children were clinically determined to have ongoing epileptic seizures. 62.1% (64/103) had generalised onset tonic clonic seizures, 27.2% (28/103) had focal onset seizures with impaired awareness and 10.7% (11/103) had other seizure types. None of the children with prolonged seizures (31/103) had an emergency seizure management plan. Non-epileptic events were being pharmacologically treated as seizures in 18.1% (30/166) children. Financial constraints were the main reason for non-compliance on follow-up.Conclusions
Gaps in optimum epilepsy management in rural Bangladesh are amenable to improvement anchored with local healthcare workers. Training and clinical care focused on recognition of common seizure types, seizure mimics and rationalising use of available AEDs can be facilitated by better referral pathways and telehealth support.
SUBMITTER: Karim T
PROVIDER: S-EPMC8984049 | biostudies-literature | 2022 Apr
REPOSITORIES: biostudies-literature
Publications
Improving epilepsy control among children with cerebral palsy in rural Bangladesh: a prospective cohort-based study.
BMJ open 20220405 4
<h4>Objective</h4>To define the prevalence and seizure subtypes among children with cerebral palsy (CP) in rural Bangladesh and explore barriers to optimum epilepsy control.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>The study was conducted in Shahjadpur, a rural subdistrict of Bangladesh.<h4>Participants</h4>Children (<18 years) with CP and epilepsy identified using the Bangladesh CP Register (BCPR) in the study site.<h4>Methods</h4>Assessments were conducted in three focused epilep ...[more]
