Abstracts

Rationale: Childhood epilepsy is a major health problem both in the developed and developing countries and, contributes as one of the most prevalent forms of chronic and disabling childhood disorders. Fear, misunderstanding and the resulting social stigma and discrimination surrounding epilepsy often force people with this disorder “into the shadows”. HIV/AIDS is a major public health problem in Uganda. The overall national HIV Sero-prevalence is 6.4% in adults and 0.7% in children. An estimated 84,000 children in the age group of 0-15 years were living with the disease by the end of 2003. It is not clear whether the clinical presentation of paediatric epilepsy in Ugandan children is affected by this illness. Methods: The objective of this study was to describe the clinical features, EEG abnormalities, and seizure classification types in epileptic children with HIV/AIDS. Study was hospital based and used a case-control design. Caretakers of epileptic children aged 18 months to 12 years attending the Mulago National Referral Hopsital’s Paediatric Neurology and/or HIV/AIDS clinics and fulfilled the selection criteria were interviewed using a pre-tested coded questionnaire. Data on the clinical features, EEG pattern, seizure classification types, were noted.Results: A total of 173 children were enrolled in the study, of these 33 cases (HIV+) were matched according to age and residence with 58 controls (HIV-). There was no significant difference in the clinical epileptic history between the two groups. Clinical features significantly associated in the cases included: weight change (p=0.005), degree of pallor (p=0.006), skin manifestations (p=0.000), nail changes (p=0.023) and lymph node enlargement (p=0.000). The predominant EEG pattern in the cases was of bilaterally synchronous spikes with sharp slow wave complexes 9(27.3%) compared to a normal EEG pattern in the controls 15(25.9%). Generalized seizures of the tonic-clonic type were the major seizure classification type in both cases and controls. Conclusions: Results suggest that HIV/AIDS does not seem to significantly affect the clinical presentation, EEG features or seizure classification types of paediatric epilepsy in Ugandan children. A prospective cohort looking at larger numbers of children with epilepsy and HIV/AIDS is recommended.